Chamber and committees

I appreciate that time is against us, and I have a specific question. A lot of the conversation today has been about the former chief executive who resigned. It is easy to make a scapegoat of individuals, when there are wider systemic issues, especially if they are not here to defend themselves. Given the issues, he clearly did not resign with a heap of glory, but did he receive any financial settlement on his resignation? If so, how much?

Mr Brannen, I have one final question, which is about a real cause of concern to me. What we have heard today has uncovered quite serious issues in a public body. You said that you are responsible for 28 other public bodies within your directorate. You talked about a new and very welcome process of red, amber and green ratings to identify bodies that may not be fulfilling their obligations. Would you be willing to publish that, in the interests of transparency, so that the public can see where any areas of concern are?

Do you personally have concerns about any of the other agencies that are under your control? There may be similar issues that we have not discovered because Audit Scotland does not have enough time, or a big enough team, to do a root and branch review of every public body, but I would hate to think that what we have seen at WICS might be happening elsewhere and that we would not know about that.

We know the obvious effect on people’s general health of waiting for longer to be seen and for treatment to start; clearly, it will be negative. Have we done any analysis of mortality rates in that respect? I am looking specifically at the numbers of those waiting for long periods of time—that is, over a year or over 18 months—and they are stark. In 2019, around 3,500 people in Scotland were waiting more than a year for out-patient treatment, and that figure is now up to 40,000, which is a massive increase.

As for the 18-month wait target for in-patient treatment, which is presumably for those with serious conditions, the number was only 486 previously—486 too many, it has to be said—but it is now up to 17,000. My suspicion and my worry are that not all of those people will make it to their treatment. Has there been any analysis of that?

That is obviously very sad. We are talking about numbers, but we are also talking about people passing away while waiting for treatment. If the incidence of that is increasing, that is clearly worrying for all of the Government and the Parliament.

One issue that we discuss often and which frequently comes up is that of situations arising in accident and emergency. In your report, you cover specific issues of overcrowding in A and E, ambulances queuing outside and people not being handed over within the one-hour target. An hour is quite a long time to be sitting in the back of an ambulance anyway. Is there any evidence that that target is being substantially exceeded? As politicians, we have access to anecdotal evidence, but is there any statistical or quantitative data to support that? What is the situation in A and E across Scotland?

It is very hard to identify which risk factor to address. I suppose that there are a number of such factors, one of which is the potential volume of people who go through the system, because it is the only option available. What work could be done to find out what percentage of those people would be immediately removed from the system if other options were available?

Another factor is the delays caused by a current shortage of staff on the ground, while a third is the throughput of people who, once they have presented to A and E, should be transferred somewhere else, but there is no somewhere else for them to go. The somewhere else is at capacity, too, so that creates a bottleneck in the system.

I presume that the answer is that all three risk factors are involved. Are there any specific areas where immediate action could be taken to alleviate the situation more quickly?

Perhaps I should declare an interest, convener, having gone through that process of getting a planned A and E appointment. Such appointments were news to me, but the approach seemed to work reasonably well.

In the interests of time, I will ask my final question, which is on appendix 3. I am new to the committee, but I am aware that you have produced previous reports on the NHS and made very specific recommendations to the Scottish Government. Appendix 3 contains nine key recommendations covering a wide range of areas for consideration. My analysis shows that, of the nine, five are in progress, limited progress has been made on three and no progress at all has been made on one; in other words, none of those recommendations has been completely implemented. Is that a normal state of affairs at this point? Without giving a personal opinion, are you content that the direction of travel is a good one? I am thinking in particular of the NHS recovery plan, which, although clearly important post the pandemic, has seen no progress. How have you reached that conclusion?

Is it inevitable that the health budget will reach 50 per cent of all Scottish Government spend? That sounds like a massive figure—perhaps one that the public is not even quite aware of sometimes. Could that be prevented?

I have a lot of questions, so I will rattle through rather than ask the whole panel to respond. I ask for brief responses.

That is a valid conversation. The reason why I raised the issue is that those of us sitting round the table, and the public who are watching, are absolutely right to be outraged by £400 boozy lunches and people flying first class for training courses.

Either you knew that there were issues but said that there were not any in the report, in which case the report was false, or you missed all those issues and, if that is the case, how could you have missed them when Audit Scotland found them?

Yes, but my question is not about any of that. My question is about your role and the role of the gentleman sitting to your right and the fact that, as two members of the board, you failed to identify any of the corporate governance issues in your annual report. Why?