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NHS Highland bosses unable to answer MSPs questions as concerns mount about future direction of the health board

By Scott Maclennan

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Highlands MSP Edward Mountain.
Highlands MSP Edward Mountain.

The mounting problems faced by NHS Highland were placed under the microscope at a bruising meeting of Holyrood’s audit committee.

The session of the Public Audit and Post Legislative Scrutiny Committee saw health chiefs bombarded with questions ranging from bullying, its dire finances and key vacancies and governance – some of which they couldn’t answer.

Attending the session were NHS Scotland chief executive John Connaghan, NHS Highland chairman professor Boyd Robertson and chief executive Pamela Dudek, who faced a particularly tough time despite only taking-up the role this week.

She landed herself in hot water while being questioned by Highland MSP Edward Mountain who asked what the board was going to do about its projected £75 million deficit.

In the back and forth,Mr Mountain said:“Here’s the challenge as I see it, 2017/18 a loss of £17.8 million, 2018/19 a loss of £18 million, 2019/20 a loss of £11 million and according to the board papers in August this year, a projected loss of £75 million – £56 million which will down to Covid and £19 million will be down to just normal losses.”

Ms Dudek said: “I believe we are taking every action possible to address the core gap and I can say at this point in the year we have got an £11.7 million risk adjusted.

“So what that means is £11.7 million that we are absolutely on track to deliver as part of our recovery programme and that we have £18 million in the pipeline of opportunity, that leaves £6 million for us that we need to address.

“This is consistent with where we were this time last year and it is also in the wake of losing three months of the beginning of the financial year when we were focussed on Covid.”

The MSP picked up on the "pipeline of opportunity" phrase to describe £18 million in savings the board is yet to make: “That actually concerns me that you’re saying that you’re in the same place as you were last year and you’re confident you’ll get down to £6 million this year, when you didn’t achieve that last year.

“Do you want to just talk to me a little bit about the £18m in the pipeline of opportunity of savings… is it gap in posts, is it reducing locums or is it not doing the operations?”

Ms Dudek said the board is considering “a whole suite of work streams”.

The Tory MSP then asked: “So shining the light down the pipeline of opportunity, using your analogy, that’s not cutting front line services, that’s not gaps in posts, and it’s not reducing workforce, so just give me some particular ideas that you are looking at so I can understand them.”

The chief executive answered: “It may well change our staff profile, in some of these ideas it may well change the shape and skill sets of staff which is a way of redesigning, reducing cost if it is reasonable and maintains the quality.

“I haven’t got the figures in front of me Edward but I am very happy to follow up and my apologies for that. I didn’t bring that level of detail in with me.”

Following the evidence session, Mr Mountain said:“The meeting raised more questions than it answered. I am deeply concerned about the capability of NHS Highland to deliver on its health and social care obligations.

“Our hard working health care professionals require stability of management and financial security. This will allow NHS Highland to address the issues of under performance, poor fiscal control, and rebooting after the Covid crisis.

“Pam Dudek said that she was attracted to the job because of the challenges that came with it. I agree with her, there are massive challenges and it will be important that these are faced head-on because we can’t repeat the last four years.

“Given the clarity that is needed after that evidence session I have requested a meeting with the chair and chief executive to iron out my concerns.”

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