Call for clarity on health spending


Scotland’s annual health spend is more than £11 billion but there remains a lack of clarity as to how that budget is being spent by NHS boards, according to a report by the Health and Sport Committee.

Convener of the Health and Sport Committee Duncan McNeil MSP said:

“Health rightly receives one of the biggest allocations of the Scottish Government’s budget. The role of the Scottish Parliament is to provide scrutiny to ensure that public money is spent wisely.

“Whilst our 14 Health Boards now provide MSPs with some information on how they spend their budgets, the issue we now face is the quality and clarity of that information.

“As a result, the Committee has been unable to answer fundamental questions about how NHS Boards spend their budgets – questions that relate to the quality, efficiency and planning of NHS services.”

The Committee’s scrutiny of the budgets of NHS Boards report also states:

  • NHS savings are important but quality and consistency of service must be maintained while allowing for flexibility to meet local needs. 
  • If and how NHS Boards are achieving quality and consistency of service will be explored in the next round of scrutiny. However, the Committee reserves the right to be sceptical when Boards’ guarantees of preserving quality, consistency and flexibility are not backed by measure or audit.
  • The Committee will return to look at the input of the third sector regarding the Change Fund, evaluation of pilot schemes, and the transition from earmarked to mainstream funding.
  • The Committee will assess the balance between additional funding and cost pressures across the whole health system.
  • The Committee must have the information necessary to answer fundamental questions of health policy such as: Are we spending wisely? How are we ensuring that services are efficient? What are we doing to ensure that the quality of service regarding outcomes for patients is protected? And how are we planning for change?
  • The Committee will continue with the survey approach it has taken but seek to shift the focus from data collection and onto issues highlighted above.

Deputy Convener of the Health and Sport Committee Bob Doris MSP said:

“Our Committee recognises that spending on health affects every community in Scotland.

“The Committee very much welcomes the Cabinet Secretary’s on-going commitment to provide the best information necessary to enable more detailed scrutiny.

“This will be particularly important at a time of public sector funding restraint and in light of major issues such as our changing demography. Such factors will clearly have an impact on how the NHS in Scotland delivers its service and indeed on health spending in the future.”


Each autumn the committees of the Scottish Parliament consider the Scottish Government’s draft budget. The Health and Sport Committee, wishing to scrutinise more closely the spending of NHS boards, undertook additional work in the spring. This report is the outcome of that work for the budget allocations for 2012-13.

The Health and Sport Committee was assisted in its inquiry by its budget adviser, Dr Andrew Walker. Dr Walker is Senior Lecturer in Health Economics, Robertson Centre for Biostatistics, University of Glasgow.

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