05.10.15
Scottish health committee questions value of cash used to meet performance targets
The Scottish parliamentary health committee has questioned whether meeting performance targets remains an “efficient use of public money”, considering there is “currently no way” to assess the investment made by the NHS to fully meet these targets.
The Health and Sport Committee’s report into the budgets of NHS boards discovered that there is no assessment in place into how much it costs boards to meet targets which measure individual performance in “key areas”.
The committee has challenged this investment, questioning whether this money could be better spent elsewhere, particularly where a board’s performance may only be 1% or 2% below the target.
Duncan McNeil MSP, convener of the committee, said: “Our NHS boards have a total budget of over £9bn and it is the role of this committee to scrutinise how this is being spent. The use of targets in the NHS has long been controversial.
“Whilst there clearly needs to be some measurement of output and delivery, our committee has questioned if meeting that final percentage of performance targets is really the best use of public money.
“Given that there is no way to measure the amount of investment that goes into this, we are calling for the government to consider whether there should be flexibility in the targets to ensure any investment goes towards actual improvements in the quality of care.”
Responding to the committee’s proposals, health secretary Shona Robison said: “We know that rigorous targets can deliver improves services for patients – as our health service is now delivering some of the lowest waiting times on record.
“However we do need to ensure we have the right targets for the right things and set at the right levels.
“This needs to balance delivering the best possible results for patients with allowing boards to respond to local needs and circumstances. That is why we have already reduced the targets we set boards from over 200 to just 20.”
The report also investigated proposals for the integration of health and social care, finding that different models and approaches were being adopted across Scotland.
Deputy convener of the committee, Bob Doris MSP, said: “Clearly the integration of health and social care is a process that is only just beginning but if we get it right, it will unlock huge benefits for the delivery of care.
“This is why as part of this process we’ve asked the Scottish government to consider if the variation between boards in the level of resource transferred to integrated joint boards is reasonable. This will be critical to the operation of these boards going forward.”
The committee also noted that several boards were able to provide evidence of costs linked with ensuring performance and A&E targets being met. It also asked the Scottish government to consider whether a one-off analysis could be undertaken to review these issues “if routine monitoring is considered too costly”.
(Top image c. Peter Byrne)