The Western Isles integrated joint board (IJB) meeting on 19th December reported
on a significant budget overspend on NHSWI services and an underspend on Comhairle
Figures were projected to end of financial year, and a decision taken to “vire” the
budget, transferring no less than £923,000 from the comhairle’s contribution to the
IJB to offset the NHSWI overspend.
This concerns me greatly, on a number of fronts:
1. When the Scottish Government budget for 2017-18 was set in February 2017, the
SNP and Green Party agreeing another £160 million for “local authority” Services,
to be used at “discretion” of the 32 local authorities, little did I envisage that
this would result in back-door funding of health services – nor do I assume would
this be the intention of the Greens. On the contrary, all publicity at present about
bed blocking and cancellation of elective surgery refers to the fundamental problem
of lack of adequate community support services to get patients out of hospital.
2. The comhairle has experienced budget cuts approximating to 30% of their revenue
budget in real terms since 2010. Over 400 posts have been lost by voluntary severance.
Eligibility criteria for services such as “care at home” and direct payments have
left families struggling to cope. How does this square with a goodwill donation of
£923,000 to protect health services? NHS boards in Scotland have not been subject
of such severe cut-backs as LA’s, indeed they have maintained inflation proof budgets.
I am not aware of any voluntary severance within NHSWI to date.
3. Only four of our 31 elected members on the comhairle sit on the IJB. Politically,
I have major issues about the comhairle delegated budget to the IJB, of no less than
£19.359 million, and how decisions are taken to account to the comhairle for this
level of expenditure. At the time of the 2017 May council elections I voiced my concerns,
and was countered with exaggerated and infantile promises being made by some budding
new prospective candidates, promising to “fight to protect local services.” Well,
they were elected, and have fallen at the very first hurdle! Santa Claus came early,
with £923,000.00 (or likely more by April 2018), going from the comhairle coffers
because the NHSWI cannot keep within their budget.
Finally, the Scottish Government agenda about public service reforms need look no
further than what has happened here to support some urgency in taking a closer look
at the management and delivery of health and social care services. Especially now,
with the SNP and Green Party about to do another deal on the 2018-19 budget.
3 Kyles Flodda
Isle of Benbecula
Letter: Council’s “back door funding” of health services