Chamber and committees

Will that cover larger cross-Government areas, such as public service reform and child poverty?

If we have continuing pressures on public finance, clearly we need to see how money is being spent. A lot of the public sector reform that we have talked about for years has also been about how we can shift to more preventative spending. I do not see how we can do that without being able to see what our money is delivering, particularly when some of that preventative spend will be long term.

I want to ask some questions about performance reporting, which you touched on earlier. Since the start of the Parliament in 1999 there has been a desire to better understand how money is performing in terms of outcomes. When I joined the Parliament in 2007, I sat on the Finance Committee, and we heard about international best practice from, I think, Virginia. The then Cabinet Secretary for Finance and Sustainable Growth, now First Minister, John Swinney, was keen to introduce a structure or framework that would help us to better understand what our money was delivering. From that came the national performance framework.

It is a bit disappointing that one of the key messages in your report is that the Scottish Government cannot clearly demonstrate that public spending is delivering the intended outcomes. At paragraph 85, you talk about the reform strategy for the national performance framework. It would be good to understand what the challenges are with the NPF and what you hope will come out of the review and refresh of the NPF.

Minister, I go back to Sandesh Gulhane’s question about regulated professional bodies and the inclusion of the General Osteopathic Council and the General Chiropractic Council. My understanding is that neither osteopaths nor chiropractors in this country are medically trained—though they are in some other countries—and I am therefore not aware of their ability to prescribe pharmaceuticals, so their inclusion is unclear. When we asked which procedures they might be covered for, we were not given an answer.

I am really concerned that we have a potential loophole that could cause confusion. People might think that, because someone is regulated by the General Osteopathic Council or the General Chiropractic Council, they can perform the procedures that are outlined in the legislation. There is no reason for people to think that, so I ask you to consider whether those two bodies should be removed from the bill to ensure that it is as clear as possible.

I would appreciate it if you would do that. If someone has cerebral palsy and requires those injections, they should go to a medical practitioner to receive them. I would be concerned if people were routinely receiving medical treatment from people who are not medically trained.

I am not criticising the work that those bodies do, but neither of them have medically trained individuals. If we are inadvertently indicating to the public that they are somehow medical practitioners, I would be concerned about that. I am grateful for your agreement to look at that again and consider whether the two groups should be removed from the bill.

Okay. That is fine, thanks. The challenge is that we have heard so many positive managerial words over the years that more transparency would be really helpful. I will leave that there for now. You may be right that I should perhaps put that question directly to NHS Tayside.

Your report also stated:

“The mental health and learning disabilities Whole System Change Programme (WSCP) in Tayside has made some progress in addressing the issues identified by the subsequent IOAG, but substantial issues and challenges remain.”

Could you advise us of the areas where progress has been made and those where issues and challenges remain?

Is there any suggestion of when that plan would be put in place?

As constituency MSP for Dundee City West, which is within the NHS Tayside area, I am acutely aware of long-standing, widespread concerns about the provision of mental health services across Tayside. Like other colleagues, I am regularly contacted by constituents who have difficulty in accessing support. I am often contacted by families and friends of constituents who have not received anywhere near the level of support that they should have had. I am in contact with NHS Tayside on behalf of constituents every single day. Mental health provision—or the lack of it—is more often than not the reason that my intervention is required.

As we heard, David Strang was appointed chair of the independent inquiry into mental health services in Tayside in July 2018. His final report was published in February 2020, and the independent oversight and assurance group published its final report in 2023—yet here we are now, at the end of 2025. I know that my constituents in Dundee will be asking what progress has been made.

I am extremely concerned that NHS Tayside simply does not have the required expertise to make the substantial improvements to patient care that your report highlights or to improve confidence on the part of members of this committee, members of the wider Parliament and, most importantly, people living in the NHS Tayside area. I would be grateful for the Auditor General’s view on whether we have now reached the point where external oversight is required.

That is really helpful. My point is that there is a lack of confidence and it will take a long time for that to be restored. One factor that would help would be more transparency. You talked about having regular meetings. Will those be held in a transparent way such that my constituents, and the constituents of other MSPs in the room, will be able to access them, so that they can see that change and the required oversight are actually happening?

Okay. That is obviously a really important part of any such process. Thanks for that.

Auditor General, your report says that you

“expect to see NHS Tayside implement these actions within the timescales it has committed to”

and that you will

“continue to monitor progress with the issues highlighted in the report and consider further reporting as necessary.”

I know that the First Minister is also actively monitoring the situation and has committed to undertaking a review next month. Can you advise the committee what NHS Tayside has committed to and the options available to you for further monitoring and reporting?