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Displaying 2811 contributions
Public Audit Committee
Meeting date: 29 January 2025
Graham Simpson
Thank you. I will leave it there, convener. I have taken up enough time. I hope that that was interesting.
Public Audit Committee
Meeting date: 29 January 2025
Graham Simpson
Those are difficult choices.
Back at the start of the meeting, Ms Lamb, you spoke about the announcement made by the First Minister and the health secretary earlier this week, in which they made a series of pledges. You said that there will be a delivery plan for those at the end of March. From that, it sounded to me as though the First Minister had made all those pledges with no idea about how they would be achieved.
Public Audit Committee
Meeting date: 29 January 2025
Graham Simpson
Others will probably ask about the detail of what was announced earlier in the week, so I will leave that to them.
There has been talk for some time about having a national conversation on the health service. The Government loves that phrase, along with task forces and consultations. We have quite a lot of that. If we had a national conversation about the health service, the Cabinet Secretary for Health and Social Care would not have time to attend football matches because members of the public would be telling him a few home truths. Has that so-called conversation started, how long will it take and what will it cover?
Public Audit Committee
Meeting date: 29 January 2025
Graham Simpson
Good morning. I want to follow up on the question about brokerage. People watching this meeting might not know what brokerage is. If I might put it in layman’s terms, it is about bailing out boards because they are overspending and need extra money. To follow up on Colin Beattie’s question, which I do not think was fully answered, what happens if a board says, “We just can’t do it—we need extra money”? Mr Gray, I know that you want to move away from that model—and rightly so—but there will be circumstances where boards just cannot meet their budgets. What will you do then?
Public Audit Committee
Meeting date: 29 January 2025
Graham Simpson
Are you saying that the conversation has started?
Public Audit Committee
Meeting date: 29 January 2025
Graham Simpson
Oh, it has.
Public Audit Committee
Meeting date: 29 January 2025
Graham Simpson
You mentioned varicose veins.
Public Audit Committee
Meeting date: 29 January 2025
Graham Simpson
In that continuing conversation, are you considering things that are of limited clinical value? I point you to what the Auditor General says:
“The Scottish Government and NHS boards should:
Ahead of 2025/26, jointly identify areas of limited clinical value and consider how services can be provided more efficiently, or withdrawn”.
When I asked him about that, the Auditor General told me:
“The Government itself, in its clinical strategy from 2016, cited a source that said that 20 per cent of medical interventions were of limited value. In our view, there needs to be transparency around what interventions exactly, in the Government’s view, are of limited clinical value”—[Official Report, Public Audit Committee, 12 December 2024; c11.]
Can you tell me what medicines and procedures are of limited or low clinical value and whether you have decided which ones you do not want to proceed with?
Public Audit Committee
Meeting date: 29 January 2025
Graham Simpson
GP practices are private businesses. On a practical level, you cannot make them do anything. The cabinet secretary might have the ambition to end the 8 am rush, but, realistically, he cannot enforce that, can he?
Public Audit Committee
Meeting date: 22 January 2025
Graham Simpson
That is fair enough.
You are aware that the committee has had quite a few meetings about the Water Industry Commission for Scotland. The Auditor General mentions it again in his report, which we are looking at today. There was what was described as a “deep dive” by each director general into sponsorship arrangements, because the sponsorship arrangements for WICS clearly broke down, and you could argue that they did not really work with Ferguson Marine, in some respects. Permanent secretary, what was the result of the deep dives, what conclusions have you drawn and can we be confident that we will not see a repeat of that situation?