Warning over ‘blame culture’ behind £8bn care budget crisis

A Holyrood committee warned that increasing bureaucracy meant different agencies can "blame each other for the lack of progress with integration". Picture: Donald MacLeod
A Holyrood committee warned that increasing bureaucracy meant different agencies can "blame each other for the lack of progress with integration". Picture: Donald MacLeod
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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.”