SERIOUS failures in the running of NHS Western Isles and a failure year after year to have in place adequate financial controls are cited amongst key findings in a report published today (Tuesday) by the Scottish Parliament's Audit Committee.
The Committee also describes the current situation whereby Western Isles Health Board has three chief executives - one suspended, one on secondment and one acting - as unacceptable and calls on the Scottish Government to work with the board to resolv
e the situation urgently.
Over all, the report finds that a number of factors contributed to the financial failings at the board, which had a cumulative deficit of £3.36 million at the end of the financial year 2006/07.
These factors included external cost pressures from changes in the wider NHS and issues stemming from the design of health services in the Western Isles.
However, the report finds that the situation was exacerbated by inadequate internal control systems and weak financial management at the board.
The committee goes on to express concern over appointment processes used in the NHS, and considers there to be a lack of transparency in the way people were appointed to temporary posts and secondments.
As such, the committee recommends that the Government reviews its appointment processes and procedures for dealing with incompetence, inefficiency and failures in performance.
Committee Convener Hugh Henry MSP said:
"It is clear that there is considerable anger and dismay, especially in the local community, regarding the failures in systems and management that have taken place within Western Isles Health Board over a number of years.
"It is not acceptable for the same failures to keep occurring year after year, as happened within NHS Western Isles.
"This committee is deeply concerned by the fact that the board has three chief executives.
"This must be resolved urgently. We also believe that the Government must review its arrangements for appointing staff to temporary posts and secondments to ensure proper transparency.
"Where failure occurs, it is simply not good enough to keep moving staff on, often to senior positions.
"There is a worry that this occurrence might reflect a wider culture in the health service of failing to address performance issues and we would be concerned if this also happens in the wider civil service.
"The Permanent Secretary at the Scottish Government should review the procedures for dealing with incompetence and report back to our committee.
"The Committee believes that the Health Directorates must bear part of the responsibility for failures at the board, as they should have ensured that the clinical strategy being pursued by the board was sustainable.
"The Health Directorates should also have identified the management failures at the board much earlier and taken more decisive action."
Mr Henry concluded that:
"The committee is, however, impressed by the achievements of the current management team in bringing the board into financial balance.
"We are concerned, though, that momentum will be lost unless there is consistency of leadership at the board and unless a sustainable and financially affordable clinical strategy is developed."
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