The Official Report is a written record of public meetings of the Parliament and committees.
All Official Reports of meetings in the Debating Chamber of the Scottish Parliament.
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Displaying 2137 contributions
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
I am trying to get my head around who is to blame here. NHS Ayrshire and Arran has been on level 3 for eight years, so there is financial intervention every single year. The idea that that is a loan is nonsense; I would put money on the fact that it is never going to pay this stuff back. The model is broken, in my view. Something is clearly going wrong, but I cannot quite work out who is to blame. Is it governance issues? Is it the board? Is it the management team? Is it the Government? Is it ministers? Is it all of the above?
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
Can we cut to the chase? Are we just dancing around the issue that the current model is not working? The unsustainability that you highlight in your audit is a long-term issue; it is not a one-off. It has been happening for nearly a decade, and it is probably going to continue in the same direction, if not get worse.
The idea is that the Government is somehow helping out by stepping in and plugging financial holes, painting the picture of it saving the board. Do you think that the Government needs to have a fundamental look at the entire model to rephrase it, reframe it and be a bit more honest with the public and the health board about how it is funded and what it expects of the board?
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
I have one final question. The idea of brokerage is political lingo, but is there a reason why the Government frames it in that way? Essentially, it is saying to boards that, if they are spending more than they have, the Government will make up the difference in the form of a loan. Are there financial or audit reasons why it would do that? Is someone sitting in a civil service room saying, “Minister, do not just give them cash—give them loans”, because it has a financial benefit or some knock-on effect down the line or in the way that the Government reports its accounting?
If we multiply the approach across all boards, it is a substantial sum of cash. Why would ministers not simply say, “Look, if you need £30 million to meet your health objectives, we will give you that”, rather than continue a pretence that the money is a loan? It is never going to be paid back.
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
It is not really a loan; there is no expectation that it will be paid back.
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
I draw your attention to paragraph 14 of the report, which I read with interest. We have spent a lot of time talking about the finances of the board, but it seems that that is not the only issue here. There are concerns about performance, services, quality and the existence of “significant operational pressures”. Could you talk us through the concerns that you identified, other than those to do with the financial problems at NHS Grampian?
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
Thank you, Auditor General. How can a hospital run out of beds? Is it that suddenly and very quickly there is an unexpected wave of people who are very unwell or is it because of poor planning and forecasting capacity?
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
Thank you. That is a very succinct analysis of the wider problem. Is the solution to the bed issue a new hospital or a new site? You state that there are physical issues in the estate, so the answer to that clearly is a new building, more beds and more people.
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
The assurance board has a role to play in all this and will be there for the foreseeable future until things have turned around.
Is the improvement plan forthcoming? Where are we at with that? Has it been signed off? Has it been ratified? Are people happy with it?
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
Good morning and thank you for your evidence so far. I have been listening to the session and I read your report with great interest, particularly as a member who has covered the region of Ayrshire and Arran for some nine years now. These issues are not new to anybody who lives in the constituencies that I represent.
I am extremely concerned by the outcomes of your report on a whole range of levels. The most important one that I am worried about is not necessarily the financially precarious position of the board but what it means for patients and people. Ultimately, the health board is not a business. I know that we are using audit language here and talking about operating losses, but we are also talking about health outcomes. What effect does operating at such a loss have operationally on the board’s ability to deliver quality healthcare to the people of Ayrshire and Arran?
Public Audit Committee
Meeting date: 26 November 2025
Jamie Greene
Surely it costs what it costs. I am confused by the language around saying that it is spending more than it should. If people are unwell, they are unwell and they need to be treated. I do not understand this countrywide approach that we are taking to the NHS—the suggestion is almost that it is living beyond its means. That seems outrageous.