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Audit Committee, 27 Feb 2007

27 Feb 2007 · S2 · Audit Committee

Item of business

Committee Reports (Responses)

Deacon, Susan Lab Edinburgh East and Musselburgh Watch on SPTV

In a sense, I am loth to prolong debate on this issue, which we have been considering for some time. I have one comment in response to the reply that we have received. For me, the letter reinforces a view that I expressed at our previous meeting. Although the examples that are given of improvements in services and service design support the fact that the consultant contract has had a positive impact, they also reinforce the question why this professional group requires such substantial changes in conditions for good practice to be levered. I will not take up the committee's time by going into detail, but I was interested, to say the least, to see the reference to the redesigned cataract pathway in Ayrshire and Arran. My colleague Ms Jamieson has left, but she might have a view on the matter and will know about the background. I am concerned that it required the changes that we have made to the consultant contract in order to lever such good practice. If the response answers one question, it raises more significant ones. As I said at our previous meeting, other staff groups in the health service—and, indeed, people in other sectors—could rightly ask why change of this scale and expense is required to improve practice. I am all for rewarding the medical profession effectively. There was a need for a massive overhaul of the contract because of the impact that that would have on recruitment and retention, which are vital. However, I was struck by how much of the response gives yet more examples of improvements that have been levered by the contract. I apologise for repeating myself, but that raises the much bigger question why the change was required to lever those improvements.