Audit Committee, 06 Mar 2001

Meeting date: Tuesday, March 6, 2001

Official Report 93KB pdf

---

Scottish Ambulance Service

We are back in public session for item 3, on the Scottish Executive's response to the committee's report, "The Scottish Ambulance Service: A Service for Life".

Members have received a copy of my letter to the accountable officer at the Scottish Executive health department and a copy of his reply. We have received a full report on progress to date, with an appraisal of the case for priority dispatch. The advice that I have received is that the committee should wait for the substantive report on priority dispatch, which will be produced in June.

I point out to members that the penultimate paragraph on the first page of the interim report states:

"researches revealed that there is very little hard evidence of the advantages … of prioritisation to be found within the UK or indeed from International sources."

I am a little concerned about that statement, as it appears to contrast with the original National Audit Office report and with our report, which highlighted the benefit of priority dispatch in England, where it has been in existence since 1997.

I suggest to the committee that I write to the accountable officer to clarify the position, and to remind him that full cognisance should be taken of the committee's opinion on the matter, which was based on the evidence that we received.

You should reread that paragraph, convener. The accountable officer refers to "hard evidence", and it is difficult to record whether advantages or disadvantages are associated with priority dispatch, because we have no previous evidence against which to measure it. That is what he means by "hard evidence", which he assumes would be provided by clinical outcomes. Such evidence does not exist.

Do you want to accept what the accountable officer says, or to remind him of our opinion?

The response is detailed and I am grateful that we have received it. We should await the production of the substantive report in June.

The issue is the importance of prioritisation. We discussed the fact that somebody who has a cut finger gets priority over somebody who has a heart complaint, and we wanted to ensure that prioritisation was dealt with. The paper covers that point, and I am not too concerned about reminding the accountable officer of our views, although that is entirely up to the committee.

I intend to remind the Executive to take cognisance of what our report said in its deliberations.

That is fine.

I am wary of going down the policy road, as that is obviously a matter for the Health and Community Care Committee. Nonetheless, we specified our views on priority dispatch in our report. We should remind the Executive about that; I hope that it will take cognisance of our views. Is that acceptable?

I disagree. I agree with Margaret Jamieson that we should not intervene at this stage. I should say that I was not present during the committee's inquiry, but I have read the papers with considerable interest. I would like the Executive to elaborate on the phrase "very little hard evidence" and to define what that means, but I presume that it will do so in its final report.

The interim report says that more work—on outcomes, I presume—is being done in Australia and Canada. It will take considerable time to get significant statistical evidence, and if we start trying to push the Executive in a particular direction, we will enter into a policy-making area.

Yes. I am wary of that. We will not do that.

The committee's feeling is that we can raise our concerns or dissatisfaction when the substantive report comes before us, so that we have, at least, a fallback position.