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Public Audit Committee
Meeting date: 28 September 2023
Richard Leonard
The main item on our agenda is to take evidence on the Auditor General for Scotland’s report on adult mental health, which was co-written with the Accounts Commission. I am pleased to welcome our witnesses: Auditor General Stephen Boyle; Leigh Johnston, senior manager, Audit Scotland; Eva Thomas-Tudo, audit manager, Audit Scotland; and Christine Lester, Accounts Commission.
We have a large number of questions to ask but, before we get on to those, I ask the Auditor General to make a short opening statement.
Public Audit Committee
Meeting date: 28 September 2023
Richard Leonard
Thank you for that introduction. To go back to the starting point of the audit, the question that you set yourself was:
“How effectively are adult mental health services across Scotland being delivered?”
How would you summarise your answer to that critical question?
Public Audit Committee
Meeting date: 28 September 2023
Richard Leonard
I will come on to ask about the focus groups in a second. Before I do so, I note that paragraph 15 in the report sets out the scale of the challenge that we face. It talks about what appear to be almost epidemic proportions, in that 22 per cent of the adult population
“may have a psychiatric disorder”.
You talk about the huge expansion in pressure and demand on services. For example,
“The number of police incidents relating to mental health increased by 62 per cent ...The Scottish Association for Mental Health ... reported a 50 per cent increase in demand for its information service”
and
“The number of calls to NHS 24’s 111 Mental Health Hub increased by 436 per cent”.
Those are startling figures, which are presumably placing huge pressure on the system. We might not have measured the outcomes, but we know something about the scale of the demand that there is.
Do you want to tell us a bit more about the qualitative information that you got from the focus groups that you met and what that told you about their experience?
Public Audit Committee
Meeting date: 28 September 2023
Richard Leonard
Okay, but is it therefore possible that that spend was deprioritised?
Public Audit Committee
Meeting date: 28 September 2023
Richard Leonard
Thank you. That is a theme that we will return to during the course of the morning. I turn to Colin Beattie, who has some questions to put to you.
Public Audit Committee
Meeting date: 28 September 2023
Richard Leonard
Thanks.
Christine Lester, will the Accounts Commission monitor the Verity house agreement and its outcomes?
Public Audit Committee
Meeting date: 21 September 2023
Richard Leonard
I think that we were told that it was a special adviser.
Public Audit Committee
Meeting date: 21 September 2023
Richard Leonard
I will move on to another area in which there has been public interest, and that is who, in the end, was responsible for signing off the contract. Mr Wilcock alluded to the 200-odd documents that the Government has released, which included email exchanges in which John Swinney’s officials spoke about banana skins, for example. There seemed to be, and still appears to be, some confusion over who, in the end, signed the contract off. Was it Derek Mackay, Keith Brown or John Swinney? Has the Government drawn any lessons from that observation of the committee?
Public Audit Committee
Meeting date: 21 September 2023
Richard Leonard
Yes, but it is not even clear, Ms Irvine, whether Mr Mackay was on holiday and therefore Mr Brown signed the authorisation, for example. All that I am saying is that there continues to be a degree of confusion about that process and where the authorisation lay.
I will bring in Mr Beattie, who has some questions that develop the theme of Transport Scotland’s role.
Public Audit Committee
Meeting date: 21 September 2023
Richard Leonard
One of the areas where we suggested that there could be a revision is the public recording of decisions. In this case, the CMAL board was overridden by a shareholder authorisation that has an equivalence with a written authority. I wonder whether you could respond—in writing, not right now—with the Government’s position on the public recording of instances of shareholder authorisation being required.