Audit Committee, 07 Feb 2006
Meeting date: Tuesday, February 7, 2006
Official Report
199KB pdf
“A review of bowel cancer services”
The third agenda item concerns the Audit Scotland report, "A review of bowel cancer services". Members will recall that we wanted clarification on a number of issues. We have now received a response from Dr Kevin Woods. Do members have any further questions?
This is not so much a question as a comment, which I preface by saying that the committee concluded that there has been substantial progress in this area. One of the areas on which we sought—and have received—further information is the delivery group that has been established. We wanted to know about the mechanisms for development and improvement. To my mind, the response seems to outline a terribly elongated process of putting in place structures, groups, reviews and the like, while time is marching on.
It is worth noting that progress is continuing. However, perhaps the lesson to be learned is that putting in place all the complex infrastructure within the Executive is not what delivers change. We do not have time to explore that; I just note that, to my mind, the response does not answer our questions about how and when things are going to happen. It could take a considerable time to put all that infrastructure in place, with no goods being delivered in the meantime.
I echo those comments. It would not be unrealistic for us to ask what action is taking place and what is actually going to happen.
On the draft protocol for managing patients, Kevin Woods says that he is
"unable to confirm a timescale for issuing the protocol at this stage".
He says that the general medical services contract "should help". I am interested in the vagueness of that. We are getting two regional teams, supported by a planning strategy team and a performance team. I am interested to know why two regional teams are being established and whether the two support teams will support both regions. The system seems fragmented, although I hope to be proved wrong about that. All the measures are dependent on when the director of delivery is appointed, so the process is being held back, although the issue requires urgent action.
In the last paragraph of the response, we are told that the Scottish Executive Health Department "plans to review options" and that there is an
"ongoing review of the GMS contract".
There will be more reviews. When will all this crystallise into something positive? The matter is urgent.
I have a slight niggle that relates to what Susan Deacon and Andrew Welsh said. The response to paragraph 24 of the committee's report, on the delivery group structure, states:
"It will be based on two Regional Teams".
I am not sure how two regional teams can be established when other services such as cancer screening are based on three regional teams. How they are able to interface with health boards in local areas has been asked about before. It seems that we have yet another set of boundaries, which concerns me.
However, as Susan Deacon said, our response to the report is positive. I commend the department for its progress in examining patient satisfaction and experience. Patient experience will teach us much about delivering services such as bowel cancer screening. The proposals outlined in the response will go some way towards addressing that.
Have members any further points to make before I ask Audit Scotland for comments?
At some stage, it would be interesting to have a map that shows the various teams in the health sector. We would probably need a large wall to put it on.
I recall that there was a large map at the recent briefing. The Health Department will have to employ more cartographers.
The issue of delivery groups is broader than just bowel cancer screening services; it covers several other areas in the Health Department. We are aware that the head of the delivery group has not yet been appointed. I suspect that it has been harder to give a definitive answer when the head is not there to imprint his or her leadership on it. I am sure that several issues will be resolved once the appointment is made.
I invite Audit Scotland for comments on the response from Kevin Woods.
Mr Robert Black (Auditor General for Scotland):
As the committee has recognised, much activity is going on in this area and across the health service as a whole. It would be appropriate to give the department time to respond to our reports and not to pursue it immediately with further correspondence. I give the committee the assurance that we will take into account its areas of concern in our periodic and regular reporting on the health service. We will build what further information we can obtain from the department into future reporting.
With that assurance from the Auditor General that further reports on the Health Department—which are quite regular—will take up our concerns, shall we note the response?
Members indicated agreement.