‘Unacceptable’ lack of information on health and social care budget, MSPs warn

A Holyrood 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 on the 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 £8 billion.

“It needs rectifying immediately and a mechanism for facilitating scrutiny of performance, spend and savings put in place.''

He spoke out after a new report from the committee said that while IAs had an overall budget of £8.29 billion 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 that some IAs had agreed their budgets for the year without confirmation as to how savings were to be made - asking Scottish Government ministers if they consider this to be acceptable.

And the committee said there was a “lack of assessement 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.''

Mr Findlay said: “We have identified some of the challenges faced by IAs including areas such as the setting of budgets, measuring the outcomes of their investment and shifting resource to deliver transformational change in health and social care.

“These are issues the committee has returned to several times in the last two years and its vital each IA immediately tackles and delivers on these challenges.

“We are concerned bureaucracy has increased allowing different agencies to blame each other for the lack of progress with integration.

“We are recommending in our report to the Government that leadership is needed from the chief officers of each IA to deliver value for the public purse, the necessary changes we highlight along with the promised transformation in the way these vital services are 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.

“This year's Audit Scotland report noted that Integration Authorities were beginning to have a positive impact, particularly with national improvement in delayed discharge.

“Further achievements include the delivery of the Scottish Living Wage for all adult social care workers, support in the community to enable GPs to focus on their core tasks, and savings of around 250 million in 2016/17.

“We will continue to monitor the budgets and effectiveness of Integration Authorities to ensure they deliver on agreed outcomes.'