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Chamber and committees

Public Audit Committee

Meeting date: Wednesday, May 26, 2010


Contents


Section 23 Reports


“Overview of the NHS in Scotland’s performance 2008/09”

The Convener

Item 2 is consideration of the section 23 report, “Overview of the NHS in Scotland’s performance 2008/09”. We have received correspondence from the accountable officer, which has been circulated to members.

There was one thing that struck and intrigued me and made me want further information. One of the witnesses from NHS Grampian, Dr Strachan, was quite explicit about the increase in the number of children under the age of 16 who present drunk at accident and emergency departments. She said that she believed that the figure had increased by “some 60 per cent” in her area.

However, the response from the accountable officer seems to indicate that there are no figures on that. Members were quite alarmed to hear what Dr Strachan, a senior member of staff, had to say, but Kevin Woods suggests that there is no evidence on the issue. I think that it would be helpful if we could clarify with Dr Strachan exactly how the figures that she used were compiled. It is in everyone’s interest for us to get to the bottom of an extremely serious suggestion. Do members agree to my proposal?

Members indicated agreement.

The Convener

Are there any other comments on Dr Woods’s response?

Anne McLaughlin (Glasgow) (SNP)

Dr Woods says that the figures

“are currently not held centrally.”

Does that mean that there are figures and that, although we cannot access them centrally, we could get them health board by health board? Dr Woods also says:

“Information Services Division (ISD) Scotland is in the process of developing a national A&E data set which may include collection of the data requested.”

Would it be in order for the committee to write to ISD to ask it to consider including such data, if it is not already considering doing that?

The Convener

Those are two reasonable points, which we can follow up with Dr Woods.

George Foulkes (Lothians) (Lab)

Anne McLaughlin has made an important point. How many times have we been told in letters or in oral evidence, by people who are supposed to be running the national health service with some kind of strategic overview, “We do not hold that information centrally”? If they do not hold information centrally, how can they have a strategic overview? How can they make decisions about the health service? How can they allocate resources? I find it astonishing that with such a huge bureaucracy, which Murdo Fraser and his comrades will no doubt be having a look at—

Murdo Fraser (Mid Scotland and Fife) (Con)

Comrades?

George Foulkes

How can the people in the huge bureaucracy down at Victoria Quay, or wherever it is now, who sit around purporting to direct the health service, have any oversight of it without such statistics? Anne McLaughlin’s point is a good one, which we should pursue.

Murdo Fraser

I will need to ask my comrades in the Liberal Democrats how they intend to deal with the matter.

I have a slightly different point, which relates to the quite striking details of rates of alcoholic liver disease on the second page of Dr Woods’s letter. The figures demonstrate substantial increases in such disease, particularly among younger age groups, which is an immensely serious matter. I am not suggesting that we should deal with it, but perhaps we should pass it on to the Health and Sport Committee, once we get the responses that we have talked about, and ask it to give the issue some attention, as it is clearly of some relevance to that committee’s work. In particular, it is relevant to consideration of the Alcohol etc (Scotland) Bill, which is currently progressing through the parliamentary system.

The Convener

We will wait for the further information that we have agreed to request.

Willie Coffey (Kilmarnock and Loudoun) (SNP)

The question whether data are held centrally or locally has been a recurring issue in this committee and others for a long time, stretching back to the beginning of the Parliament. Members seem to be giving the message that sometimes we would like to know about the data in a national Scottish context. There is merit in asking for that from time to time. We will not get that context for every detail that we ask for in this committee and others, but we would like some indicators. For example, when we discussed antidepressant prescribing in a previous meeting, we were interested in the Scottish picture, but it was not readily available. It would be useful in some cases, but I am not certain which committee would be the one to point the way towards gathering those kinds of statistics for the other committees. It is something to think about.

The Convener

We previously agreed that we would invite the accountable officer to the committee to speak about that. It would be useful to pursue the matter with him, because a number of members have raised similar concerns. If members agree, we can invite Dr Woods to the committee.

George Foulkes

On the whole report?

The Convener

Yes, and that issue would be a significant part of it.

Cathie Craigie (Cumbernauld and Kilsyth) (Lab)

I know that this would not have been included in the Auditor General’s report, but the letter from Dr Woods to the committee states:

“Almost two-thirds (64%) were sent home directly from the emergency department.”

It would be interesting to see how the figures change for presentation at emergency departments when minor injury units are associated with the hospital. Presumably many of those people should have presented at a minor injury unit rather than A and E. It would be interesting to find out whether statistics are being gathered on that, as more and more hospitals, particularly in the Glasgow area, are running a full A and E with a minor injury unit close by.

The Convener

We can write to Dr Woods ahead of his evidence session to flag that issue up to him. He can respond in writing ahead of coming to the committee or address the point when he attends the meeting.

Anne McLaughlin

I just want to point out that although we do not have centrally held figures for the number of young people who are admitted to A and E because of alcohol, we have such figures for young people who are admitted to hospital overnight.

Willie Coffey is right—some figures are held centrally and some are not, but it would help if we were explicit in the letter. In the letter to Dr Woods we said that we

“would be grateful if you would provide figures, by health board”.

Perhaps we should have added, “and if you do not hold them, could you get them in?”, because then it would be possible for him to gather the information, rather than gathering it ourselves. As Dr Woods helpfully reminds us at the end of his letter, rates for liver cirrhosis in Scotland are

“50% higher than the EU average.”

It is clear that alcohol is a huge problem, and we must do everything that we can to deal with it. Our questions should be more explicit.

The Convener

Okay. We will pursue the correspondence as we have agreed, and invite Dr Woods to the committee to give evidence.


“Commonwealth Games 2014: Progress report on planning for the delivery of the XXth Games”

The Convener

Item 3 is consideration of the section 23 report, “Commonwealth Games 2014: Progress report on planning for the delivery of the XXth Games”. Correspondence from the accountable officer has been circulated to members, and we will deal with it section by section. The first section is headed “Pension Arrangements”. Do members have any comments on it?

Anne McLaughlin

It is reassuring to know that the company has a maximum amount that it will spend. We are told that

“the scheme is not a ‘public sector final salary scheme’ meaning the company knows exactly how much it will pay for each employee”

and that it is

“substantially cheaper than the public sector equivalent.”

It is reassuring to know that the maximum cost will not exceed £3 million. Because of the new regulations, the company must provide pensions.

The Convener

I am intrigued. I am led to believe that the chief executive is a member of the Strathclyde Pension Fund, in which I declare an interest as a beneficiary through my previous employment. I do not understand why he is a member of that local authority fund rather than the pension arrangement that is outlined here. I would be interested to know the reasons for that and its implications. It appears that the company is making some provision and accounting for it. Does anyone from Audit Scotland want to comment on that, or are you reasonably happy with it?

Angela Cullen (Audit Scotland)

We are reasonably happy with the response. We have not looked at the pension fund in detail.

The Convener

Okay. There is nothing else to say on that. “Road Map” is the next heading, which refers to page 17 of the business plan, which has been circulated. Do members have any thoughts or comments to make on that? I think that it is just a matter of record more than anything for the committee to comment on.

Murdo Fraser

Yes.

The Convener

The third heading is “Athletes’ Village”. My recollection is that, at the time, there were issues to do with the development of the village that the company could not comment on because the tendering process was at a significant stage. I do not know whether there are any issues arising from the conclusion of that process. Has anyone from Audit Scotland looked at what has come out of the tendering process?

Angela Cullen

We have not looked at anything else since we published the report. We will look at the Commonwealth games again in a second report next year.

The Convener

Okay. Willie—sorry, Bill Kidd.

Bill Kidd (Glasgow) (SNP)

I thought I was back at school—that is what everybody called me.

The last paragraph of this section mentions the “second phase of development” that was to be “undertaken after the conclusion of the Games” and “a further 750 units.” I wonder about the prospects of that development still going ahead, given the current economic circumstances. Will those have an impact on the finances of the games? Have any changes had to be made to the plans because of the economic situation, and will those 750 units still go ahead?



The Convener

We could clarify that.

Bill Kidd

I do not know whether the planned costs of the games included the cost of that further development taking place.

10:15

The Convener

It would be worth clarifying that. I am puzzling over whether we would clarify it with the organising committee or with Glasgow City Council. We will leave Jane Williams to determine who to ask whether the overall costings of the project are dependent on the final property development phase going ahead.

Under the next heading, “Inflation”, I was intrigued to read:

“It was suggested by the Committee during the evidence session on 27 January that inflation had been built into the financial planning for the Games for the first time only in 2010.”

My recollection is that it was actually Liz Hunter who said that—it is as if she is trying to rewrite her evidence. Her evidence at the meeting was somewhat contradictory and confused, but we can get hold of the Official Report and maybe we need to write back to her. It was certainly not the committee that said that; she said that and it is outrageous that she tries to say in her letter that we suggested it.

During the past few days I noticed that there was some coverage on accounting for inflation. Do members have comments on how inflation is being treated?

George Foulkes

In her subsequent letter, which is dated 6 May, Liz Hunter wrote:

“the agreed Games Budget would translate to £524m in cash terms”.

However, in the next paragraph, she went on to say:

“The Games partners are determined to work within the agreed budget which remains unchanged from that announced in November i.e. £454m at 2007 prices”.

Why is she still talking about 2007 prices? Why does not she stick to the £524 million?

The Convener

Can Audit Scotland throw any light on that?

Angela Cullen

We understand that the original bid to the Commonwealth Games Federation had to be in 2007 prices, to ensure that it was comparable against the bids of all the countries that were bidding. Updates on those costs against the budget at 2007 prices need to be maintained, as does updating for inflation—so there need to be two different comparable budgets.

George Foulkes

Okay, as long as we have a budget that is in cash terms, which is the one that people like us—I do not mean you lot in Audit Scotland—understand, because it is a bit more realistic.

The Convener

How can people make comparisons if the bid is at 2007 prices but the reality is that the cost will be in cash prices? If inflation is running at different levels in the countries that are bidding, how can comparisons be made?

Angela Cullen

I understand that if inflation in each country is stripped out and the 2007 prices are kept, there is more comparability. In some economies inflation might be running at 25 per cent, whereas in others it might be running at 2 per cent, so people would not be comparing like with like.

The Convener

So people are comparing what is actually delivered and pricing it accordingly.

Tricia Meldrum (Audit Scotland)

There is a benchmark, so that the final costings can be compared with a clear statement of the initial cost on those prices.

Willie Coffey

I am looking at the tables on pages 21 and 22 of Glasgow 2014’s “Annual Business Plan 2010/11”. Table 1 shows the 2007 benchmark prices and table 2 shows the budget at projected outturn prices with the inflationary element across the board. We would be interested if any budget lines stood out, beyond the inflationary amount, which would suggest cost overruns and so on. There do not appear to be such issues, but that remains to be seen.

I am interested in the contingency figure that is expressed on page 20—the additional £20 million that has been set aside to be used only as a last resort. That money appears to be built into table 1 as a spend item, although I might be getting confused about that, because several contingency pots have been established. One was £40 million, but it was then topped up. Is the Audit Scotland team aware of that? If the £20 million is to be used only as a last resort, I would not expect it to be built into the budget lines on page 21.

Angela Cullen

I will attempt to answer that and Tricia Meldrum can correct me if I am wrong. There are two contingencies. There is a contingency fund of £60 million—in 2007 prices—in table 1 on page 21, and there is a special contingency of £20 million that is to be used only in exceptional circumstances. No spend is forecast against the £20 million because it is to be used only as a last resort.

Willie Coffey

Thank you.

The Convener

Does anyone from Audit Scotland have any comment to make on the response on inflation?

Mr Robert Black (Auditor General for Scotland)

I do not think so, convener.

The Convener

Okay. Are there any comments on the sections headed “OC-Generated Income” and “Ticketing”?

Anne McLaughlin

Can somebody remind me why we asked the organising committee about projected ticket sales? Is it because we were concerned that it was overestimating the number of tickets that will be sold? We asked a number of questions about that. The response tells us what the projections are based on, but it does not reassure me, because it admits that Glasgow is smaller than Manchester. We did ask the organising committee to compare Glasgow with Manchester. If our motivation for asking the question was the concern that I mentioned—I think that it was—I am not sure that the question has been answered.

Murdo Fraser

As I remember it, the committee was sceptical about whether the ticket sales projections were realistic given the population and catchment area of Glasgow and the likely spend. I am not sure that the answer that we have received fully reassures us.

The Convener

We should also bear in mind the point that it is not just the actual population of the defined area of the venue that is important but the socioeconomic profile and the willingness and ability of people in the area to spend money on events such as the games. My understanding is that the area on the periphery of Manchester probably contains more people with significantly more disposable income. That must impact on the potential ticket sales.

Anne McLaughlin

The organising committee states that in its response. It acknowledges that there is a “lower average income” in Glasgow and a lower population, but it does not state how it came to the conclusions that it reached. It mentions non-revenue seats, seat kills and so on, but those would be the same anywhere. I just cannot see anything in the response that makes me think, “Yes—that’s how they came to that conclusion.” Obviously, if there is going to be a problem and the organising committee is going to have to attract more ticket sales, the earlier it gets on to that, the better.

The Convener

We can certainly try to clarify that. Are there any comments on the remainder of the letter?

Willie Coffey

An alarm should sound on the broadcasting issue. It is not clear whether we are getting a deal with the BBC to broadcast the games. We already have a deal in place with Australia. That is great—it is to be welcomed—but I do not understand what the problem or issue is with the BBC. Did we get any clarification of what the difficulties are and when we might get a resolution? Does anybody know?

Tricia Meldrum

Our understanding is that hopefully something would be agreed by next year. That is fairly in line with typical timescales for agreeing these deals. The BBC has only recently agreed the deal to screen the Delhi games, which are happening this year, so things can happen a wee bit later. The Australian deal was concluded quite early in the process. It is still obviously a concern.

Willie Coffey

It is concerning that the letter states:

“The OC has also reviewed its domestic broadcast revenue target downwards during the budget review.”

Why would it do that if it does not even have a deal—or any semblance of a deal—in place? What is going on? I do not get it.

The Convener

It says in the organising committee’s business plan:

“During 2010/11 we aim to ... Continue to negotiate with the BBC with a view to achieving a ‘bundled’ agreement where the BBC agrees to act as Host Broadcaster in exchange for the domestic Rights to cover the Games.”

Obviously such an agreement is fundamental to the financial success of the games. I suppose that we should ask for a progress report on when it expects that to be concluded.

Willie Coffey

We should also ask about the differing approach to covering Manchester compared with Glasgow. I do not know what the differing approach is or whether it is to do with scale. I would like to understand a wee bit more about the broadcasting issue and whether there is a plan for free-to-air broadcasting or internet media broadcasting. How the games are broadcast to the public around the world is bound to be of interest.

The Convener

The business plan has been presented to us. The letter of 6 May comments on the spend profile, including inflation. Are there any comments on that?

George Foulkes

I have a general comment on the games partnership structure, which is shown on page 7 of the business plan. Accountability, which is illustrated on that page, seems to go round in circles. Does the organising committee report to any parliamentary committee other than the Public Audit Committee?

The Convener

It does not report to us. The only reason why we are looking at the business plan is that Audit Scotland has produced a report.

George Foulkes

Which committee deals with sport in the Parliament? Is it lifelong learning or the jumping up and down committee, or whatever it is called?

The Convener

It could be a couple of committees. The Health and Sport Committee would have an interest from the sports perspective and the Local Government and Communities Committee would probably have some degree of interest because of the involvement of Glasgow City Council.

George Foulkes

I am talking about a committee not just having an interest in it but regular oversight of it. We have four more years until the games. Things could go drastically wrong in the planning. All the people listed on page 7 of the business plan are Government or council people. There is no regular parliamentary scrutiny, is there?

The Convener

We will have the opportunity to look at this again next year once the Auditor General produces his next report. He will be reviewing progress.

George Foulkes

So, this committee will review regularly the proposed expenditure right up until 2014.

The Convener

Depending on what the Auditor General and Audit Scotland do, the committee might have the opportunity to do that, but we do not have the right to commission work on any issue at our own hand.

George Foulkes

You know my view on that. It is astonishing that a committee of the Parliament does not have the right to do that. I do not know why the hell we are here as an elected Parliament unless we have some degree of responsibility. I mean no disrespect to the Auditor General; he is very good, and produces a lot of reports. However, we ought at some point to be able to examine our remit so that we can commission reports from the Auditor General, or else there is no reason for us to be sitting here.

10:30

The Convener

That is part of a bigger debate, on which a number of members have commented. As far as this is concerned, we are constrained by whatever the Auditor General and Audit Scotland decide to do. There will be a further report for us to comment on.

George Foulkes is right—given that the Glasgow 2014 strategic group is chaired by the First Minister, the wider issue is how Parliament is able to hold those who are involved to account. There are a number of levels at which that can be done. There will be financial implications, so there will be an opportunity each year at the budget debate. Other committees can decide to examine various aspects of the Commonwealth games bid and the progress that is being made. Those are the parliamentary opportunities, and in addition we will have the opportunity to comment on the progress report from the Auditor General.

George Foulkes

I have a second, and even more general, question on the issue. In the past when I have asked about some issues, the Auditor General has said that he cannot report until after the expenditure has been incurred. In this case, very creditably, we are considering the expenditure at an early stage, before the vast majority of it has been incurred. Is that a change in policy? Can we do the same in other cases? If there is a major infrastructure project, for example, can we examine it at an early stage rather than waiting until the money is committed?

The Convener

I invite the Auditor General to comment.

Mr Black

Those things are a matter of judgment. Generally speaking, audit is a retrospective process, as the committee is aware. I would report to the committee only on expenditure that has already been incurred and audited, so that we have reliable financial numbers.

Over the years, I have adopted the policy that if there are very significant projects that might present significant risks to public money, I will ask Audit Scotland to report at key points during the project and—explicitly and implicitly—use the language of the risks that we see. For example, a couple of major areas of risk that we saw in relation to the Commonwealth games project were around the allowances for inflation, which are by no means clear, and some of the income projections, with the United Kingdom economy heading into quite a severe recession.

Using the language of risk is appropriate; we have done it in other reports. We did it first in relation to this Holyrood Parliament building, on which I made three reports that informed Lord Fraser’s inquiry. As we go forward, we will bear in mind some of the major capital projects that have been committed and consider whether particular pieces of work need to be done.

That said, there is a limit to our resources. The team that does that type of work, under Barbara Hurst and Angela Cullen, is really stretched, and we cannot second-guess the desire of an organisation such as this, with all its expertise, to undertake projects such as this at its own hand. Fundamentally, the committee’s role is to hold others to account for their actions and their performance. We are not resourced to second-guess that process, and nor should we be.

George Foulkes

Nevertheless, while accepting that constraint and qualification, we should welcome and encourage the initiative that the Auditor General has taken. Rather than crying over spilled milk and saying that it is terrible after the event, when hundreds of millions of pounds could have been saved, it is much better to get in at an early stage and say, “Unless you change this, you will spend—and waste—a huge amount unnecessarily.” It is good that the Auditor General is doing that.

The Convener

Okay. I see that members have no further comments on the letter of 6 May.

Are we agreed that we will start to prepare a draft report, and in the meantime ask our clerking team to request further information and go back on the issue of inflation? We can then return to the matter.

Members indicated agreement.