Chamber and committees

I want to pick up on a few issues that have come up, particularly the variation between in-house auditing and that done by external auditors. Do you have any statistical information that could allow us to compare performance or completion against targets, for example? That would give us a feel for whether external auditors are more on target than your internal teams, or not, as the case may be.

I ask you to stick to the timeliness of completion, as I have some other questions about that.

Yes—I was called back at 2 in the morning. I have to say that all the people whom I spoke to were lovely. I am really grateful to every one of them: it was clear that they were all really overworked and were doing their best.

However, I think that you get the gist of my point. People end up in a vicious circle in which the only option is to present to A and E, and we all know the problems that A and E departments are facing.

I will move on, because there is a lot to cover.

We have to talk about delayed discharge. I know that this is not a political setting, but ministers have promised to eradicate delayed discharge. That is ambitious and probably not achievable. There are targets—official and unofficial—but the statistics do not seem to bear out that progress is being made on that.

That can be analysed in a number of ways, such as by using the average number of people per month who are waiting to be discharged or the number of days that are spent in hospital by people who are ready to be discharged. I will not go into all the numbers, but where are we at with delayed discharge in Scotland at the moment? Are we making any progress at all, or are things getting worse?

There is not continual improvement; it is continually getting worse.

That goes back to my first question. If no other options are available, it is no surprise that people present at hospital. Therefore, the rest of the system needs to be working in order to take the pressure off. However, that is not a new problem. We have been talking about that problem in the Parliament for more than a decade—it has definitely been talked about in the Parliament for longer than I have been an MSP. Why have we not got to the bottom of that? Is it simply the case that people are getting sicker? Are there more sick people or not enough doctors? What on earth is going on? Why do we still face endless missed targets and waiting times that are going up and up?

So the current performance rate is about 65 to 70 per cent.

A very good morning to you. I will see if my voice lasts; I will try my best. As you can probably hear, I am recovering from illness, including Covid.

I thought that I would share a little story with you, because it is probably indicative of a situation that many people in Scotland have found themselves in. When I was unwell, I made the decision to call 111 for assistance, in line with the advice. I picked up the phone at 8 pm, and—I know this because I have just checked the data on my mobile phone—I spent two hours and 24 minutes trying to speak to somebody. The call was not answered for an hour and 12 minutes and I was in a waiting queue along, I presume, with many other people. I expect that many of those people simply hung up, but I hung in there as best I could.

When the call was answered, it was dealt with by a operator who was not medically trained, but who did their best to assist. The outcome of that two-and-a-half-hour phone call was simply this: “If you feel really bad, go to the hospital, or we’ll get an out-of-hours GP to call you back.” I said, “Yes, please.” The out-of-hours general practitioner eventually called me back at 2 o’clock in the morning—some six and a half hours after I first called. The outcome of that conversation was to be told, “If you feel really bad, phone an ambulance or get yourself to hospital; otherwise, call your GP in the morning.” I duly did that.

The third and final part of my story is that I called the GP at 3 minutes past 8 that same morning and was told that there were no appointments left, because it was 3 minutes past 8. I was told—guess where this is going—to call 111 or, if I felt really unwell, to get myself to hospital.

I suspect that that is an experience that is shared by many people. Does that really sound like an NHS that is working for people?

I ask because the data that I have is from the Audit Scotland report, which is from September 2023, so you may have something more up to date.

Yes, please.