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Public Audit and Post-legislative Scrutiny Committee Thursday 10 December 2020 Session 5 © Parliamentary copyright. Scottish Parliamentary Corporate Body Information on the Scottish Parliament’s copyright policy can be found on the website - www.parliament.scot or by contacting Public Information on 0131 348 5000 Thursday 10 December 2020 CONTENTS Col. INTERESTS......................................................................................................................................................... 1 DECISION ON TAKING BUSINESS IN PRIVATE ....................................................................................................... 1 SECTION 22 REPORTS ....................................................................................................................................... 2 “The 2019/20 audit of NHS Tayside” ............................................................................................................ 2 “The 2019/20 audit of Social Security Scotland” ........................................................................................ 22 PUBLIC AUDIT AND POST-LEGISLATIVE SCRUTINY COMMITTEE 29th Meeting 2020, Session 5 CONVENER *Jenny Marra (North East Scotland) (Lab) DEPUTY CONVENER *Graham Simpson (Central Scotland) (Con) COMMITTEE MEMBERS *Colin Beattie (Midlothian North and Musselburgh) (SNP) *Neil Bibby (West Scotland) (Lab) *Bill Bowman (North East Scotland) (Con) *Alex Neil (Airdrie and Shotts) (SNP) *Gail Ross (Caithness, Sutherland and Ross) (SNP) *attended THE FOLLOWING ALSO PARTICIPATED: Stephen Boyle (Auditor General for Scotland ) Carole Grant (Audit Scotland) Leigh Johnston (Audit Scotland) Fiona Mitchell-Knight (Audit Scotland) Mark Taylor (Audit Scotland) CLERK TO THE COMMITTEE Lucy Scharbert LOCATION The Mary Fairfax Somerville Room (CR2) 1 10 DECEMBER 2020 2 Scottish Parliament Section 22 Reports Public Audit and Post-legislative “The 2019/20 audit of NHS Tayside” Scrutiny Committee 10:02 Thursday 10 December 2020 The Convener: I welcome our witnesses from Audit Scotland this morning. Stephen Boyle, [The Convener opened the meeting at 10:00] Auditor General for Scotland, is with us in the committee room; Fiona Mitchell-Knight, audit Interests director, audit services, and Leigh Johnston, senior manager, performance audit and best The Convener (Jenny Marra): Good morning, value, are appearing remotely. I give a special and welcome to the 29th meeting in 2020 of the welcome to the Auditor General; it is the first time Public Audit and Post-legislative Scrutiny that I have convened a meeting since he took up Committee. Before we begin, I remind members, his post and I offer him my warm congratulations. witnesses and staff that social distancing I understand that the Auditor General will make measures are in place in committee rooms and a brief opening statement. across the Holyrood campus. In addition, a face covering must be worn when moving around and Stephen Boyle (Audit General for Scotland): exiting or entering the committee room, although it Thank you for your introductory words, convener, can be removed once you are seated at the table and welcome back. in the committee room. Good morning, everybody. The sixth I also remind all those who are present to turn consecutive report on NHS Tayside updates the mobile devices to silent mode so that they do not committee on the progress that the board has affect the committee’s work. made against the concerns about financial performance and governance issues that featured Because of my return and membership in earlier reports. Today’s report sets out the changes, Anas Sarwar and Willie Coffey are no progress that NHS Tayside is making in meeting longer members of the committee. On behalf of its financial and performance targets and some of the committee, I thank them for all their work—in the risks that lie ahead. Willie’s case, for many years—on the committee and I thank Anas Sarwar for stepping in while I The external auditor gave an unmodified audit was on maternity leave. I am very grateful to them. opinion on the 2019-20 financial statements. She highlighted the board’s effective financial I welcome Gail Ross back to the committee. As management and on-going improvement in it is her first meeting, I ask Gail Ross to declare governance arrangements. In 2019-20, the board any relevant interests. delivered £26.3 million of savings but still required Gail Ross (Caithness, Sutherland and Ross) additional financial support of £7 million from the (SNP): Thank you, convener. I was a councillor on Scottish Government. The current three-year Highland Council until 2016 and I received financial plan from 2020-21 aims to achieve break remuneration for that. If I need to, I will declare even each year, but significant financial savings other interests that are relevant to the subjects will need to be made to achieve that. that come up as we go along. The Covid-19 pandemic has had a significant The Convener: Thank you. impact on the focus and priorities of NHS Tayside and the effect of that on its financial position and savings targets have not yet been reflected in its Decision on Taking Business in financial plans; it now needs to do so. Private Overall service performance improved last year, but long-standing concerns about mental health services resulted in a highly critical independent 10:01 report on mental health services in Tayside being The Convener: Item 2 is to decide whether to published in February 2020. NHS Tayside also take items 5, 6 and 7 in private. Do any members needs to implement its plan to improve mental object? health services. There are no objections, so I confirm that we NHS Tayside is making progress under its new agree to take those items in private. executive leadership team, but there are still risks ahead. The achievement of a balanced financial position depends on the successful delivery of a 3 10 DECEMBER 2020 4 transformation programme that reflects its new pandemic to detract from the work that we were and evolving priorities. doing before the pandemic? Although the report is before us today and was published only last week, I am joined today by Fiona Mitchell-Knight, the a lot of the statistics and figures predate the appointed auditor, and Leigh Johnston. Between pandemic. The mental health vacancy figures are us, we will look to answer your questions. from November 2019, which is more than a year The Convener: I will kick off the questioning on ago. Before your colleagues come in, can you tell the section 22 report. This is the sixth year that me why the progress of transformation was slow Audit Scotland has had to use its emergency before March? powers to write a section 22 report on NHS Stephen Boyle: There are a number of different Tayside, and I think that this is the eighth year that aspects to that. I thought carefully about the NHS Tayside has needed extra cash from the section 22 report for NHS Tayside this year very Scottish Government. The report makes it clear much for the reason that you outlined: the fact that that, although progress is being made, there has been a history of statutory reporting on transformational progress has been “slow”. The NHS Tayside. Many of the factors in the report NHS Tayside board acknowledges that the pace existed pre-Covid, so it is not sufficient to say that needs to increase. In your opinion, why has the the pandemic, in itself, overrides the pace been slow? organisational challenges that existed previously. Stephen Boyle: I will start and then invite Fiona We thought that it was necessary to update the Mitchell-Knight to augment my remarks. Our committee on the progress that the organisation sense is that NHS Tayside was making progress. had made. That was our judgment. As the chief You are right that that has been long in the executive of the board has said, the pace needs to making, given the number of reports that my increase. The report documents the continuing predecessor chose to make on the challenges that need to tackle the organisation’s cost base and the board faced over many years, including those the progress that is being made on aspects of its relating to its financial position. The reasons governance arrangements. Those challenges behind those challenges are well documented. existed, but progress was being made. It is now The committee is, of course, very familiar with the clear that, because of the impact of the pandemic, board’s challenges in delivering a balanced there are elements of a game changer. financial position and tackling governance issues. There are also the underlying cost issues of its In many respects, NHS Tayside has pivoted organisation. from a transformation programme and now identifies its remobilisation programme as its new Until the pandemic struck, the organisation was plan for the future. As we note in the report, it now making progress. That is borne out by the fact that needs to move quickly. All NHS organisations will the board reported that some of its service need a post-Covid plan, but NHS Tayside in performance indicators were broadly in line with particular needs to show its progress. national performance targets and, in some cases, above those targets. That pointed to an The Convener: You talked about cost base and organisation that was making progress, and then governance. Why do you think that progress on the pandemic struck. those two specific elements was slow prior to March? I understand that progress will have As the convener touched on, our report notes slowed since then—there is no question about that the board still has to make significant financial that—but why was progress in those areas not savings in order to deliver financial balance within faster before March? the next three years. To do so in the context of the pandemic, it now needs to rapidly increase the Stephen Boyle: I will touch on the cost base pace and, in effect, deliver a new plan that shows and then ask Fiona Mitchell-Knight to say a bit how NHS Tayside will look in the future. more about some of the specifics of the Significant challenges remain, albeit that we say governance and the progress that has been made.

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