Agenda item 2 is the committee's consideration of a follow-up response from the Scottish Executive to its eighth report of 2004, on the "Overview of the National Health Service in Scotland 2002/03". I invite members' comments on or reactions to the Executive's response. There are quite a lot of papers for the meeting; members should ensure that they have the correct overview paper in front of them.
I just want to check that I am looking at the right papers. Are we considering the batch of papers that begins with a letter to you dated 7 February, convener?
Yes. That is the one.
I have one point and one question. The point is about the estimated costs of agenda for change. It was indicated previously that the costs would be in the range £130 million to £160 million. I recall asking specifically at our most recent meeting where in that range the costs would fall and was told that they would fall at the upper end of the range. I note that in paragraph 20 of the pay briefing attached to Kevin Woods's response, he now gives the estimate £150 million to £160 million, so the lower end of the range has fallen out of the estimate.
On the press coverage—in The Scotsman in particular—of the funding numbers, we are not entirely clear how the totals were calculated. The figure of £239 million was mentioned. That figure was contained in information that came to the committee under cover of the letter from Ian Gordon of 10 January 2005, at the end of which is an annex that refers to the Audit Scotland estimated additional costs of pay modernisation. The figure that the Scottish Executive gave under that heading was £238,788,000. That figure was not in our report.
We have tracked the movement of the sums of money for pay modernisation since we first reported in August 2004—the figures are from the Health Department. Recent written evidence to the committee stated that the cost of the consultant contract had moved from £22 million to £31 million. The cost of the general medical services contract has moved from £64 million back in August 2004 through to £82 million in December 2004 and now sits at £85 million. The cost of agenda for change, as Susan Deacon has just pointed out, started in the range £130 million to £160 million and now sits at £150 million to £160 million.
The figures being quoted are for 2004-05, but the briefing goes on to say that the cost by the time agenda for change is implemented in 2005-06 will be in the £180 million to £200 million bracket. Was the initial estimate for 2004-05, or was it for the total cost once agenda for change was implemented?
We have asked the department only for figures by year, so I can report to you only the figures that the department gave us for 2004-05. In its most recent evidence to the committee, the department put the figure at about £190 million for 2005-06, which is within the range that you mention.
That figure is for full implementation. I would have thought that, if one were forecasting the costs, one would forecast the total costs and not simply the costs of the first year of implementation. By the time of full implementation, the likely outturn figure will be £190 million.
That is the figure that the department is giving for 2005-06.
I had not realised the complexities; we seem to be looking at shifting sands. As Susan Deacon has pointed out, the figure for agenda for change has already gone up.
That question would probably be more appropriately put to the department. However, we have to acknowledge that there will never be an accurate point estimate of the cost of what are complex pay deals. Agenda for change in particular involves very large sums of money. The way in which the pay deals work through to application in individual health boards for individual groups of staff will depend on many factors. There will be a lot of uncertainty. We have to acknowledge that. I am sure that the department will be working hard to keep its estimates up to date, but we will never reach a point at which we have the definitive figure for the cost of the pay deals.
I understand that, but I wanted to emphasise that we are dealing with shifting sands.
The explanation in the letter from Ian Gordon talks about the difference between the department's estimates for the GMS contract and the Auditor General's and Audit Scotland's estimates. The letter mentions the initial primary medical services resource and then
Some of Ian Gordon's figures will be based on the totality of the money going into primary medical services and others will be based on additional costs. That is why we did not use those figures in our report; they do not compare like with like. We wanted to unpack the figures and we asked the department to help us with that.
I want to place on record our view that it is not accurate to talk about these numbers as Audit Scotland's estimates. What we have here is a list of numbers that we have obtained from the health boards. We did not have confidence in the figures and therefore did not include them in our report to this committee.
I am just quoting back what is said with the figures.
For the record, they are not Audit Scotland's estimates.
It seems strange that it was hoped that an initial lump of money would suffice, but that people could then come back and ask for more. That does not say much about the ability to forecast what the actual costs of the contract will be.
I want some information from Audit Scotland on agenda for change costs and, in particular, the estimates at 19 January. I am concerned that just 57 per cent of the workforce have been matched and that we have seen the range of costs increase. How often will we or Audit Scotland have an update on the situation? We have seen a £20 million move but only 57 per cent of the workforce have been matched into their new job specifications. How will we be able to track the costs? Is there a problem in relation to the department anticipating increases? The jobs that are not matched are the ones that are more difficult to track.
I assure the committee that the auditors of the Health Department and all health boards will look closely at the numbers in this year's audited accounts for the pay deals. When we report to you later in the year, with our next overview of the health service, we will have reliable numbers for the expenditure that has been incurred. However, it will be for the department, not Audit Scotland, to estimate what the additional commitments that are yet to be met will be. I wonder whether Audit Scotland can help by explaining how we think the numbers are moving.
Everyone will recognise that there is still an element of uncertainty because, as you say, the job matching needs to be done. I do not think that anybody will suffer a detriment, but the issue is quite complicated. For 2004-05, as the Auditor General has said, we should be able to audit more accurately the cost that is incurred at each board level. However, at the end of this year, we will still be working on some uncertainty about future expenditure.
Do members have any final questions?
Is there any chance of the estimates going down or being overestimates? Is that a pious hope, given that all the figures seem to be going up as the story unfolds?
I am not sure that we can answer that.
I do not think that Audit Scotland can answer that.
I look forward to finding out the answer.
We will know it when we get the next set of audited accounts. There being no other questions, we now have to decide what to do about the Executive's response. Given that we are preparing a financial overview report and that this is a response to a previous report, I suggest that, rather than prolonging discussion of our eighth report, we should incorporate any other specific concerns that we want to raise into the future report that we are now working on and simply note the response from the Scottish Executive. Is that agreed?