Chamber and committees

I am sorry to labour the point, but what is the budget, for example, for the Larbert site? What is the budget for the NHS Golden Jubilee site? Where do they now sit?

The financial memorandum has been questioned by the Auditor General, and it was also questioned pretty heavily by the Finance and Public Administration Committee, which told you that you needed to go back and do your sums again and come back with a revised financial memorandum. I cannot remember a time when it was necessary for a Government department to revise its financial memorandum because it was seen to be so out of sync with what people estimated the costs would be. Do you feel embarrassed about that?

You accept, though, that there has been a delay.

Okay, but the Audit Scotland report came out in February, yet, just two days ago, in this Parliament, the chief executive of NHS Dumfries and Galloway told the Health, Social Care and Sport Committee:

“I have worked in the NHS since the 1980s. I am a finance director by background and I have never seen a position as challenging as this.”

He then went on to speak about

“an existential challenge to our current service models”.

He also said:

“technically, I cannot afford one in 10 of my workforce”.—[Official Report, Health, Social Care and Sport Committee, 2 May 2023; c 13-14.]

There is severe pressure on territorial health boards, is there not? It looks a bit more like the picture painted by Audit Scotland than the one that you have painted for us this morning.

Okay. If, for example, the NHS Golden Jubilee site is open by the end of the year, how does that compare with when you expected it to be open when the construction work was originally procured?

Okay. A lot of this morning’s discussion will be about the financial pressures on the national health service. Caroline Lamb, you are the accountable officer responsible for £19 billion of public money, so it is quite important that we get an understanding that you are on top of the pressures that you face. I will turn to Craig Hoy, who has some questions to put to you.

This next question might be for Caroline Lamb. One of the criticisms, or part of the analysis, in the Audit Scotland report is that one of the flaws in the NHS recovery plan, which was launched in August 2021, was that it did not come as a result of proper consultation with the territorial health boards. There was a commitment—perhaps a political commitment—that, within 100 days of the election in 2021, the NHS recovery plan would be published, but the consequence of that, according to the analysis in the Audit Scotland report, is that the health boards were not involved. Is that a matter of regret for you?

That pretty much brings us to the close of the session. There are two things in the report that I want to highlight, on which I would welcome your views. One is the agenda for reform. The clear message from the Auditor General is that the level of funding for the NHS is at a record level—£19 billion—yet we continue to see suboptimal outcomes. I guess that the debate about what we need to do to change and reconfigure services is central to that.

Some of this goes back to the Christie commission of over 10 years ago and what it said about having a preventative agenda and taking a broader view of public health, rather than just having a view of the institution of the national health service. That rests on public debate and engagement, so, in closing, it would be useful to find out your perspective on that and what your plans are in that regard.

The other issue is related to that. One of the key recommendations in the report—you said that you accepted the recommendations—was that you publish annual progress updates on service reform. Is it your intention to do that?

I will bring in Craig Hoy in a second. We have spoken about the number of GPs, and about recruitment and retention and so on. Last year, the committee was quite exercised by the broader picture of GP data, which we took up with you in correspondence. I can characterise it as follows: on the one hand, we have GPs saying, “We’re seeing more patients than ever”, and, on the other hand, our postbags are full of correspondence from people saying, “I can’t get an appointment with a GP.” We were quite keen to have transparency on that. We certainly corresponded about an oversight group that you had put together that was, I think, an attempt to get into the granular detail. Can you update us on that work?

We have been told a few times that the report is from a moment in time, but it came out in February, and we are now in May, so it was not that long ago. Before I bring in Sharon Dowey, can I just ask whether you are planning to revisit the NHS recovery plan, which is one of the headline recommendations in the Auditor General’s report?