Scottish Government Draft Budget 2013-14 Thank you for letter of 2 November 2012 which included a request for further information, helpfully notified to us earlier in the week by your Committee Clerks, together with a range of additional questions of which there was not sufficient time to ask during the meeting on 30 October 2012. I have provided a detailed response to your request for additional information which is included within two annexes as follows:- Annex A: reply to the questions contained within your letter of 2 November 2012 advised previously by Committee Clerks on 31 October 2012; and Annex B: reply to the further questions suggested by members that are annexed in your letter of 2 November 2012 You will appreciate that this information has been drawn together at short notice so if there is anything more you need please do let me know. My officials and I are keen to support the Health and Sport Committee in providing the detailed information it requires in supporting the Scottish Parliament‟s essential scrutiny of the Government‟s Draft Budget plans for 2013-14. ALEX NEIL 1 ANNEX A i. Information on filling of nursing vacancies Statistics The last published figures reported on vacancies within NHS Scotland as at 30th June 2012 and formed part of ISD Workforce statistics released on 30th August. The statistics recorded 984 (wte) vacancies, against a total Nursing & Midwifery workforce of 56,183.7 (wte), representing 1.75% of the total. In relation to the 984 vacancies, 72.4% had been vacant for less then 3 months. 20.3% of the vacancies had been vacant for 3 months or more. 7.3% of the vacancies are recorded as unknown in terms of duration. This last category is currently the subject of enquiry with ISD. Process All vacancies require financial approval before they can be released for filling, and because the NHSS no compulsory redundancy policy means that any staff displaced are entitled to be given the first opportunity for new vacancies. All vacancies are required to go through the redeployment process, and if this does not identify a suitable candidate it will then progress to internal than external advert. ii. Data on healthy male life expectancy At the Health and Sport Committee on 2 October 2012, John McLaren quoted figures stating that between 2006 and 2009, male healthy life expectancy in England had risen by 3 years, in Wales by 4 years, but fallen by one and a half years for Scotland. The figures he referred to were published by ONS in their statistical bulletin “Health Expectancies at birth and at age 65 in the United Kingdom, 2008- 2010” which was published on 29 August 2012. The figures he referred to were from table 5. See link: http://www.ons.gov.uk/ons/dcp171778_277684.pdf At face value, the figures he quoted are correct. Male HLE in Scotland was 61.2 years in 2005-07 and 59.8 in 2008-10, a difference of 1.4 years. However, the footnotes to the table indicate that this difference is not statistically significant (and neither is the difference for Wales). HLE estimates are based on survey data and the robustness of the estimates relies on the size of the sample whereby the larger the survey sample, the more robust the estimates will be. The ONS publish 95% confidence intervals around their estimates to provide information on the robustness of an estimate. The confidence interval around the 2008-2010 estimate of 59.8 years is 58.0 to 61.6 years. In layman‟s terms this means that if they conducted the survey 100 times and calculated HLE each time, they would expect to get an estimate between 58.0 and 61.6 years 95 times out of 100. 2 As this confidence interval overlaps with the 2005-07 estimate, the difference is not statistically significant. This does not mean that the data is wrong, just that it does not allow us to identify such small changes year on year. This is a consistent issue with survey data. Unless we ask the questions of everyone in the country, our estimates will always be subject to sampling variation. The HLE measure in the National Performance Framework is a long-term measure and we do not expect to see large changes on an annual basis. Our assessment of whether it is improving is based on the long-term trends rather than year on year fluctuations. iii. Detailed analysis of £800m maintenance backlog Attached is a breakdown of the backlog maintenance by risk category. Low Medium Significant High Total NHS Board Risk Risk Risk Risk Backlog £m £m £m £m £m NHS Ayrshire &Arran 8.8 7.1 33.0 14.4 93.3 NHS Borders 4.5 - - - 4.5 NHS Dumfries and Galloway 5.9 20.8 21.3 10.6 58.6 NHS Fife - 23.3 37.5 2.3 63.1 NHS Forth Valley - - - 18.9 18.9 NHS Grampian 87.2 18.1 44.4 14.8 164.5 NHS Greater Glasgow and Clyde 53.5 57.0 44.4 20.8 175.7 NHS Highland 15.2 26.6 22.9 14.2 78.9 NHS Lanarkshire 5.8 10.0 22.8 88.4 127.0 NHS Lothian - 59.0 45.0 36.0 140.0 NHS Orkney - 2.4 2.9 17.5 22.7 NHS Shetland 0.2 0.2 4.1 1.9 6.4 NHS Tayside - 27.0 11.2 0.4 38.6 NHS Western Isles 1.8 0.5 0.4 0.0 2.7 Territorial Boards 192.9 272.0 289.8 240.2 994.8 National Waiting Times Centre 0.3 0.2 - - 0.5 State Hospital - - - - - NHS National Services Scotland - - - 12.3 12.3 NHS Education for Scotland 0.1 - - - 0.1 Healthcare Improvement Scotland 0.1 0.0 - - 0.1 NHS Health Scotland 0.4 - - 0.4 Scottish Ambulance Service 1.1 0.2 0.1 - 1.4 Special Health Boards 2.0 0.3 0.1 12.3 14.7 Total 194.8 272.3 289.8 252.5 1,009.5 iv. Details of cost of equipment replacement 3 Based on NHS Board Local Delivery Plan and centrally funded equipment programmes the planned equipment spend for 2012-13 is £63 million, £69.5 million for 2013-14 and £76.3 million for 2014-15. v. Equal pay progress Summary Position Equal Pay claims remain live within the NHS, however no claims settled to date and no liability admitted. Recent decisions through tribunals have served to reduce both the scope and timeframe of any possible claim. The volume of cases is likely to reduce significantly as a result of recent tribunal decisions. It is still not possible to quantify the potential value of any claims as comparator information on grades has not been provided. No financial impact is therefore quantified or anticipated at this stage. Detailed Position Following an Employment Tribunal hearing in Scotland in November 2011 the NHS in Scotland was successful in establishing that any case that was raised against the Trust predecessor of the NHS Board had to have been brought within 6 months of Trust dissolution. This ruling was appealed, but a recent Judgment by an Employment Appeals Tribunal (Donnelly & Foley v Greater Glasgow Health Board) found in favour of the Health Board and upheld this position. This means that the vast majority of the NHS Scotland claimants will now have the back pay period for their claim, if successful, limited to a six month period namely 1 April 2004, when their Trust was dissolved and 1 October 2004 when Agenda for Change was introduced. Overall the number of claims is reducing and the position remains that claims still do not provide sufficient detail about the comparator jobs to allow an estimate to be made of the likelihood of the success of the claims or of any financial impact that they may have. The NHS Scotland Central Legal Office and Equal Pay Unit are continuing to monitor the progress of all equal pay claims in NHS Scotland as well as developments relating to NHS equal pay claims elsewhere that may further inform the position. They continue to advise that it is not possible to provide any financial quantification at this stage because of the lack of information available. On the basis of their view the appropriate accounting treatment is to disclose the claims as a contingent liability that is not possible to quantify. This is a view which is discussed with Audit Scotland in advance and endorsed by them. SGHSCD and the Central Legal Office will again meet with Audit Scotland around February 2013 to discuss disclosure in the 2012- 13 annual accounts, but it is not expected to change from the position that has been agreed since 2009-10 that it is an unquantifiable contingent liability. 4 Birmingham Case The Health and Sport Committee specifically asked about the recent ruling in England on the Birmingham case, but this will have no impact on the current equal pay cases in Scotland. This is because any appeals relating to this ruling would need to have been lodged within 5 years, but as the current equal pay cases relate to a period before the introduction of Agenda for Change (ie 2004) then time period has expired. vi. Evaluation of the change fund (not yet complete) There is a commitment to monitor and report on progress of the use and impact of Change Fund resources. However it's important to ensure that monitoring and evaluation requirements are proportionate and not excessively burdensome to partnerships (i.e.