Chamber and committees

That is very helpful. I will develop that theme a little bit. There is the question of innovation. It comes back to the fact that it is not just about the money but about how we do things. You cite in the report a couple of examples of innovation. One of those—the NHS 24 system—is a bit more long-standing and structural. It has been reviewed and reformed.

There is a case study in the report about the Scottish Ambulance Service intervention. I think that you said that it has established an integrated clinical hub to introduce a level of clinical judgment to determine whether, where there are calls for ambulances to attend, a reasonable demand is being placed on the service. The finding that the Scottish Ambulance Service supplied to you was that, when interventions were made, it was discovered that up to 50 per cent of the calls did not require a 999 ambulance. That result is based on intervention in 15 per cent of calls. Will you reflect on that? If there were a greater level of intervention so that more calls were screened or had that clinical judgment applied to them, would that lead to the same kinds of results right across the entire service?

Okay. Obviously, we are talking about people, but, from an audit point of view, the unit cost to the health service of agency staff is considerably more than the cost of a direct employee, is it not?

Thanks. Another area mentioned in your report is NHS 24 interventions. By the same token, how effective have they been? Is NHS 24 revising the way that it works? Is more investment going into it, particularly given the Covid-experienced environment that we are now in? The delivery of public services is viewed slightly differently, is it not, in light of what had to happen over the course of the pandemic? Can you enlighten us on the NHS 24 changes or interventions and how effective they have been?

That is fine. We will, I am sure, return to those issues in subsequent sessions on the NHS.

Is the clinical hub a pilot in one particular geographical area? How is that working?

I am quite sure that we will be interested in keeping a close eye on that.

Thank you. We have mentioned the national treatment centres a few times this morning. They are, in part, a national health service response, in place of the private sector, to some of the pressures. Three national treatment centres that were scheduled to open last year did not open. The last I saw, they were scheduled to open in the first half of this year. Rumour has it that the First Minister, in one of her final acts, may open one before the end of the week, but whether that is true remains to be seen.

My serious point is that there have been delays. Can you elaborate on your understanding of the reason why the opening of those treatment centres was delayed? That delay has also contributed to the pressures that we have been talking about for the past hour and 20 minutes, has it not? Can you update us on whether those NTCs are on schedule to open this year?

Thank you. We will add that to the list of watching briefs on which the committee will need to keep an eye. I have one more question before we draw to a close. I will also bring in Sharon Dowey, Bill Kidd and Willie Coffey for one last go each.

I am interested in teasing this out. I know that, in July 2022, new national planned care targets were announced. As I understand it, the deadline for some of those targets has already passed without their being met. Are you aware of whether those targets are being reviewed and do you know what the new targets and timescales will be?

That was a public information announcement by the Auditor General. Excellent. Craig Hoy wanted to come in on this area.

One of the most startling figures in the report is in paragraph 46, where you talk about the extent to which bank or agency nursing staff are being called upon. Those figures are for the three health board areas that you have looked at in most depth and they are striking. You say that the expenditure on bank nursing is up by 57.2 per cent in NHS Lothian, by 90.5 per cent in NHS Highland and, in NHS Ayrshire and Arran, by even more at 90.8 per cent. Why on earth is that happening?