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Item 3 is a letter from the Scottish Executive on health board allocations for 2000-01. I ask members not to mention the A-word. Members will see from the letter that the Executive is offering to facilitate a briefing session for members on health financial allocation. I am keen to take up that offer.
On the deficits that are faced by the trusts?
Yes. My point is that an overspend is being experienced by the trusts. The officials who are to give us this briefing are those who will have access to that kind of information. As it will be a private briefing session, members will probably end up asking questions on that information anyway. It would be better for us to ask whether they are happy to answer such questions. If we make them aware of the fact that members will ask about that, they will be able to avail themselves of the information that we want, in advance of the meeting. Is that acceptable to the committee?
That would be helpful and would aid our general understanding. As an economist, I know that it is always helpful to consider trends. Would it also be possible to view the figures from the past three years, to analyse the determination of priorities? I would find it useful to examine those figures, to establish the trends in health service spending.
I apologise for the fact that I seem to make a habit of missing these meetings, for one reason or another. However, at one meeting I recall that, during the general briefing, several financial issues were raised by committee members. Obviously, people still have a lot of questions about the way in which those decisions are made and the mechanics of the process. I remember that several such questions were asked, which were nothing to do with the current figures but with the way in which the process worked.
It is useful to ask about the mechanics of the process, and about the way in which the money is allocated. However, Mary is asking for information that is publicly available. There is absolutely no point in getting officials to go through that information, as we can access it anyway. Everybody has to publish their own accounts, and the figures are all available.
We should have the right to question them on such information as the trends and priorities of the past three years.
Do members not think that that is fundamentally important? It may be boring for people in the public gallery that we are always talking about procedures. However, this is the first time that we have been responsible for the health board allocation funds. We must ensure that the information with which we are provided is adequate for us to have a rational discussion.
I agree with what Dr Simpson and Mary Scanlon have said. This year, this committee has no particular input into the budget bill for health and community care. However, in coming years we will have that input. I am happy to put up my hand and say, "I know that I have an awful lot to learn about health service budgeting and finance". We must take advantage of every opportunity. However, that means not only taking what is on this bit of paper, but trying to get the fullest picture possible, down to some of the nuts and bolts—certainly the nuts and bolts that we will be required to know, in future years, to fulfil our role as a committee in drafting the budget bill.
I would, therefore, like to add a list of questions to which I would like answers in the revised documentation with which we should be presented.
If committee members have any other issues or questions that they would like to be addressed in that context, they should e-mail them to me.
I would like to put my questions on the record.
Okay. If anybody else has questions that they want to add to Richard's—after he has spoken—they should e-mail them to me by close of play tomorrow afternoon, when we will respond to them.
Last year, one-off funding was allocated to every health board to ease pressures. I would like to know if that has been included in the baseline budget before the percentage increases this year.
That is a fairly comprehensive list. I am not sure whether anybody wants to add something to that now.
The only other thing is the Scottish Ambulance Service.
I was going to raise that.
I was going to raise it later in the meeting. We have a common interest at the moment, as comments that have been made on other occasions indicate that there is a feeling in the committee that at some point we should give greater consideration to the Scottish Ambulance Service. We need to go beyond funding and to explore the question of whether it was set up in the correct way.
I am particularly interested in the prescribed drugs expenditure in column 8. Has any account been taken of the difficulties that GPs are experiencing because of licences expiring and their not being able to obtain generic drugs? That is already putting budgets under pressure.
I notice that the Westminster Health Select Committee has recently published a report on the generic drugs issue and the fact that there appears to be some hoarding by pharmaceutical companies. I have not had a chance to read the report, but it was fairly damning. Excessive generic drug costs are adding to health service costs. It is an issue worth pursuing. Irene, could you formalise that as a question and e-mail it to me before tomorrow afternoon?
Yes.
Are there any other points?
Can you add that the generic prescribing licences are not the only problem with prescribing? Another issue is the patient pack plan, which was introduced under European legislation and has created costs. The first of those problems may go away, because Susan Deacon's response to Mary Scanlon's question indicated that this was a temporary issue that would be handled within budgets, but I am concerned that the problem of the patient pack plan will not go away. There has been a step increase in costs that will continue into next year. That makes Irene Oldfather's question particularly pertinent.
Are you referring to bubble packs?
Yes.
They are talking about a £7 increase in the cost of generic drugs. That could hardly be put down to bubble-pack wrapping.
No. It must be very expensive wrapping.
I would like to know what statistical baseline is used. How is the Executive assessing health inflation? What is it using when it draws up statistics for increases? Does it simply use the basic rate of inflation? It is very easy to skew the statistical baseline.
When he was before the Finance Committee, Jack McConnell said that there would be a real-terms budget as well as a cash budget. A gross domestic product deflator is being used for that. I, along with other members of the Finance Committee, made the point that a general GDP deflator is appropriate at level 1, less appropriate at level 2 and inappropriate at level 3. Ben Wallace is right. We need to know, even within this budget, what inflators are being used. The pharmaceutical inflator must be considerably higher. There are others, such as training, that may be a little lower. We need to know the inflator across the various columns, not just for the health budget as a whole.
I would like clarification on the Highlands and Islands travel scheme and distant islands allowance. In particular, I would like to know why the Highland Health Board has received £250,000 and the Western Isles Health Board has received £2.5 million. It would be helpful if we could have some idea of what criteria were used to calculate those figures.
I may come back to those members who have made points to clarify that we have the gist of what they wanted formulated into a question.
A couple of points are of particular concern for me. First, Greater Glasgow Health Board's £25 million budget was probably drawn up before the two recent reports on poverty, ill health and too-early death in Glasgow. I would like more clarification on that budget.
Behind these figures there are a lot of details of the sort that you have mentioned, which will come out at the meeting. However, on the big issues it is fair that we give prior warning of what we are going to ask. When we get to the meeting, a number of people will come up with questions about the meaning of individual figures that they may not yet have thought of.
I advise the committee that the Audit Committee is investigating the Scottish Ambulance Service in relation to the previous National Audit Office report. There will be visits to various parts of Scotland to examine the service as it is delivered. Some of the points that Dorothy-Grace Elder has made will obviously be picked up, but I ask members of the committee to get a copy of the NAO report on the Scottish Ambulance Service because it will answer many of the questions that Dorothy has asked this morning.
That is very useful. The clerk has said that she will have all members of the committee sent a copy of the NAO report into the Ambulance Service. If members think of any other questions or issues, they should e-mail me by tomorrow. When the Executive gets our response, it may regret ever asking us whether we wanted a briefing.