Committee
Finance and Public Administration Committee 06 June 2023
06 Jun 2023 · S6 · Finance and Public Administration Committee
Item of business
Public Service Reform Programme
Good morning, and thank you for joining us. Last week, we had interesting evidence from Police Scotland in which it was made clear that that body simply would not have been created had it not been mandated by Government. I want to ask you some perception questions about your world. In Scotland, with 5.5 million people, we have 14 territorial boards and five national boards, and there is duplication of human resources directors, information technology directors and finance directors. Have you and your equivalents had discussions about attempting to change the scale and the current organisational structure? I know that the British Medical Association has released a report on that, but have you looked at the issue or suggested some change with your face-off equivalents in other boards?
In the same item of business
The Convener
SNP
Welcome back to the second half of our meeting this morning. We now continue our evidence taking on the Scottish Government’s public service reform programme...
Claire Burden (NHS Ayrshire and Arran)
Good morning. As ever, there is a mixture with regard to NHS Ayrshire and Arran. Given the unique nature of our population, there are things that I can do wi...
The Convener
SNP
Last week, we heard evidence on the information technology side, which was not just about health, that all sorts of public bodies are fishing in the same poo...
Claire Burden
Absolutely. We currently have quite a low baseline in NHS Ayrshire and Arran, and we are putting in foundations. We are not seeking whistles and bells; we wa...
The Convener
SNP
You have mentioned a couple of times the number of people you have. The Argyll and Bute IJB is not here, but its population is 85,000, so it is an even small...
Claire Burden
Absolutely. There are regional and national networks over and above our territorial boards. The west of Scotland works as a region, and there will be opportu...
The Convener
SNP
One of the terms that we politicians hear from the public is “postcode lottery”, which I personally detest and which I think really means local decision maki...
Claire Burden
In our sub-specialties, there is a need for regional and national models. They are already in place for vascular cardiac services, in which people go to a sp...
The Convener
SNP
My final question was going to be aimed more at the health and social care partnership, but I will try it with you anyway. Your area covers three local autho...
Claire Burden
Without doubt, it would be easier to have one partner. There are four of us, and each of us is trying to deliver for our local population. The needs of peopl...
The Convener
SNP
That opens up a discussion on preventative spend, which is a huge area on which the committee has already spent a lot of time. I will restrain myself on that...
Michael Marra
Lab
You have talked a little about IT programmes, and I notice that in your submission you say that the work that you have been doing “starts us on the journey ...
Claire Burden
It has since been revised. My understanding is that the IT strategy was revised in 2022, and we are aligned with the commitment to move to a unified platform...
Michael Marra
Lab
Thank you. On reading your submission, I wondered about the scale of the change required. In the course of the committee’s inquiry, we have discussed the sh...
Claire Burden
I still think that it is conservative, but it is affordable. In the private sector, we would be looking at 3 per cent of budgets being dedicated to IT, where...
Michael Marra
Lab
I want to broaden that question out beyond the digital infrastructure to the delivery of health services across the whole board area, including where service...
Claire Burden
The software that comes with the upgrades just puts us in a completely different place. In each of our two acute hospitals, we do not have a bed board; bed m...
Michael Marra
Lab
On the broader issue of how you deal with a rapidly ageing population, are you advocating a technological approach to changing services instead of talking ab...
Claire Burden
The aims of this year’s plan are threefold. First, we have to address our bed-based care, which is the most expensive component in the delivery of care. We t...
Michael Marra
Lab
On workforce planning, you have said in your submission that you have “around 9,400” permanently contracted full-time staff. Is that correct?
Claire Burden
That figure waxes and wanes by about 400, but that is right.
Michael Marra
Lab
In some of the evidence that we have had so far, there has been a little bit of dubiety about the Government’s absolute position on managing the workforce. T...
Claire Burden
In the first instance.
Michael Marra
Lab
In the first instance?
Claire Burden
Until we can get into reform and dramatically change the way in which a hospital works, our ability to bring our head count down demonstrably and sustainably...
Michael Marra
Lab
So you think that your ability to meet any broader intent in that regard is limited until we get into reform. Is that a process that needs to be led more—wit...
Claire Burden
It is about our ability, as a health and social care system, to get into that more generally. Those in primary care are desperate to do more. If they were to...
Michael Marra
Lab
But you have had consistent budget deficits for the past six years, and perhaps longer, prior to the pandemic.
Claire Burden
Yes.
Michael Marra
Lab
What would headroom that allowed you to invest in that shift look like? Would it eliminate the deficit, reduce it or give you a surplus? Have you had any gui...