Committee News Release
CAU 006/2004
Friday 2 July, 2004
AUDIT COMMITTEE REPORTS ON NHS OVERVIEW AND STAFF PAY MODERNISATION
A report published today by the Parliament’s Audit Committee has questioned whether the Scottish Executive’s Health Department will be able to determine if new NHS staff contracts in Scotland are leading to improved patient services.
The Committee reports that the Scottish Executive’s Health Department is not in a position to measure whether the new contracts will deliver their predicted benefits or whether services will improve as a result.
Evidence presented to the Committee paints a picture of mounting financial pressures for Scotland ’s NHS Boards - despite additional funding. One of the most significant cost pressures is pay modernisation, which introduces new contracts for NHS staff.
The Committee’s findings include:
- The Committee is concerned that the Health Department does not have a clear vision of how and when service re-design is going to be achieved, other than through pay modernisation;
- The Committee is also concerned that the full potential of new contracts to effect positive change in Scotland may not have been exploited and may not sufficiently reflect the needs and circumstances of the NHS in Scotland;
- The Committee considers that improvements in information are essential if the benefits of increased investment are to be accurately monitored and reported on. Information systems have not kept up with changes in clinical practices. This runs the risk of acting as a perverse incentive for the NHS if it continues to be measured on out-of-date practices.
- No targets have been set for efficiency savings arising from the recent NHS re-organisation, the Health Department should do more to ensure that NHS Boards are releasing savings by removing duplication of functions and reducing management overheads;
- Spreading good practice in order to achieve best value appears limited and some NHS Boards are failing to deliver predicted savings.
- It will remain difficult to drive change and to foster a culture where cost recovery plans are taken seriously if the tradition of one-off payments continues;
Committee Convener Brian Monteith said:
“Pay modernisation is clearly expected to realise important patient benefits and encourage the re-design of services to make better use of resources.
“Yet the Scottish Executive’s Health Department lacks robust information on the costs of pay modernisation and the patient benefits which are expected to result appear not to have been determined in all cases.
“At the same time, NHS information systems have not kept up with changes in clinical practice and improvements which are essential if the benefits of increased investment are to be monitored and reported. The Committee has therefore recommended that the Executive’s Health Department set out how and when it plans to overhaul information collection.
“Over all, our Committee is not convinced that the Health Department is able to ensure that value for money will be delivered from the extra investment in the NHS in Scotland .”
To sum up, Brian Monteith added:
“In light of our findings the Committee concluded that the Health Department is not in a position to measure whether planned efficiencies will be delivered; whether the benefits of pay modernisation will be achieved and whether the services to patients will improve as a result.”
Background notes:
The Audit Committee’s report is available on the Scottish Parliament’s website.
The report sets out the Committee’s findings and recommendations in relation to its inquiry into the report of the Auditor General for Scotland (AGS) entitled:
“Overview of the National Health Service in Scotland 2002-03” AGS/2003/12. This report is available online at: http://www.audit-scotland.gov.uk
The Audit Committee held three evidence sessions on 16 March, 30 March and 27 April and took evidence from Lothian NHS Board, NHS Borders, NHS Ayrshire and Arran and the Scottish Executive Health Department.
In undertaking the inquiry the Committee’s primary concern was to examine whether and how patient services will improve as a result of increased spending on the NHS in Scotland and how the value for money being provided by the funding increases will be demonstrated.
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