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  AU/S2/05/R1

1st Report, 2005 (Session 2) 

The 2003/04 Accounts of NHS Argyll and Clyde

CONTENTS  

REMIT AND MEMBERSHIP

THE REPORT 

ANNEXE A – EXTRACTS FROM THE MINUTES

Extract from the Minutes – 18th Meeting 2004 (Session 2)
Extract from the Minutes – 20th Meeting 2004 (Session 2)
Extract from the Minutes – 22nd Meeting 2004 (Session 2)
Extract from the Minutes – 23rd Meeting 2004 (Session 2)
Extract from the Minutes – 24th Meeting 2004 (Session 2)
Extract from the Minutes – 1st Meeting 2005 (Session 2)
Extract from the Minutes – 2nd Meeting 2005 (Session 2)
Extract from the Minutes – 3rd Meeting 2004 (Session 2)
Extract from the Minutes – 6th Meeting 2004 (Session 2)

ANNEXE B – ORAL EVIDENCE AND ASSOCIATED WRITTEN EVIDENCE

WRITTEN EVIDENCE

Letter from Ian Gordon Head of Health Department and Chief Executive, NHS Scotland (Acting) to the Clerk
Letter from the Clerk to Mr Neil Campbell, Chief Executive, NHS Argyll and Clyde
Submission from NHS Argyll and Clyde

24th Meeting 2004 (Session 2), 21 December 2004

ORAL EVIDENCE

Mr Neil Campbell, Chief Executive, NHS Argyll and Clyde
Mr James Hobson, Director of Finance, NHS Argyll and Clyde
Mr David Meikle, Divisional Director, NHS Argyll and Clyde

SUPPLEMENTARY WRITTEN EVIDENCE

Submission from NHS Argyll and Clyde
Letter from Dr Peter Collings, Director of Performance Management and Finance Scottish Executive Health Department to the Clerk
Letter from Mr Neil Campbell, Chief Executive, NHS Argyll and Clyde to the Clerk
Submission from NHS Argyll and Clyde

1st Meeting 2005 (Session 2), 11 January 2005

ORAL EVIDENCE

Mr John Aldridge, Scottish Executive Finance and Central Services Department
Mr Trevor Jones, Former Head of Scottish Executive Health Department and Chief Executive of NHS Scotland


SUPPLEMENTARY WRITTEN EVIDENCE

Letter from Dr Kevin Woods, Head of Scottish Executive Health Department and Chief Executive of NHS Scotland to the Clerk
Submission from Scottish Executive Health Department

2nd Meeting 2005 (Session 2), 25 January 2005

ORAL EVIDENCE

Dr Kevin Woods Head of the Scottish Executive Health Department and Chief Executive of NHSScotland
Dr  Peter Collings, Director of Performance Management and Finance, Scottish Executive Health Department
Ms Carmel Sheriff, Head of Performance Management- West Boards
Mrs Julie McKinney, Finance Manager- West Boards

SUPPLEMENTARY WRITTEN EVIDENCE

Letter from Dr Kevin Woods, Head of Scottish Executive Health Department and Chief Executive of NHS Scotland to the Clerk
Letter from Mr Neil Campbell, Chief Executive, NHS Argyll and Clyde to the Clerk
Submission from NHS Argyll and Clyde
Letter from John Aldridge, Finance Director to the Clerk

ANNEXE C – OTHER WRITTEN EVIDENCE

Remit and membership 

Remit:

1. The remit of the Audit Committee is to consider and report on-

(a) any accounts laid before the Parliament;
(b) any report laid before or made to the Parliament by the Auditor General for Scotland; and
(c) any other document laid before the Parliament concerning financial control, accounting and auditing in relation to public expenditure.

2. No member of the Scottish Executive or junior Scottish Minister may be a member of the Committee and no member who represents a political party which is represented in the Scottish Executive may be convener of the Committee.

(Standing Orders of the Scottish Parliament, Rule 6.7)

Membership:

Mr Brian Monteith (Convener)
Susan Deacon
Robin Harper
Margaret Jamieson
George Lyon
Mrs Mary Mulligan
Mr Andrew Welsh (Deputy Convener)

Committee Clerking Team:

Clerk to the Committee

Shelagh McKinlay

Senior Assistant Clerk

David McLaren

Assistant Clerk

Clare O'Neill

The 2003/04 Accounts of NHS Argyll and Clyde

The Committee reports to the Parliament as follows—

INTRODUCTION

1. This report sets out the Committee’s findings in relation to the Auditor General for Scotland’s (AGS) report entitled “The 2003/04 Audit of Argyll and Clyde Health Board.”

Remit

2. At its meeting on 16 November the Committee agreed the following remit for this inquiry:

In considering and reporting on the AGS section 22 report on the accounts of NHS Argyll and Clyde the Committee will examine:

  • Financial and wider management practice at NHS Argyll and Clyde ; and
  • The way in which the Scottish Executive Health Department supports and monitorsthe performance of NHS Argyll and Clyde.

Evidence

3. The Committee held three oral evidence sessions on 21 December 2004, 11 January 2005 and 25 January 2005. The following witnesses gave evidence to the inquiry:

21 December 2004 - Mr Neil Campbell, Chief Executive, Mr James Hobson, Director of Finance and Mr David Meikle, Divisional Director, NHS Argyll and Clyde.

11 January 2005 - Mr Trevor Jones former Head of the Scottish Executive Health Department and Chief Executive of the NHS in Scotland, and Mr John Aldridge, Finance Director, Finance and Central Services Department Scottish Executive and former Director of Performance Management and Finance at the Scottish Executive Health Department.

25 January 2005 – Dr Kevin Woods, Head of the Scottish Executive Health Department and Chief Executive of the NHS in Scotland, Dr Peter Collings, Director of Performance Management and Finance, Mrs Julie Mckinney, Finance Manager West Boards and Ms Carmel Sheriff, Head of Performance Management – West Boards, at the Scottish Executive Health Department.

Written evidence received by the Committee can be found at Annexe B.

Findings and Recommendations

4. The Committee’s main findings and recommendations are set out at Appendix A.

NHS ARGYLL AND CLYDE PRIOR TO DECEMBER 2002

5. The Committee considered evidence on the performance of NHS Argyll and Clyde prior to December 2002 when the four Chief Executives responsible for NHS services in the area resigned their posts.

6. Their resignations followed the publication of the report by the Independent Support Team appointed by the then Minister for Health and Community Care.1

7. Having considered the report of the Independent Support Team along with oral and written evidence from witnesses, the Committee considers that prior to December 2002, there was a significant failure of management at NHS Argyll and Clyde over a period of years.

8. This management failure was evident in:

  • Savings plans not being achieved;
  • Service developments costing more than planned ;
  • Staffing levels continuing to rise despite financial problems;
  • Fragmented relationships between the Board and the Trusts;
  • Long-term over reliance on non-recurring funding which masked the underlying deficit ; and
  • The failure to redesign services, particularly in community care and long term care services, to provide better quality clinical care and bring the cost base in line with allocations.2

9. Financial problems in NHS Argyll and Clyde have been exacerbated by the over-reliance on non-recurring monies to mask recurring deficits. The Committee has consistently warned against the inappropriate use of non-recurring monies. This is an issue which the Committee will address again in its forthcoming NHS Financial Overview Report.

FINANCIAL PLANNING AND CLINICAL STRATEGY SINCE DECEMBER 2002

NHS Argyll and Clyde Financial Plan

10. The financial plan drawn up by the new management team at NHS Argyll and Clyde would lead to in-year financial balance being achieved in 2007/08 – at which point the accumulated deficit would be £73m (having peaked earlier at £78m). (Cols 888 and 889) (The auditor’s report stated that, on the latest projections at the time their report was produced, the cumulative deficit would approach £100m (£94m) by 2007/08.)3 While the financial plan has been subject to revision since December 2002, NHS Argyll and Clyde have continued to maintain that in-year financial balance should be achieved in 2007/08.

11. Despite a cycle of discussion which involved 22 meetings and further significant informal contact the Board’s five year financial plan has not yet been agreed with the Department.

12. Indeed, the Committee received conflicting evidence on whether the Board’s financial starting position was agreed following the appointment of the Interim Management Team. 4

Why the Financial Plan Was Not Agreed

13. Mr Jones and witnesses from SEHD gave evidence to the Committee on why they did not believe it was appropriate to sign off the Board’s financial plan. SEHD believed that the in-year deficit needed to be eliminated more quickly than proposed by the Board, partly to prevent the cumulative deficit from rising further. 5

14. In evidence to the Committee Mr Jones contrasted NHS Argyll and Clyde’s approach with that of other NHS Boards which had been facing financial difficulties, (specifically NHS Lanarkshire and NHS Tayside), and which had achieved financial recovery more quickly. (Cols, 933, 936)

15. However, witnesses from NHS Argyll and Clyde made it clear that, in their view, in-year balance could not be achieved more quickly without unacceptable detriment to services. Mr Campbell confirmed in evidence that the independent support team advised the then Minister for Health and Community Care that financial balance should be recovered over a period of five years. 6

16. NHS Argyll and Clyde emphasised their desire to ensure that future savings were made on a recurring basis and that the actions needed to achieve such savings, in particular service redesign, would take more time to implement. (Cols 878-879, 901, 903)

17. NHS Argyll and Clyde also clearly stated that the Board is not able to repay the accumulated deficit alone. (Cols 889, 899, 902) Dr Collings stated in evidence that the priority was for the in-year deficit to be eliminated as quickly as possible and that when a plan for achieving in-year balance had been agreed, the Department and the Board could consider a range of non-recurring ways to eliminate the accumulated deficit. (Col 1002)7

Analysis of the Financial Plan

18. Mr Campbell set out the management team’s “road map” for action which covers four main areas;

  • Achieving financial balance;
  • The modernisation of clinical services;
  • Development of a new corporate organisation and structure; and
  • “To Keep the Show on the Road” – i.e. to continue to provide high quality services throughout the period of change (Col 874)

19. SEHD, Mr Jones and Mr Aldridge provided the Committee with general evidence of the way in which the Department analyses and evaluates Boards’ financial plans8 - including taking account of the “need to continue to provide services at an appropriate level”. (Col 935)

20. In addition, in evidence considered by the Committee in respect of its inquiry into the AGS report entitled “Overview of the financial performance of the NHS in Scotland 2003/04” the Department stated, “ it has become increasingly apparent that the financial data supplied by Boards is not of sufficient quality and coverage to allow the required level of analysis and monitoring.” 9 The Committee wishes to note that this is a cause for concern, although members welcome the Department’s candour as demonstrating its commitment to improve matters.

NHS Argyll and Clyde Clinical Strategy

21. Since December 2002 there have been ongoing efforts within NHS Argyll and Clyde to agree and implement a clinical strategy to modernise and improve services for people in the area. Under the Board’s’ financial plan major service redesign (which is dependent on the clinical strategy) is to release £25m of a total saving of £35m to the recurring cost base. (Col 903)

22. However, the clinical strategy has not yet been costed. This poses questions about how confident the Board can be that this £25m saving will be achieved. The Auditor’s annual report to NHS Argyll and Clyde also recorded that there is a significant risk that that the savings targets in the recovery plan will not be achieved. 10

FINANCIAL PLAN AND CLINICAL STRATEGY: FINDINGS AND RECOMMENDATIONS

23. The new management team has made good progress in the development of a new corporate organisation and in continuing to provide services to the local population in extremely difficult circumstances. The Committee notes for example that performance against national targets on waiting times and delayed discharges was strong. The team has also achieved significant savings.11

24. However, the Committee is concerned at the very serious risks that remain, namely that:

  • Savings are not achieved;
  • The cumulative deficit continues to grow; and
  • The mounting financial problems facing the Board affect its ability to maintain services.

25. These risks are closely linked with the failure to agree a financial plan with SEHD and the lack of a fully costed clinical strategy.

26. The Committee is at a loss to understand;

  • The failure to agree the financial plan; and
  • The time taken to provide even indicative costs in relation to the clinical strategy.

Agreement of the Financial Plan: Findings and Recommendations

27. The Committee does not doubt the genuine desire of both parties to reach agreement on the financial plan. Failure to agree the plan has led to difficulties for both the Board and SEHD. Yet despite the clear incentives for the plan to be agreed this has not happened.

28. Without an agreed financial plan;

  • The Board’s ownership of the plan may diminish, increasing the likelihood of slippage and increasing the deficit;
  • The Board is unable to move forward with significant strategic change necessary to improve services and live within budgets; and
  • The Department cannot hold the Board to account effectively for their performance in managing the financial position.

29. The relationship between the Department and the Board has therefore proved ineffective in resolving this fundamental issue. The Committee notes the lack of continuity in the personnel representing the Department at the meetings to agree the plan and considers that this was unhelpful in seeking agreement on the plan.

30. The collective failure of the Department and the Board to agree a financial plan over this period is unacceptable. The situation must not be allowed to persist or to happen again in respect of this or any other NHS Board.

31. The Board and the Department must take urgent action to agree the financial plan. Both parties must agree that the plan is realistic and achievable . The Board and the Department must also agree how the cumulative deficit is to be addressed.

32. The Committee considers that poor information and in particular a lack of shared understanding in relation to costs within NHS Scotland contributed significantly to the failure to agree the financial plan. However there were other factors at play.The Committee recommends that SEHD examine what should be done to ensure that such disagreements are more successfully and speedily resolved.

33. The Committee also recommends that, in future, the level of agreement between the Board and the Department as to a Board’s starting financial position, and in particular the level of any deficit, should be specifically recorded.

Analysis of the Financial Plan: Findings and Recommendations

34. The Board presented a reasoned case as to why financial recovery should not be achieved prior to 2007/08. However, evidence from SEHD did not satisfactorily set out the analysis which underpins its assertion that financial recovery could be achieved more quickly without risk to clinical services. The Committee does not consider that a high level comparison with other Boards who have experienced financial difficulties is a sufficient assessment.

35. The Committee concludes that the Department is not able to demonstrate that it has the information and capacity necessary to undertake proper analysis and evaluation of the Board’s financial recovery plan .

36. The Committee recommends that the Department review;

  • the financial data submitted by Boards; and
  • its own practices and capacity,
  • in order to improve the analysis and evaluation of Boards’ financial plans.

37. In addition, the Committee believes that the Department must ensure that accurate cost information for NHS Scotland is provided, since without a full understanding of service costs, it is impossible to determine whether cost savings are reasonable.

Clinical Strategy: Finding and Recommendation

38. The Committee considers that financial planning and the development of the clinical strategy were not properly linked by NHS Argyll and Clyde.

39. Given that the delivery of the clinical strategy is crucial to financial recovery, the Board must take urgent action to cost the clinical strategy.

ACCOUNTABILITY ISSUES

The Accountability Review Process

40. The Committee considered in detail the Accountability Review correspondence submitted as written evidence. Mr Jones also discussed in some detail issues that were addressed through the Accountability Review process. 12

41. It was in Mr Jones’ letter of 15 November 2001 that the scale and seriousness of the problems facing Argyll and Clyde are first recognisable in the Accountability Review correspondence. The over-reliance on non-recurring income and capital receipts to achieve financial balance was first explicitly mentioned in Mr Jones’ Letter of 12 February 2002. While the Board reported a balanced position prior to 01/02 it is highly likely that there was a significant underlying deficit during that period. Therefore, prior to February 2002 the Department was either unaware of the Board’s recurring deficit and over-reliance on non-recurring monies or it was not recorded under the Accountability Review process.

42. In addition, the fact that redesign of services was the key to ensuring that the Board could live within its means is not explicitly mentioned until the letter of 3 August 2002. The Committee also considers that, year on year, the correspondence was inconsistent in the way it addressed key issues.

43. In summary, from the correspondence available to the Committee, the process failed to identify the looming financial crisis early enough and did not make the connection between the need to actively redesign services and achieve financial balance until the financial position had become critical.

44. The Committee considers that the Accountability Review process failed to achieve clarity and understanding between the Board and the Department and in particular:

  • Did not identify core issues in a structured and consistent way;
  • Focused on performance against targets at the expense of key strategic issues such as service redesign; and
  • Did not address or record financial and service planning issues in a transparent, consistent and integrated way.

45. The Minister announced changes to the Accountability Review process in October 2004. 13 These changes are welcome. However, they will not necessarily address the problems that arose in this instance.

46. The Committee recommends that a more fundamental review of the Accountability Review process be undertaken to ensure that:

  • Core issues are identified and reviewed in a structured and consistent way;
  • The issues addressed strike the right balance between performance against targets and strategic issues;
  • Service and financial planning issues are addressed and recorded in an integrated way; and
  • Financial issues are reported transparently and consistently. In particular the way in which Boards use non-recurring funding should be explicitly recorded.

Assurances in relation to Argyll and Clyde’s Liabilities

47. The Department has given verbal assurances that the Board would have access to cash throughout the recovery period (04-08) to meet its liabilities. However the former Accountable Officer would not agree to issue a written assurance since he felt it was inappropriate to authorise a Board to spend cash that had not been allocated to them when he considered that there was no firm plan to ensure that the Board would fulfil its financial duties. (Cols 936- 937). In their evidence SEHD stated that, in their view, a written assurance is not necessary, particularly given that the Minister has given the same assurance in public proceedings of the Parliament. (Col 1006)

48. The Committee appreciates the difficulties faced by the Department in authorising expenditure beyond the Board’s income. However, the refusal to issue a written assurance has not succeeded in controlling the deficit and the sums of money involved in meeting the Board’s liabilities are considerable - £35.4m in 2003-04.14

49. The Committee therefore considers that a verbal assurance that the Board’s ongoing liabilities would be met is unacceptable practice. In order to ensure that Accountable Officers can be held properly to account, the Committee expects a written assurance to be given in such circumstances.

Accountable Officer Duties

50. The Committee has noted Mr Campbell’s evidence that each year he is in breach of the Memorandum to National Health Service Accountable Officers because the Board sets out to spend more than it receives in income. (Col 884)

51. The Committee wishes to highlight the provisions in section 15(8) of the Public Finance and Accountability ( Scotland) Act 2000 which places a duty on Accountable Officers to obtain a written authority if they are required to act in a way which is inconsistent with the proper performance of their functions as set out under the Act. This issue is addressed in the Memorandum to National Health Service Accountable Officers which states that Accountable Officers have a “particular responsibility to ensure that, where you consider that any action which you are required to take is inconsistent with the proper performance of your duties as Accountable Officer, you obtain written instructions from the Board for which you are designated…” 15

52. The Committee recognises that seeking such a written authority would not have resolved the difficulties being experienced within the service in Argyll and Clyde. However, it is a duty placed on Accountable Officers for their own protection and the Committee recommends that any Accountable Officer seek a written authority in such a situation. Securing such a written authority also clarifies the lines of accountability.

APPENDIX A

FINDINGS AND RECOMMENDATIONS

SUMMARY

NHS ARGYLL AND CLYDE PRIOR TO DECEMBER 2002

  • Having considered the report of the Independent Support Team along with oral and written evidence from witnesses, the Committee considers that prior to December 2002, there was a significant failure of management at NHS Argyll and Clyde over a period of years. (Para 7)

FINANCIAL PLAN AND CLINICAL STRATEGY RECOMMENDATIONS

  • The new management team has made good progress in the development of a new corporate organisation and in continuing to provide services to the local population in extremely difficult circumstances. The Committee notes for example that performance against national targets on waiting times and delayed discharges was strong. 16 The team has also achieved significant savings. 17(Para 23)
  • However, the Committee is concerned at the very serious risks that remain, namely that
    • Savings are not achieved;
    • The cumulative deficit continues to grow; and
    • The mounting financial problems facing the Board affect its ability to maintain services. (Para 24)
  • The Committee is at a loss to understand;
    • The failure to agree the financial plan; and
    • The time taken to provide even indicative costs in relation to the clinical strategy.(Para 26)

Agreement of the Financial Plan: Findings and Recommendations

  • The relationship between the Department and the Board has therefore proved ineffective in resolving this fundamental issue. The Committee notes the lack of continuity in the personnel representing the Department at the meetings to agree the plan and considers that this was unhelpful in seeking agreement of the plan. (Para 24)
  • The collective failure of the Department and the Board to agree a financial plan over this period is unacceptable. The situation must not be allowed to persist or to happen again in respect of this or any other NHS Board. (Para 30)
  • The Board and the Department must take urgent action to agree the financial plan. Both parties must agree that the plan is realistic and achievable . The Board and the Department must also agree how the cumulative deficit is to be addressed.(Para 31)
  • The Committee considers that poor information and in particular a lack of shared understanding in relation to costs within NHS Scotland contributed significantly to the failure to agree the financial plan. However there were other factors at play.The Committee recommends that SEHD examine what should be done to ensure that such disagreements are more successfully and speedily resolved. (Para 32)
  • The Committee also recommends that, in future, the level of agreement between the Board and the Department as to a Board’s starting financial position, and in particular the level of any deficit, should be specifically recorded. (Para 33)

Analysis of the Financial Plan: Findings and Recommendations

  • Evidence from SEHD did not satisfactorily set out the analysis which underpins its assertion that financial recovery could be achieved more quickly without risk to clinical services. The Committee does not consider that a high level comparison with other Boards who have experienced financial difficulties is a sufficient assessment. (Para 34)
  • The Committee concludes that the Department is not able to demonstrate that it has the information and capacity necessary to undertake proper analysis and evaluation of the Board’s financial recovery plan . (Para 35)
  • The Committee recommends that the Department review;
    • the financial data submitted by Boards; and
    • its own practices and capacity,

in order to improve the analysis and evaluation of Boards financial plans. (Para 36)

  • In addition, the Committee believes that the Department must ensure that accurate cost information for NHS Scotland is provided, since without a full understanding of service costs, it is impossible to determine whether cost savings are reasonable. (Para 37)

Clinical Strategy: Finding and Recommendation

  • The Committee considers that financial planning and the development of the clinical strategy were not properly linked by NHS Argyll and Clyde. (Para 38)
  • Given that the delivery of the clinical strategy is crucial to financial recovery, the Board must take urgent action to cost the clinical strategy. (Para 39)

ACCOUNTABILITY ISSUES

The Accountability Review Process

  • The Committee considers that the Accountability Review process failed to achieve clarity and understanding between the Board and the Department and in particular:
    • Did not identify core issues in a structured and consistent way;
    • Focused on performance against targets at the expense of key strategic issues such as service redesign; and
    • Did not address or record financial and service planning issues in a transparent, consistent and integrated way. (Para 44)
  • The Committee recommends that a more fundamental review of the Accountability Review process be undertaken to ensure that:
    • Core issues are identified and reviewed in a structured and consistent way;
    • The issues addressed strike the right balance between performance against targets and strategic issues;
    • Service and financial planning issues are addressed and recorded in an integrated way; and
    • Financial issues are reported transparently and consistently. In particular the way in which Boards use non-recurring funding should be explicitly recorded. (Para 46)

Assurances in relation to Argyll and Clyde’s Liabilities

  • The Committee therefore considers that a verbal assurance that the Board’s ongoing liabilities would be met is unacceptable practice. In order to ensure that Accountable Officers can be held properly to account, the Committee expects a written assurance to be given in such circumstances. (Para 49)

Accountable Officer Duties

  • The Committee recognises that seeking such a written authority would not have resolved the difficulties being experienced within the service in Argyll and Clyde. However, it is a duty placed on Accountable Officers for their own protection and the Committee recommends that any Accountable Officer seek a written authority in such a situation. Securing such a written authority also clarifies the lines of accountability. (Para 52)

ANNEXE A

AUDIT COMMITTEE
EXTRACT OF MINUTES
18th Meeting, 2004 (Session 2)
Tuesday 26 October 2004

Members Present:

Susan Deacon Robin Harper
Margaret Jamieson Mr Brian Monteith (Convener)
Mr Andrew Welsh (Deputy Convener)  

Apologies were received from George Lyon.

AGS Section 22 Reports: The Committee received a briefing from the Auditor General for Scotland on section 22 reports by the Auditor General for Scotland entitled “The 2002/03 Audit of the National Library of Scotland”, “The 2003/04 Audit of the Scottish Prison Service”, “The 2003/04 Audit of Argyll and Clyde Health Board” and “The 2003/04 Audit of Lanarkshire Health Board”.

AGS Section 22 Reports (in private): The Committee considered its approach to section 22 reports by the Auditor General for Scotland entitled “The 2002/03 Audit of the National Library of Scotland”, “The 2003/04 Audit of the Scottish Prison Service”, “The 2003/04 Audit of Argyll and Clyde Health Board” and “The 2003/04 Audit of Lanarkshire Health Board”. The Committee agreed to take evidence on the section 22 report entitled “ The 2003/04 Audit of Argyll and Clyde Health Board” and agreed to consider further arrangements for the evidence taking at a future meeting. The Committee agreed not to hold an inquiry on the section 22 reports entitled “ The 2002/03 Audit of the National Library of Scotland”, “The 2003/04 Audit of the Scottish Prison Service” and “The 2003/04 Audit of Lanarkshire Health Board” at this time.

AUDIT COMMITTEE
EXTRACT OF MINUTES
20th Meeting, 2004 (Session 2)
Tuesday 16 November 2004   

Members Present:

Robin Harper Margaret Jamieson
George Lyon Mr Brian Monteith (Convener)
Mary Mulligan Mr Andrew Welsh (Deputy Convener)

Apologies were received from Susan Deacon

AGS Section 22 Report on Argyll and Clyde Health Board Accounts (in private): The Committee considered arrangements for its inquiry into the report by the Auditor General for Scotland entitled “ The 2003/04 Audit of Argyll and Clyde Health Board.” The Committee agreed to seek written evidence from the Scottish Executive Health Department and Argyll and Clyde Health Board.

The Committee also agreed the following remit for its inquiry:

In considering and reporting on the Auditor General for Scotland’s section 22 report on the accounts of Argyll and Clyde Health Board relating to the financial year 2003/04, the Committee will examine:

  • Financial and wider management practice at Argyll and Clyde Health Board; and
  • the way in which the Scottish Executive Health Department supports and monitors the performance of Argyll and Clyde Health Board.

The Committee also agreed that Ian Gordon, acting Head of Health Department and Chief Executive of NHS Scotland be invited to give evidence, accompanied by Dr Peter Collings, Director of Performance Management and Finance.

The Committee further agreed, by division, that the evidence session with Argyll and Clyde Health Board should be held in Edinburgh: For 5 (Robin Harper, Margaret Jamieson, George Lyon, Mr Brian Monteith, Mary Mulligan), Against 1 (Mr Andrew Welsh), Abstentions 0.

AUDIT COMMITTEE
EXTRACT OF MINUTES
22nd Meeting, 2004 (Session 2)
Tuesday 7 December 2004

Members Present:

Susan Deacon Robin Harper
Margaret Jamieson George Lyon
Mr Brian Monteith (Convener) Mary Mulligan
Mr Andrew Welsh  

AGS Section 22 Report on Argyll and Clyde Health Board Accounts (in private): The Committee considered arrangements for its inquiry into the report by the Auditor General for Scotland entitled “ The 2003/04 Audit of Argyll and Clyde Health Board.” The Committee agreed to take evidence from Mr Trevor Jones, former Head of the Scottish Executive Health Department and Chief Executive of NHS Scotland, and Mr John Aldridge, Scottish Executive at a future meeting.

AUDIT COMMITTEE
EXTRACT OF MINUTES
23rd Meeting, 2004 (Session 2)
Tuesday 14 December 2004

Members Present:

Susan Deacon Robin Harper
Margaret Jamieson George Lyon
Mr Brian Monteith (Convener)  

Apologies were received from Mary Mulligan and Mr Andrew Welsh.

AGS Section 22 Report on Argyll and Clyde Health Board Accounts (in private): The Committee considered arrangements for its inquiry into the report by the Auditor General for Scotland entitled “ The 2003/04 Audit of Argyll and Clyde Health Board.” The Committee agreed, in light of his forthcoming appointment as Head of the Scottish Executive Health Department and Chief Executive NHS Scotland, to invite Dr Kevin Woods to give evidence at a future meeting.

AUDIT COMMITTEE
EXTRACT OF MINUTES
24th Meeting, 2004 (Session 2)
Tuesday 21 December 2004

Members Present:

Susan Deacon Robin Harper
Margaret Jamieson George Lyon
Mr Brian Monteith (Convener) Mary Mulligan
Mr Andrew Welsh  

AGS Section 22 Report on Argyll and Clyde Health Board Accounts: The Committee took evidence from-

Mr Neil Campbell, Chief Executive, Mr James Hobson, Director of Finance and Mr David Meikle, Divisional Director, NHS Argyll and Clyde.

  • AGS Section 22 Report on Argyll and Clyde Health Board Accounts (in private): The Committee considered the evidence taken on the section 22 report by the Auditor General for Scotland entitled “The 2003/04 Audit of Argyll and Clyde Health Board.” The Committee also considered arrangements for its inquiry into the section 22 report by the Auditor General for Scotland entitled “The 2003/04 Audit of Argyll and Clyde Health Board.” The Committee agreed to write to Mr Neil Campbell and the Scottish Executive Health Department seeking clarification on a number of issues raised during discussion and to consider the responses at a future meeting.

AUDIT COMMITTEE
EXTRACT OF MINUTES
1st Meeting, 2005 (Session 2)
Tuesday 11 January 2005

Members Present:

Susan Deacon Robin Harper
Margaret Jamieson George Lyon
Mr Brian Monteith (Convener) Mary Mulligan
Mr Andrew Welsh  

AGS Section 22 Report on Argyll and Clyde Health Board Accounts: The Committee took evidence from-

Mr Trevor Jones, former Head of Scottish Executive Health Department and Chief Executive of the NHS in Scotland , and Mr John Aldridge, Finance Director, Finance and Central Services Department, Scottish Executive and former Director of Performance Management and Finance at the Scottish Executive Health Department.

AGS Section 22 Report on Argyll and Clyde Health Board Accounts (in private): The Committee considered the evidence taken. The Committee also considered further arrangements for this inquiry. The Committee agreed to write to witnesses seeking further information on issues raised during discussion.

AUDIT COMMITTEE
EXTRACT OF MINUTES
2nd Meeting, 2005 (Session 2)
Tuesday 25 January 2005

Members Present:

Susan Deacon Robin Harper
Margaret Jamieson George Lyon
Mr Brian Monteith (Convener) Mary Mulligan
Mr Andrew Welsh  

AGS Section 22 Report on Argyll and Clyde Health Board Accounts: The Committee took evidence from-

Dr Kevin Woods, Head of Scottish Executive Health Department and Chief Executive of the NHS in Scotland, Dr Peter Collings, Head of Performance Management and Finance, Mrs Julie McKinney, Finance Manager – West Boards and Ms Carmel Sheriff, Head of Performance Management – West Boards, Scottish Executive.

AGS Section 22 Report on Argyll and Clyde Health Board Accounts (in private): The Committee considered the evidence taken. The Committee agreed to write seeking information on a number of issues raised during discussion.

AUDIT COMMITTEE
EXTRACT OF MINUTES
3rd Meeting, 2005 (Session 2)
Tuesday 8 February 2005

Members Present:

Susan Deacon Robin Harper
Margaret Jamieson George Lyon
Mr Brian Monteith (Convener) Mary Mulligan
Mr Andrew Welsh  

AGS Section 22 Report on Argyll and Clyde Health Board Accounts (in private): The Committee considered an issues paper on its inquiry into the report by the Auditor General for Scotland entitled “ The 2003/04 Audit of Argyll and Clyde Health Board.” The Committee agreed to consider a draft report at a future meeting.

AUDIT COMMITTEE
EXTRACT OF MINUTES
6th Meeting, 2005 (Session 2)
Thursday 10 March 2005

Members Present:

Susan Deacon Robin Harper
Margaret Jamieson George Lyon
Mr Brian Monteith (Convener) Mary Mulligan
Mr Andrew Welsh  

AGS Section 22 Report on Argyll and Clyde Health Board Accounts (in private): The Committee considered a draft report on its inquiry into the section 22 report by the Auditor General for Scotland entitled “ The 2003/04 Audit of Argyll and Clyde Health Board.” The report as amended was agreed to.


Footnotes:

1 Report of the Independent Support Team on NHS Argyll and Clyde, NHS Argyll and Clyde submission 24 January 2005

2 Report of the Independent Support Team and Cols 877-879,881,904,942-946,1003

3 NHS Argyll and Clyde, Auditors’ Annual Report, Executive Summary, page 2

4 Cols 900-901,944,1001-1004, Letter from John Aldridge 22 February 2005, Letter from Neil Campbell 24 February 2005

5 Cols 932-933, 936-937, 944-945, 1002-1004 and Letter from John Aldridge 22 February 2005

6 Cols 874, 889, 899, 902, Letter from Neil Campbell 24 February 2005

7 Letter from Dr. Kevin Woods 23 February 2005

8 Cols 935, 951, Letter from Dr Kevin Woods 23 February 2005

9 Submission from Dr Kevin Woods, 7 February 2005, Committee paper AU/S2/05/04/1

10 NHS Argyll and Clyde, Auditors’ Annual Report, page 6, paras 2.4 and 2.6

11 Cols 874-875, 882-884, Accountability Review Letter from Trevor Jones August 2003, Accountability Review letter from Peter Collings September 2004

12 Accountability Review Letters: Geoff Scaife, 12 June 2000; Trevor Jones, 31 May 2001; Trevor Jones, 15 November 2001; Trevor Jones, 12 February 2002; Trevor Jones, 3 August 2002; Trevor Jones, August 2003; Peter Collings 21 September 2004.

13 Scottish Executive News Release “Changes to Health Board Accountability”, 11 October 2004.

14 Letter from Dr Kevin Woods 23 February 2005

15 Memorandum to National Health Service Accountable Officers, SEHD April 2002, para 5.1

16 Accountability Review letter from Dr Peter Collings, September 2004

17 Cols 874-875, 882-884, Accountability Review Letter from Trevor Jones August 2003, Accountability Review letter from Peter Collings September 2004