Chamber and committees

You mentioned that as one example. What other examples do you have? How wide ranging is the reimbursement policy?

Will you give us a list of all the items that were subject to that agreement?

It is about anything that raised a personal tax implication or was a benefit to staff that is perhaps out of line with what other public bodies do.

Who approves the actual items?

How was the board apprised of that?

Staying on the issue of staff, the increases in the use of agency and bank staff—which is a favourite topic of ours—are pretty eye-watering. In paragraph 26 of your report, you say that total agency staff costs increased by 25 per cent in 2022-23, and that there was a 79 per cent annual increase in spending on agency nurses. That figure continues to go up. Every time there is a report, we are assured that the NHS is working on that and that it will manage it down, but that does not happen. That is a huge cost to the NHS. Is there any belief that that figure might reduce in future? It is such a significant cost.

I will move on to estate management. For a number of years, the capital budget that has been available to the NHS has been fairly generous, relative to other areas of the public sector, and there have been lots of new building projects and so forth. In paragraph 27, on page 16 of the report, you say:

“Around 70 per cent of the estate is in good condition and used efficiently.”

However, it is likely that there will be some constraints on that budget in the future, given the cuts to the capital budget. In the briefing, you recommend that the Scottish Government should

“develop and publish a national NHS capital investment strategy”

to clarify how its spending will be prioritised in the future and how the overall estate will be managed. Why do you believe that that strategy is so important? Do you know whether the Scottish Government intends to accept that recommendation?

You said that the Scottish Government has accepted the recommendation. Did it give any indication of the timescale? I realise that it is probably quite a big task.

Will the Government come to you once that is in place, or will it just publish its strategy?

My final question is on monitoring and support. Just before paragraph 37, in the subheading on page 20, you conclude that

“There is a need for greater clarity about Scottish Government monitoring and support”.

What made you decide to make that recommendation? You sketch out a bit about it in some of the other paragraphs, but what led you to make it?