Audit Committee, 07 Nov 2007

Meeting date: Wednesday, November 7, 2007

Official Report 96KB pdf

---

“Primary care out-of-hours services”

We move to agenda item 5. We have received a response from the accountable officer, but I think that some questions need to be considered further. Those questions are tied in, to an extent, to other considerations about general practitioner contracts and investment in the health service. I would want to be convinced that we are getting value for money and a significant improvement in service for the substantial investment that has been made. I would want to be persuaded that the primary care out-of-hours service is functioning properly. Judging from what we have seen so far, I am not sure that all the questions have been answered.

Many recommendations are marked as "Accepted". NHS Scotland has responded, and it has initiated action. We should at least appreciate the prompt response on the points that are agreed.

Being relatively new on the committee, I am not sure what it is now open for us to do. What stage are we at? How can we follow up the matter?

A report was prepared, and we have received a response from the accountable officer. As Andrew Welsh said, NHS Scotland has accepted a number of the recommendations that were made. We note that, but do we have adequate assurances that we will get sufficient value for money and that there will be improvements in service commensurate with the substantial investment that has been made?

I tend to agree with you on that point. I note the

"improved job satisfaction amongst GPs in Scotland",

which

"showed an increase from 56 to 75 per cent".

I am not surprised, given what they are paid—I think that the average salary is now over £100,000 a year.

I am not sure whether additional pressures are being experienced in such services as accident and emergency units and the Scottish Ambulance Service as a result of the lack of provision of out-of-hours services. I have certainly experienced that over the past year and a bit. Is there any way in which we can follow up that issue?

Audit Scotland is working on the GMS contract, I believe. That is an on-going piece of work—I cannot recall off the top of my head when the report is due. Perhaps the Auditor General could refresh my memory.

The report is due in the summer of 2008.

Rather than going into the issue further at this stage, we might wish to keep the matter on hold and wait until that further work on GMS contracts and related issues has been completed. We could reconsider the whole range of issues at that time.

Does the Auditor General or anyone in his team have any further comments to make on the matter?

No, except to confirm that, as Murdo Fraser said, we are carrying out a study on the GMS contract as a whole. That follows up work that we did previously on the consultant contract and out-of-hours services. A body of evidence will become available to the committee next year. It could well be that that will be a good time to consider those matters together.

We will return to the matter. In the meantime, do we agree to note the response?

Members indicated agreement.