Questions raised over Scots £8bn care budget
● MSPS criticise lack of scrutiny of integration authorities
MSPS have attacked the “unacceptable” lack of information on the £8 billion plus budgets spent by integration authorities on health and social care.
Elected members on Holyrood’s health and sport committee have complained that there is “little by the way of information on the financial position” of the organisations, which work to provide more integrated care.
Committee convener Neil Findlay said: “There’s a distinct lack of data to identify and evaluate outcomes, including spending and savings.
“This would be unacceptable for any public money let alone over £8bn. It needs rectifying immediately.”
A Scottish Parliament committee has hit out at the “unacceptable” lack of information on the £8 billion plus budgets spent by integration authorities (IAS) on health and social care.
MSPS sitting on Holyrood’s health and sport committee complained there is “little by the way of information on the financial position” of the organisations, which work with health and social care staff, the voluntary and independent sector to provide more integrated care.
Committee convener Neil Findlay said there were concerns that increasing bureaucracy meant different agencies can “blame each other for the lack of progress with integration”.
Mr Findlay said: “There’s a distinct lack of data to identify and evaluate outcomes, including spending and savings. This would be unacceptable for any public money let alone over£8bn. It needs rectifying immediately and a mechanism for facilitating scrutiny of performance, spend and savings put in place.”
Mr Findlay spoke out after a new report from the committee said that, while IAS had an overall budget of £8.29bn, there was “no breakdown of this figure to individual integration authority level”.
The MSPS said this made scrutiny of budgets “very challenging”, as they branded the lack of transparency over how public cash is spent as “unacceptable”.
The report raised concerns some IAS had agreed their budgets for the year without confirmation as to how savings were to be made.
And the committee said there was a “lack of assessment of the outcomes” of the money spent by IAS, with the MSPS saying: “We are very concerned IAS are taking allocation and investment decisions without assessing, or even possessing the ability to assess the relationship between and effectiveness of spending on outcomes.”
It called on the government to provide the organisations with “clear parameters” so that spending can be measured against specific outcomes. The MSPS said: “The complete lack of benchmarking or assessment of performance across IA must be addressed. Only in this way can efficiencies and best practices be identified.”
The report added: “The Scottish Government must have confidence its priorities are being met.
“There is currently very little data on the overall performance of IAS or information on how they are allocating their money.
“The inability of the Scottish Government to evaluate IAS’ performance against its own priorities cannot be desirable, an issue which must be resolved as a matter of priority.
“We are concerned bureaucracy has increased allowing different agencies to blame each other for the lack of progress with integration.
The committee’s concerns come amid growing fears over the robustness of the care sector in Scotland.
In September, Age Scotland pointed to a looming crisis following reports that patients in some of parts of Scotland are being left without food, water, and essential medicines.
The charity issued the warning after minutes from an emergency meeting of Argyll and Bute Health Social Care Partnership reportedly showed a shortage of care workers had left those dependent on help with basic needs at “high risk”.
The minutes said that because it was not possible to ensure all scheduled visits were provided, some patients missed on out medication and personal care, with others “going without food or fluids for prolonged periods of time”.
Earlier in the autumn, the social care recruitment crisis was laid bare by our sister title, the Edinburgh Evening News, which detailed how thousands of positions in the capital were lying vacant, with prospective staff able to earn more money by walking dogs or stacking supermarket shelves.
It found that one recruitment site was looking to fill 1,102 vacancies in Edinburgh, where more than 2,200 people are either waiting for an assessment for care at home or have been assessed as needing support and are waiting for it to be delivered.
A Scottish Government spokesman said: “Integration is one of the most ambitious programmes of work this government has ever undertaken.
“It is already delivering health and social care services that are working more efficiently, putting people at the very heart of treatment decisions.”
“There’s a distinct lack of data to identify and evaluate spending and savings. This would be unacceptable for any public money let alone over £8bn”
THE work of Scotland’s Integration Authorities, if it is going smoothly, shouldn’t attract much attention. These 31 organisations, established last year, exist to ensure the proper delivery of social and health. Working with health and social care staff, the voluntary sector and private industry, IAS spend more than £8 billion a year to marshal a joined-up approach to care. Given the sums of money involved, we would expect IAS to be under intense scrutiny by MSPS. We would also expect them to explain exactly how they’re spending their budgets. It would seem IAS are currently failing in this regard. The Scottish Parliament’s health and sports committee has sharply criticised the lack of transparency surrounding the spending. With an ageing population and longer life expectancy, the efficient delivery of social and health care is one of the greatest challenges the Scottish Government faces. In these early days of IAS, politicians should be able to observe and understand every part of the work they do. Otherwise, how on Earth can they – or voters – know whether they are worth the considerable expense associated with their establishment? Committee convenor Neil Findlay MSP raises the troubling prospect of increasing bureaucracy being used by different agencies to blame each other for a lack of progress in integration. IAS were established to ensure that the often complex relationships between different organisations involved in the provision of social and health care became as straightforward as possible. Currently, there is no detailed breakdown of how money is spent by each of the 31 IAS. This is simply unacceptable. The provision of vital social and health care to those who need it is not, of course, simply a matter of balancing budgets. We must also know that they service provided is of an acceptable quality. While there is no clear breakdown of spending, we have no way of knowing whether this is so. IAS have a vital role to play and, in the years to come, they will find their workload expanding. There will always be teething troubles with any new bureaucratic system. In the case of Scotland’s heavily-funded Integration Authorities, those teething troubles must be addressed immediately. And if managers cannot provide answers on spending, they should have very good reasons indeed.