Chamber and committees

Just to emphasise Graham Simpson’s point, he is asking questions about PFI contracts of varying value, one of which is coming to an end at the end of 2025, which is not that far away. We would expect you to have a bit more detail to furnish us with this morning.

The question that he asked about Wishaw general is pertinent because of the value of the contract, which is £100 million in capital value terms. I recognise that some of the other ones are quite small: one is due to expire at the end of 2029 and is valued at £2.7 million, which is probably small fry in the overall scheme of things. However, we would expect you to have a bit more detail to give us about a larger one such as a significant general hospital that is coming up to the end of its PFI term.

I will follow up another point that Graham Simpson made, which is about savings. Perhaps you can help me, because I do not quite understand why, when we see real-terms increases in the NHS Scotland budget year on year, territorial NHS boards are asked to come up with savings. Will you explain that to me?

But does a territorial health board not have a budget for staffing?

So what is the current estimate of costs for those seven treatment centres?

Good morning. I welcome everyone to the 20th meeting in 2024 of the Public Audit Committee.

The first item on our agenda is for Fulton MacGregor to declare any relevant interests to the committee. Fulton joins us online. Over to you, Fulton.

The principal item on our agenda is further consideration of the Auditor General for Scotland’s section 23 report “NHS in Scotland 2023”. In the interest of transparency, I refer members to my membership of two trade unions that organise workers who are employed in the national health service.

I welcome our witnesses this morning. We are joined by Caroline Lamb, who is the chief executive of NHS Scotland and the director general of health and social care for the Scottish Government; Richard McCallum, who is the director of health and social care finance, digital and governance for the Scottish Government; and John Burns, who is the chief operating officer of NHS Scotland.

The committee has got quite a number of questions to put to you, but, before we get to those, I invite Caroline Lamb to make a short opening statement.

Okay. I will ask one final question. Last year, we had a discussion about the national treatment centres, their costs, why they had gone over time—why they were being delayed—and so on. You wrote back, director general, on 22 July last year, explaining that the “original plan” was to open up six centres by 2021, at a cost of £200 million of public money. You also appended a table setting out details of seven centres that were yet to be completed, which had an estimated cost of £827 million. Why was there such a huge increase in the costs that were budgeted for the building of those treatment centres?

But that would not be impossible, would it? Given that it has gone from £200 million to £827 million, we can easily see how it could continue to rise.

Why are you so resistant to doing that? Over a year ago, you were sat there and you and I had an exchange about the Auditor General’s recommendation to produce annual reports that would give greater transparency and clarity about whether progress was being made. You said—rather dismissively, I think—that you were not really interested in what you described as “a dry annual report.” Why do you have such resistance to the idea of openly publishing an annual summary of progress being made or not?

You understand why, to us as the Public Audit Committee, it is unsatisfactory that, in this year’s report, the Auditor General had to repeat a recommendation. On the recommendation to

“Publish annual progress updates on the reform of services”,

under the heading “Limited progress”, he said:

“We repeat the recommendation in this report.”

Reform is the watchword of the new Cabinet Secretary for Health and Social Care, so why have you not come up with the standard of reporting that the Auditor General thinks is required?

On the 2023 report, the Auditor General, in a fairly stark summary, said that there was

“no single overall vision for how health services will look in future.”—[Official Report, Public Audit Committee, 21 March 2024; c 36.]

When I raised that with the then First Minister at a meeting of the Conveners Group in the Parliament, he said:

“I respectfully disagree with the Auditor General on that point”.

Where do you stand on that?