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MSP Mountain put NHS Highland chiefs on the spot

By Tom Ramage

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The senior leadership of NHS Highland today came under scrutiny during a session of the Public Audit and Post Legislative Scrutiny Committee.

Edward Mountain, the only Highlands and Islands MSP in attendance, has commented that the evidence session “raised more questions than it answered” as to the future direction of NHS Highland, which is forecasting a £75 million overspend.

He raised the issue of long-running financial problems: “Here’s the challenge as I see it, 17/18 a loss of £17.8m, 18/19 a loss of £18m, 19/20 a loss of £11m and according to the Board Papers in August this year, a projected loss of £75m, £56m which will down to Covid and £19m will be down to just normal losses.”

Edward Mountain: wants concerns addressed by NHS Highland
Edward Mountain: wants concerns addressed by NHS Highland

Pam Dudek, new chief executive of NHS Highland replied: “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 £6m 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.”

Mr Mountain responded: “That actually concerns me that you’re saying that you’re in the same place as you were last year and your confident you’ll get down to £6m this year, when you didn’t achieve that last year.”

He added: “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?”

The chief confirmed there were "a whole suite of workstreams” being considered but the health board intended to protect frontline services.

The Highland MSP asked: “So shining the light down the pipeline of opportunity, using your analogy, that’s not cutting frontline services, that’s not gap 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.”

“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,” responded Ms Dudek.

She went on: “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 MSP commented: “Today’s 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 underperformance, 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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