Thank you for inviting me here today to give evidence to the committee regarding “The 2017/18 audit of NHS Highland: Financial sustainability”.
As you are aware, NHS Highland is currently not financially stable, and I would like to take a few moments to outline the reasons for that position. There is an increasing challenge in balancing the three areas outlined by the Auditor General, namely finance, waiting times and the quality of care.
In NHS Highland, we have continued to ensure that there is a clear focus on the quality and safety of care—including adult social care—through our Highland quality approach, while maintaining key waiting times for patients, which has been to the detriment of our ability to maintain financial balance in 2017-18.
There are significant challenges that are specific to the delivery of care in remote and rural areas and island populations that, without doubt, are complex and more costly due to the significant distances. Covering 41 per cent of the most remote and rural geography of Scotland, with an ageing population, it has been more challenging every year for NHS Highland to sustain the historical models of care within budget, due in part to our inability to recruit key members of staff.
Our focus has been on ensuring that we can provide an appropriate and timely response to keep people safe, both in and out of hours, but that has come at a significant cost.
As a board, we are committed to the reduction of waste in the system and the transformation of services to ensure that we have sustainable and integrated care, fit for future generations, for the people of the Highlands.
In order to do that, we must change. Such change inevitably takes time, but we have already embarked on that journey, and I thank our outstanding staff for their continued efforts. I will be very happy to do my best to answer questions from the committee. Thank you, convener.