Public Audit Committee, 17 Jun 2009

Meeting date: Wednesday, June 17, 2009

Official Report 166KB pdf

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Scottish Government (Progress Report)

Agenda item 4 is to consider a progress report from the Scottish Government on recommendations that the committee has made in relation to NHS Western Isles and free personal and nursing care. Members have a letter from Kevin Woods and some details about that.

It is worth putting on record our appreciation for the work that many people have undertaken in relation to the Western Isles. What we discovered was an inefficient and ineffective health board, but there has been a huge effort on everyone's part to turn that around; the work that has been done is commendable. It is right that, just as we were critical of some of the performance in the past, we give credit where improvement has been made. I do not suggest for a minute that all the problems have been solved or that all the issues have been resolved, but, in difficult circumstances, some of the people there have made huge progress, which is worth noting. I note the recent developments, such as the announcement by the cabinet secretary about further funding, including brokerage for NHS Western Isles, and the fact that there are senior posts to be filled. Do members have any comments?

We were certainly right to criticise, but we should also pay tribute to the leadership and ability that have turned the situation around. It really is down to the people at the top. If they are good, everything else will follow. It is a tribute to them that things are looking up in the Western Isles. I am glad that that has happened. Without Audit Scotland's reports and back-up, none of that would have happened. Audit Scotland gave us the tools, and this committee delivered.

Do we agree to thank Kevin Woods for his report and note its contents?

We should also note that Nicola Sturgeon agreed to give NHS Western Isles the money, which I think we suggested—I certainly suggested it.

Okay.

What about free personal and nursing care? Have I missed that part?

Do you wish to comment on that?

I am not clear exactly where we are now, not in relation to the reporting but in relation to the follow-up.

We asked specific questions of the Government and we now have its response to those questions. If the committee decides that it wishes to do something else, it is entirely open to it to do so. You will see that there has already been an affirmative order to end charging for food preparation; the board has amended guidance following the Auditor General's report; and there are eight workstreams on major issues relating to free personal care.

What about the projected shortfall in the money that is being made available? I think that £40 million was being added in the current financial year and £40 million was projected for the next financial year. I think that there was some difference of opinion between the Auditor General and the accountable officer about how much would be needed to fill the gap. I do not know where we are on that.

That is a fair point. The report states:

"The Committee wishes to receive more detailed information about the review of future delivery and costs."

I am not sure whether that has been addressed.

I could not find reference to the issue anywhere. I might have missed it.

Is it not covered by the statement that there is a review on-going between the Scottish Government and the Convention of Scottish Local Authorities? Page 1 of paper 4 refers to

"draft guidance on a national framework for eligibility criteria".

That is our report. I am looking at Kevin Woods's response and I do not see it mentioned there. We could ask for more information in the next progress report.

It would be helpful if the clerk could do that, perhaps with some guidance from the Auditor General. I was worried that there was a projected shortfall that might create some problems with the implementation of the policy. I think that the committee was worried about that, too.

That specific question is not addressed. We can seek more information on that.

I have a related question on the response to our first question, which is in annex B of paper PA/S3/09/12/4. The second paragraph talks about the review that the Scottish Government and COSLA will undertake jointly. It states that

"the review will be to promote and establish mechanisms to improve the provision of personalised and preventative services, to enable people to remain at home—and independent—for longer."

I am sure that that is what the majority of older people would want; however, the service is failing across the country just now. I do not think that local authorities are able to provide that 24-hour response to people who choose to live at home. I am, therefore, glad that the joint review will look into that. We need to know the costs of that and how it will be paid for, as it is a costly service.

As members have no further comments on the provision of free personal and nursing care, we will follow up the specific points that have been raised and note the response.