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Health and Community Care Committee HEALTH AND COMMUNITY CARE COMMITTEE Wednesday 3 May 2000 (Morning) £5.00 Parliamentary copyright. Scottish Parliamentary Corporate Body 2000. Applications for reproduction should be made in writing to the Copyright Unit, Her Majesty’s Stationery Office, St Clements House, 2-16 Colegate, Norwich NR3 1BQ Fax 01603 723000, which is administering the copyright on behalf of the Scottish Parliamentary Corporate Body. Produced and published in Scotland on behalf of the Scottish Parliamentary Corporate Body by The Stationery Office Ltd. Her Majesty’s Stationery Office is independent of and separate from the company now trading as The Stationery Office Ltd, which is responsible for printing and publishing Scottish Parliamentary Corporate Body publications. CONTENTS Wednesday 3 May 2000 Col. BUDGET PROCESS................................................................................................................................. 819 ORGANISATIONS (CONTACTS) ................................................................................................................. 869 INVITATION ........................................................................................................................................... 869 BUDGET PROCESS (REPORT) .................................................................................................................. 870 HEALTH AND COMMUNITY CARE COMMITTEE 11th Meeting 2000, Session 1 CONVENER *Mrs Margaret Smith (Edinburgh West) (LD) DEPU TY CONVENER *Malcolm Chisholm (Edinburgh North and Leith) (Lab) COMMI TTEE MEMBERS *Dorothy-Grace Elder (Glasgow ) (SNP) *Mr Duncan Hamilton (Highlands and Islands) (SNP) Hugh Henry (Paisley South) (Lab) Margaret Jamieson (Kilmarnock and Loudoun) (Lab) *Irene Oldfather (Cunninghame South) (Lab) *Mary Scanlon (Highlands and Islands) (Con) Dr Richard Simpson (Ochil) (Lab) *Kay Ullrich (West of Scotland) (SNP) Ben Wallace (North-East Scotland) (Con) *attended WITNESSES John Aldridge (Scottish Executive Health Department) Pat Daw son (Scottish Association of Health Counc ils) Sarah Melling (Scottish Executive Health Department) Neil McConachie (Board General Managers Group) CLERK TEAM LEADER Jennifer Smart ASSISTANT CLERK Irene Fleming LOC ATION Committee Room 2 819 3 MAY 2000 820 Scottish Parliament objectives that we include in the departmental report cover the full range. Health and Community Care I apologise for a typographical error. On page 48, footnote 3 of table 4.1, which refers to pre- Committee natal illness specific grants, should read “the above figures exclude mental-illness specific Wednesday 3 May 2000 grants”. The Convener: There are those of us who say (Morning) that you would have to be mad to have children, but I think that that is taking things a bit too far. [THE CONVENER opened the meeting at 09:37] We will try to restrict our questions to the presentation of the figures, the technical aspects Budget Process of the budget and the figures that you have presented to us. We might query the way in which aims, objectives and targets and so on are thrown The Convener (Mrs Margaret Smith): Good about in a haphazard way at points. There are morning everybody. We are here to investigate the questions about why issues are raised at one point Executive’s budget. The First Minister and the when they might fit better elsewhere. We will raise Executive have called upon the parliamentary a number of such presentational issues with the committees, and indeed the whole population of Finance Committee. We are aware that the Scotland, to examine the budget. The Health and document is for consumption by the population at Community Care Committee must consider the large—not that I am suggesting that you would health budget in particular. have seen 20 people reading it on the bus today— Do the witnesses intend to give a brief and should be as transparent and accessible as presentation on the figures, or would they prefer to possible. Because of time constraints, we will not go straight to questions? touch on a number of issues today but will comment on them at another time. John Aldridge (Scottish Executive Health Department): I have not prepared a presentation, Mary Scanlon (Highlands and Islands) (Con): but I would like to clarify a couple of points. We are supposed to have an informed and reasoned input to the budget process, as are the The Convener: Perhaps you could give us an people of Scotland. To enable us to do that, you explanation of what you do before we begin our need to speak a language that we—and the questions. people of Scotland—understand, and to present John Aldridge: Thank you. I am the director of the information in a way that allows us to make finance in the Scottish Executive health informed decisions about priorities. department. On my right is Mrs Sarah Melling, I have a copy of the Highland Health Board who is head of the financial monitoring and control health improvement programmes and trust division of my directorate. implementation plans. The long and boring five- The departmental report that you have before year plan and ten-year plan documents are of you is the descendant of a long line of documents great interest, but how do we know that they are that goes back to something called the “Scottish following the Scottish Executive’s spending plans, Commentary on Public Expenditure”; it seeks to commitments, aims and objectives? I see those in explain spending across the Scottish Executive’s the HIPs and TIPs, but I do not see the equivalent block of expenditure. It tries to adopt a consistent information in your document, so my first point is, approach across all programmes, which means where is that information? that, occasionally, compromises must be made My second point follows on from that and gives since what would be ideal for one programme you an example of why we need that information. might not be ideal for another. Last week, we had two excellent submissions that The targets in the health and community care made it clear to me that we must put more chapter have been picked to tie in with the resources into preventive care. On pages 56 and commitments that were set out in “Making it work 60 of “Investing in You”, where do I see that we together”, the Executive’s programme for could shift resources from x to y to put more government, which are the most important emphasis on preventive care? The figures are not commitments that the Executive has made. It is given to us in a way that reflects the aims and clear that the programme for government objectives, or that allows us to shift resources to commitments do not cover the health department’s meet the priorities that we feel are not being whole range of activity. We might want to revisit resourced adequately. that in future to ensure that the targets, aims and 821 3 MAY 2000 822 09:45 preventing ill health and improving health. Much of John Aldridge: Thank you, convener. I will deal the expenditure that goes to health boards is also with those questions in turn. used for that purpose, to meet local priorities. Many health boards have imaginative and positive The first was about the Scottish Executive initiatives to tackle those issues. equivalent of HIPs and TIPs, and where to find the Mary Scanlon: I did not really want the 42nd or national guidance that sets the scene for th development of those programmes and plans. 99 announcement about the £26 million that That guidance comes from a number of depends on people smoking more cigarettes to documents. There is the “Priorities and Planning have more preventive health care. Guidance for the National Health Service in You mentioned a number of documents that Scotland”, which is produced from time to time. provide the background to the budget figures, in The most recent one was produced the year particular the priorities and planning guidance before last, and was reinforced last year, following document that is two years old. I come back to my the election of the new Administration. It sets out initial point: this consultation is open not just to the the priorities for the health service across committee, but to the people of Scotland. Do you Scotland, and identifies the three clinical priorities expect those people, and every community council of cancer, coronary heart disease and mental in the country, to get your plethora of glossy illness and the new focus on children’s services. It documents and examine all the spending also sets out the broad areas in which health announcements and re-announcements on boards and trusts must direct their activity, which hypothecated taxation? Do you expect them to are towards developing primary and community plough through the document on priorities and care, restructuring hospital services and, planning guidance to find out whether their health crucially—the point that you mentioned in your board is spending their money properly? You said second question—improving health and that things could be done better; this is an preventing ill health. opportunity for us to do that. How can the The priorities and planning guidance document information be presented to us, and to the people sets the guidelines, or the broad parameters, of Scotland, in an open, transparent, honest and within which HIPs and TIPs should be developed. easy-to-understand way that will allow us to have Successive Administrations have taken the view an informed input? that it is important to leave a fair amount of John Aldridge: I certainly have no quarrel with discretion to the health boards and trusts to take
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