Chamber and committees

Thank you for the Scottish Funding Council’s submission, which is very useful.

In common with much of the information that we have received, there is a lot to say about the internal operations of your organisations. We explored some of those issues with the Auditor General in the previous evidence session—you might have caught some of it. There is your internal operation as public bodies, but there is also the broader programme of reform and what the Government intends to do about the sectors for which you have some responsibility.

With regard to the SFC in particular, it is interesting to understand your internal processes, but the broader reform of the post-school system must surely be the meat of reform in your area. Do you feel that there has been sufficient guidance or direction from the Government regarding where you are headed and what you should be helping to govern?

Okay.

It is good to see you in front of the committee, Mr Boyle. We have not seen you for a while. Today, we are looking at your report on fiscal sustainability, which was published in November, but a lot of the things that you say remind me of comments that you have made previously. In that regard, I have picked out five Audit Scotland reports from the previous 15 months.

In your report “NHS in Scotland 2024: Finance and performance”, you said:

“fundamental change in how NHS services are provided is now urgently needed.”

In “The 2023/24 audit of the Scottish Government Consolidated Accounts”, which was published in October 2024, you said:

“The Scottish Government’s projections suggest that it cannot afford to pay for public services in their current form.”

Back in November 2023, in “The 2022/23 audit of the Scottish Government Consolidated Accounts”, you said:

“Fiscal sustainability is one of the highest-ranking risks in the corporate risk register.”

In October 2023, in “The Scottish Government’s workforce challenges”, you said:

“The Scottish Government’s projections suggest that it cannot afford to pay for public services in their current form.”

Having read those reports, and your most recent one, it feels to me as if you are banging your head against a brick wall. You started today by saying that the concerns that you have raised remain valid post-budget. Is there a sense of real frustration that you are not being heard?

I wonder whether the warnings that you repeatedly give us—and that you give the Government directly—in terms of detailed analysis are not sufficient to animate the Government into recognising the medium-term financial position. I am trying to understand that. Collectively, we have echoed and highlighted some of your concerns and, we hope, have put our own on to the Government’s radar. In your view, what would be sufficient to animate the Government to act?

If we can see delivery against a plan, that will be positive. Previous medium-term financial strategies have shown that there is a significant gap. The Scottish Fiscal Commission has highlighted the significant gap between revenue and projected expenditure in the near-term budgets over the next couple of years. The budget this year could be described as doing no harm but, on the current trajectory, does it store up problems for years to come?

Given the various reports that you have written, when it comes to broader fiscal sustainability, which parts of the public realm in Scotland are most vulnerable at the moment?

Does the Australian system not represent a better comparator for Scotland than the system in the US?

I think that we would all be supportive of that, and I entirely agree that the bill has shone a useful light on palliative care. I also understand that the financial memorandum is about direct consequences of the bill. However, with regard to the impact on the public purse, if we are all saying that palliative care services have to improve—we know that hospice care, in particular, is in a pretty dire and financially precarious situation in various parts of the country—investment would have to be made. That is not represented in the financial memorandum, but there is an impact on the public purse.

You mentioned earlier that palliative care practices that are in place will be disrupted by the introduction of assisted dying. Could those practices become defined as assisted dying under the terms of your bill and, therefore, become more problematic and, necessarily, more expensive? You talked about people’s pain being traded off against an acceleration towards death, which is, I think, an acknowledged practice in palliative care. Is there a risk that the introduction of the system as you have defined it will make such practices more difficult and, as a result, more expensive?

My last question is about cross-border interaction with the UK on this matter. Under the scope of your bill, as drafted, the access criteria are far wider than those in the bill that recently passed its first reading in the UK Parliament. Your bill also makes it explicit that the treatment would be provided in the NHS, whereas there is no such explicit commitment in the UK bill, at the moment. People in the UK will also face potentially very high legal costs in order to access the provisions in the bill if it is passed by the UK Parliament.

Is there not a significant risk that, in the event of both bills being passed, a significant number of people will come to Scotland to access that form of care on the NHS in Scotland? Therefore, the numbers will be much higher, and the costs of accommodating people and making the care available will be significantly higher, too.