Pre-Budget Scrutiny 2020-21

 

About the Inquiry

At the start of the Parliamentary Session, the Committee agreed to adopt a full year budgeting approach, building an element of budget scrutiny into all aspects of its work, as detailed in its 2nd report, 2016 (Session 5) Health and Social Care Integration Budgets.

The Committee has sought to remove the direct link between the Scottish Government’s draft budget and its budget scrutiny with a view to using evidence gathered throughout the year to influence the content of future draft budgets and the relative priorities given to the health elements.

The Health and Sport Committee’s budget scrutiny process reflects the recommendations of the Budget Process Review Group report, which recommends full year budgeting and an outcomes-based approach to scrutiny.  The emphasis is on pre-budget scrutiny, with committees expected to write to the relevant Minister at least six weeks prior to the budget being published setting out their policy priorities.  The Scottish Government is then expected to respond to points raised by subject committees alongside its Budget.

In 2018, the Committee undertook pre-budget scrutiny in May/June and published a report in October 2018 aimed to feed into the budget process, rather than responding to the Budget when published.  The Scottish Government provided a detailed response shortly after the Budget was published, in December 2018.  As such, the Budget Process Review Group recommendations were reflected in the Committee’s approach.  A similar approach for pre-budget scrutiny 2020-21 is outlined below.

Committee approach

In recent years, the focus of the Committee’s budget scrutiny has been the Integration authority (IAs).  IA budgets totalled £8.9 billion in 2018-19, of which £6.3 billion was from NHS budget.  IAs therefore account for almost half of the total health and sport budget and this justifies a continued focus on IA budgets in the pre-budget scrutiny for 2020-21, particularly in light of the ongoing concerns raised by the Committee in respect of the progress of integration.

The Committee has undertaken several inquiries looking at various aspects of the integration of health and social care.  A number of common themes can be revisited as part of the forthcoming pre-budget scrutiny:

  • Budget setting process
  • Linkages between budgets and outcomes
  • Shifting the balance of care
  • Set aside budgets
  • Benchmarking performance
  • Delayed discharge / unscheduled hospital admissions
  • Leadership
  • Transparency of budget information

Timetable

Formal evidence sessions were scheduled as follows:

21 May 2019

Evidence session with Integration Authorities' representatives focusing on budget-setting challenges, reporting against outcomes, operation of the set aside budget, leadership and other cross-cutting budget issues.

The following Integrated Joint Boards attended: 

  • Edinburgh
  • South Lanarkshire
  • East Ayrshire

Official Report - 21 May 2019

4 June 2019

Evidence session with Integration Authorities’ representatives focusing on performance data, specifically in respect of delayed discharge and unscheduled hospital admissions, taking evidence from a selection of IAs, including both stronger and weaker performers.

The following Integrated Joint Boards attended:

  • Glasgow City
  • Aberdeen City
  • West Lothian

Official Report - 4 June 2019

September/October 2019

Publication of pre-budget report incorporating recommendations to the Scottish Government on the health and sport budget.

December 2019/January 2020

Post-budget evidence session with Cabinet Secretary to review budget proposals in the light of the Committee's pre-budget repot.

Evidence

The Integrated Joint Boards invited to the evidence session on 21 May 2019 submitted the following written evidence in advance of the meeting:

The Integrated Joint Boards invited to the evidence session on 4 June 2019 submitted the following written evidence in advance of the meeting:

The Scottish Parliament Information Centre (SPICe) published their briefing on health and social care integration on 26 June 2019 and this can be accessed below: 

Correspondence

To help inform the Committee's oral evidence sessions on pre-budget scrutiny, the Convener wrote to the Cabinet Secretary for Health and Sport seeking further information on aspects of the budget, including some relating specifically to integration authorities.

The Convener received a response from the Cabinet Secretary for Health and Sport on 20 May 2019.

The Convener received a further letter from the Cabinet Secretary for Health and Sport on 5 June 2019 providing information on Integration Authorities' final 2018-19 allocations and 2019-20 budgets.

Following the evidence session on 21 May 2019 with Edinburgh, South Lanarkshire and East Ayrshire Integrated Joint Boards, the Convener issued letters requesting further information on a range of issues that arose during the meeting: 

Following the evidence session on 4 June 2019 with Glasgow City, Aberdeen City and West Lothian Integrated Joint Boards, the Convener issued letters requesting further information on a range of issues that arose during the meeting: 

The responses received are listed below:

The Convener of the Local Government and Communities Committee wrote to the Cabinet Secretary for Communities and Local Government on 31 October 2019 following their pre-budget scrutiny sessions.  The Health and Sport Committee were copied in on this letter for information on the financial sustainability of local authorities and Integrated Joint Boards funding key issues raised in the letter.

 
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