Audit Committee, 13 Sep 2005

Meeting date: Tuesday, September 13, 2005

Official Report 154KB pdf

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Community Care

Agenda item 3 is the Scottish Executive's follow-up response to the committee's second report in 2005, on community care. Members have the Health Department's response before them. Members will recall that our report was published in March this year. We received a response from the Health Department and asked for further clarification, so this is the department's second response to our original report.

I invite comments on the response from members, and from Audit Scotland if it has any comments.

The response says that the Health Department has done this, that and the next thing, but it is the Executive, not the department, that has written to the Convention of Scottish Local Authorities. Does that mean that the letter has greater emphasis because it comes from the Executive rather than from the department? What remit does COSLA have to ensure that local authorities complete the returns that are required and what happens if local authorities continue to ignore a request?

There are two questions from Margaret Jamieson to which we cannot have an immediate answer. In seeking closure for this item, the committee will have to decide whether it wants to contact the department again, with a further letter, or whether we should send the department a copy of the Official Report of the meeting so that officials can read our concerns. The issue might be addressed in a number of ways, but at some stage we will need to put it to bed. However, that is not to say that members should not ask questions.

Are there any more concerns?

It is difficult to join in on such work at this stage. However, I note that paragraph 27 of the committee's report stated:

"The Committee was concerned to note that SEHD undertook no systematic risk assessment on the consequences of inaccurate estimates."

In response, the Executive says:

"The Executive will endeavour to undertake a systematic risk assessment for future cost exercises of this nature."

That suggests to me that this is not the only instance in which the Executive has not done a systematic risk assessment. Has the committee done any general work on risk assessment in the past? Given that the answer seems to be about more than the specific matter that we raised, should we ask the Executive about its approach to risk assessment across the board and not just in this case? The issue is interesting and important.

Members can correct me if I am wrong, but I think that we have had some concern about that in the past. I seem to recall, for example, that the committee was concerned about risk assessment not being properly applied in the case of individual learning accounts. In that case, it seemed that the move from the Scottish Office to the Scottish Executive structure and the relationship that departments therefore had with departments at Whitehall had allowed a gap to open up in risk assessment. In the example that we are considering now, the policy has no origins in Whitehall. Its origins are here in the Scottish Parliament, so that cannot be an excuse.

Your point is relevant to the accompanying letter, which states:

"local authorities did not previously record this specific expenditure."

It is obvious to most members that there has been a great deal of debate, various committee reports, then legislation and then the time to apply it. It strikes one that it might have been possible for local authorities to get a bit ahead of the game and begin to gather that information for benchmarking in the future. The response mentions a pre-expenditure assessment in the future, so that there will be benchmarks against which the outcomes of policies can be measured. We do not know how that will work or how successful it will be, but it is certainly an advance on the past position with regard to the policy.

It might be worth considering the point at which we reach a benchmark, given that as the policy is introduced over a number of years there will have to be some measurement against which we can determine whether it is effective. We might need to clarify that. [Interruption.] I shall wait until there is no more noise from the window of mass disruption, although it seems that the window may not be the cause of the sound. I suspend the meeting until we have found the source of the noise.

Meeting suspended.

On resuming—

As I said, it would be useful—not only for the committee, but for the Parliament in general—for there to be some determination of the point at which we should benchmark outcomes in future discussions. The first year might not be the most appropriate, because time is needed for development; even the second year might not be appropriate. Should we begin to measure outcomes in the third year of a policy to see whether there is a pattern, whether value for money is being achieved or whether queues are developing? Audit Scotland and the Health Department might usefully consider that, so that we can have a debate or discussion on the matter from a point of view where we all agree the facts. That is, of course, part of the committee's role.

Those are my observations on the response to the committee's report, and I take into account the points that were made by Margaret Jamieson and Margaret Smith.

My point, which is by way of observation, relates to paragraphs 45 to 49 of the committee's earlier report, on the theme of joint working. That has been a recurrent theme here and in other parliamentary committees and in debates and discussions elsewhere.

I am disappointed about the tone and emphasis of the Executive's response. Its references major heavily on legislation, guidance, administrative solutions, systems and structures but are light on things such as developing people capacity, training, education and culture change, yet those are the things that, more often than not, make the difference in effective joint working and the consequential improvements to services. To be fair to the Executive, there is a lot of activity in those areas. I am disappointed that that is not reflected in its response to our report.

My point follows on from what Susan Deacon said. We have heard about the issues around collecting data on personal care in terms of the role of the local authorities and the Health Department.

As the committee is aware, we are moving to closer joint working and developing the role of community health partnerships. I do not want to see that become yet another obstacle to our ability to gather the kind of information that tells us exactly what the outputs on personal care are likely to be in the future. We need to flag up at this stage that, although there is another development in the delivery of health services, it should improve the delivery of the service and not become a further obstacle to our ability to analyse outcomes. When we return to the issue in the future, we will need to consider that other part of the jigsaw.

As some members may be aware, the Health Committee is considering this policy area. Given that the committee does not deal with policy, I seek members' agreement to forward to the Health Committee our report and the various responses from the department, together with the Official Report of the meeting and other relevant material. It would be useful for that committee to have the information. Are we agreed?

Members indicated agreement.

Members have raised a number of points on the response. Should we write again to the department, send a copy of the Official Report or take up another opportunity at some time? What are members' preferences?

I would like to see the letter that the department sent to the Convention of Scottish Local Authorities and to hear how the provision of data will be monitored in the future.

That will require a letter. Are members agreed that we will write to the department, enclosing a copy of the Official Report? We can say that the committee would welcome a response to the points that have been raised, including the point on the letter to COSLA. We do not want the issue to keep running on. I am concerned that we may have to put the item on the agenda again. If we write to the department again, we will get the information that we seek.

It is important that we are consistent in our rhetoric. We need to be consistent in our push towards an outcomes-based approach. In this policy area in particular, that approach is a recurrent theme. We should focus much more on getting the results in the end and not on the minutiae of what goes beforehand. It is important that we practise what we preach. Our concern should be to keep up the pressure on the Executive. We should drive for results, report back on them and be a little less concerned about some of the process that goes on at the Executive end.

That point is well made. As usual, we need information. My concern is that, if we formalise things too much, we will have a series of running items on our agenda. It is sufficient for us to receive a response to our discussion today. Is it agreed that we will send the letter?

Members indicated agreement.