Chamber and committees

You have stated on the record in this committee and publicly elsewhere that you believe that there might be areas of healthcare provision that the NHS provides at the moment but which might not be offered in future. We can perhaps pick your brains on that some other day.

Going back to the finances, I was intrigued to see that you report nearly £700 million of savings in a single year across the NHS. That is a marked increase on previous years. Do we have any understanding of how boards have made those savings? Savings can sometimes be a dangerous word. What kind of things have been cut? We know that staff costs have gone up and that some salary settlement agreements have been reached, so there will have been no savings in that regard. Equally, we know that some waiting lists have come down, which will have required investment. Where are the savings being made? What do they look and feel like in the NHS on a daily basis?

My colleague Mr Beattie will be asking about the new arrangements that are replacing brokerage, so I will just park that issue.

What I could not quite understand from your report is the variety of deficits that the boards are facing. I note that, in the last four financial years that your report covers, at the top of the list—the worst offender, if you like—seems to be NHS Ayrshire and Arran, an area that I have represented for nearly a decade now. I find it hard to understand why it has received £130 million of brokerage, while Fife has received only £44 million, or less than a third of that. Is that because there is a view that these boards are just struggling to make ends meet? Is it because of higher demand? Do they have a different demographic from other NHS boards? Are there other fundamental reasons relating to the way in which they are governed or operated?

Good morning to all our guests. I will start with some practical questions. When was the last time that UHI Perth either financially broke even or made a surplus?

Thank you. I might come back in later, convener.

That is very helpful.

This is my final question, convener. What does the future of UHI Perth look like? Many colleges have been explicit with the Parliament, other stakeholders and the Government that they may hit a financial wall and cease to be going concerns in the future. That is not a situation that anybody in any of our local areas wants to see for our local colleges, and I am sure that the same is true in Perth.

Given what we have heard today about some of the issues that are outside your control, you surely must be left in quite a perilous financial position now. I am thinking of your relationship with UHI; the top-slicing model, which has been criticised by many board members over the years; the cap on your FE credits, the flat-cash settlement from Government; your indirect relationship with the Funding Council; and the fact that you have pretty much maximised cost savings to the bare bones. What does the future look like?

Did it break even, or, if there was a surplus, what was it?

At a more forensic level, have you seen from any of the audits of these boards any evidence of the repayments featuring in their accounting?

In your opening remarks, you made it clear, as you have in the past, that there has been what one might call record, or increased, funding for health—I guess that it depends on how you quantify it and over which period of time—with health spending by the Government 25 per cent higher in real terms than it was 10 years ago. One could argue that it is a good thing that the Government is spending more money on the health service but, in the same breath, you said that the outcomes are not necessarily matching the extra spend.

I do not know whether any analysis has been undertaken of what is driving that or what we might need to change. I will not ask you to delve into policy changes—I understand why you would not want to do that—but I am interested in what was said earlier about the disparity between the performances of health boards. I will come on to levels of intervention in a second, but I note that exhibit 1 paints a complex picture of how the funding is allocated and spent through the territorial boards, the national boards and the complicated integration authority structure. Is that complexity part of the problem?

In your opening remarks, you made it clear, as you have in the past, that there has been what one might call record, or increased, funding for health—I guess that it depends on how you quantify it and over which period of time—with health spending by the Government 25 per cent higher in real terms than it was 10 years ago. One could argue that it is a good thing that the Government is spending more money on the health service but, in the same breath, you said that the outcomes are not necessarily matching the extra spend.

I do not know whether any analysis has been undertaken of what is driving that or what we might need to change. I will not ask you to delve into policy changes—I understand why you would not want to do that—but I am interested in what was said earlier about the disparity between the performances of health boards. I will come on to levels of intervention in a second, but I note that exhibit 1 paints a complex picture of how the funding is allocated and spent through the territorial boards, the national boards and the complicated integration authority structure. Is that complexity part of the problem?

Okay. The Glen Rosa has now been forecast to cost £185 million. That figure is reflected in your own report. Is there any understanding on your part that that will be covered by the Scottish Government? Your report makes a very specific reference in paragraph 75, which says:

“slippage and cost overruns ... represents a poor use of public money.”

That also seems to inhibit the Government’s ability to present proper accountable officer assessments of the costs of the projects.

Looking at the table that you submitted in exhibit 5, in layman’s terms, it seems that the cost over the last six years has just been spiralling out of control with an unending price attached to the project. Is it your understanding that there is simply a blank cheque available to get this job finished?