“Overview of the NHS in Scotland’s performance 2010/11”
The next item is consideration of a response by Derek Feeley to correspondence from the committee on the section 23 report, “Overview of the NHS in Scotland’s performance 2010/11”. We have had a relatively extended correspondence on the health improvement, efficiency, access and treatment—or HEAT—targets, and Mr Feeley’s response has been circulated to members. Do members have any comments? I know that Mary Scanlon has been pursuing the matter.
Indeed. At one of my first Public Audit Committee meetings, I raised the issue of HEAT targets that had not been met and were suddenly dropped. I have read the explanation provided. Instead of our having to ask why certain HEAT targets have been mysteriously dropped—for example, the target for reducing the increase in prescriptions for antidepressants has been changed to faster access to psychological therapies—I would welcome a bit more transparency at the time of the change.
I am probably the only committee member who remembers the big discussion that the committee had on antidepressant prescribing, but the fact is that these things were not at all clear. Perhaps we should have kept Derek Feeley behind to answer the questions, because his response specifically refers to the change from reducing antidepressant prescribing to access to psychological therapies that Mary Scanlon has just highlighted. The rise in prescribing antidepressants was huge—
It was.
It was not at all clear why there was a sudden shift to the other target. Mary Scanlon makes a fair point, in that we need to know why the service shifts between targets, recommendations and so on. To be honest, I do not think that I understood from Derek Feeley’s response why such shifts happen. I really am not clear about that.
It is not clear.
I am at a disadvantage, because I was not part of the initial discussion. We have written twice on the matter now and it is up to members who want to pursue it further to suggest how we do so.
We have probably done enough in raising the issue.
The concerns are certainly on the record.
There are two things to highlight in Mr Feeley’s response. First, he says that targets that are not met by a clear end date are revised, and why the targets were not met is analysed. Secondly, he says that some targets, such as that for antidepressant prescribing, are superseded by others. Perhaps we should reiterate that if a target is dropped or superseded that should be brought to the attention of a committee or parliamentarians instead of its simply sliding surreptitiously off the scales.
So that we do not drag the whole thing out.
Indeed.
Are members proposing that we write back to Mr Feeley, noting the response but suggesting that, for the sake of transparency, any changes to targets should be notified—to the Health and Sport Committee, I guess, rather than us?
That is fair.
The targets are published, but we are asking that attention be drawn to any changes.
They are published but they can be dropped suddenly. The other target that I mentioned in the initial discussion—reducing the NHS sickness absence rate to 4 per cent—was dropped because it was not achieved, but I am happy to concentrate on the antidepressant prescribing target. Overall, it would be helpful to have more transparency in the HEAT targets.
I suggest that we note the correspondence but write to Derek Feeley, thanking him for his response and asking whether instead of simply publishing targets there could be a mechanism for notifying or drawing attention to any HEAT targets that are changed or dropped.
It is also reasonable to include analysis and the reasons why targets have been dropped or changed.
Are members agreed?
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