 Adonwong a gyd y dwyloeddion y rhanfodolion, gyda Sgrutiniaethau Oedon yma yn 2018. Os ydych chi fod i gyfrifio'i gailiol i fyfyddo armellodau certiaethu, ni i fyddwch ar gêm, erbydd i'ch gweithio'r ddefnyddiaeth. Prygau 1-dysgrifenni ar gyfer y cyfnodd bwyntlif yma, iddych chi gydai i gydau ddylch, iddyn nhw i gydag ddodolion, i gydai i gydig yn 3 i 4, i gydig yn 3 i gydig. Dylch yn ddodolion. Dylch yn rhanfodd. Item 2 is the 2016-17 audit of NHS Tayside. I would like to welcome our witnesses today, Paul Gray, director general health and social care, Scottish Government and chief executive NHS Scotland, and Christine McLaughlin, director of health finance, Scottish Government. I would like to ask Paul Gray the opening question if I may. Mr Gray, we have received a letter from you setting out a series of all the investigations that are on-going into NHS Tayside and also a list of timescales, as we have it. It seems to me that there are about half a dozen of these investigations. Some of them are statutory and clearly you couldn't hand them over to anyone else, but I'm wondering if you were at all tempted to kind of pull that into one big investigation. That's for clarity, that's my first question. The second question is if you could perhaps take us through these investigations, your understanding of what they will cover, when they will report and also your anticipated timescales for them. Thank you. I'll bring Christine in on some of the detail, if I may. Your first question was, would it be better or simpler to bring them all into one? We have thought about this, but as you say, there are a number of statutory aspects to this with which we shouldn't interfere. What I propose to do once I've received the main reports that I'm expecting in the course of the next few weeks is to review the whole. I will say quite frankly to the committee that, while I expect what we receive to be sufficient in its coverage, if there is something that I feel is missing from what has been done, I will ask for that to be followed up. We will go on the basis that at the moment what has been commissioned is sufficient, but if it appears not to be or if the committee were at any point to raise questions that we thought would not be adequately covered in what we have done, I'm not resistant to the idea that we might need to extend the scope a little. However, to stop at this point and decommission what's already going on, we would do much more harm than good. That's my broad answer to your first question. I'm anxious not to repeat unnecessarily what's in my letter and correspondence, so I'll step very quickly through the main components, but I'm happy to take further questions as we go. The external review by Grant Thornton is the first one that I will mention about NHS Tayside's financial governance reserves and use of deferred expenditure. The board responds to the initial independent review into the allocation of eHealth funding, and that's due on 15 May, so that's next week. That will be shared with the committee and decisions about any further action that will be informed by the findings of the review. That is a pretty broad-based review by Grant Thornton into what Tayside has done and is doing. There's a formal inquiry under section 281A of the Charities and Trusty Investment Scotland Act by Oscar, and that timing is for them. I understand from Christine that they have written to the committee further about that. In one sense, any follow-up action will be a matter for Oscar, but, in the other sense, it is that if Oscar are to make recommendations to us that go beyond Tayside, we'll want to take those pretty seriously. One of the things that we're already considering is a better separation between the oversight of endowment funds and the responsibilities of non-executives on the board. I'm quite happy to place on record that that's firmly in our view. Professor Sir Lewis Ritchie will continue as the chair of the Assurance Advisory Group and report to me on 15 October. I'm not waiting for that to do other things that will come out of Grant Thornton and Oscar. I also have the returns from the chairs of the NHS boards on their use of endowment funds, so that's all boards. Oscar will respond to me initially on that by the end of May, but I don't expect that to be their final response. I'm happy to give the committee more detail on those responses should they wish it. I'm probably writing, rather than trying to go through them line by line today, but again, I'm happy to take it as the committee prefers. NHS national services Scotland commissioned work by its internal auditors, KPMG, and that has reported. I was due to meet the chair and the chief executive of NSS last week to discuss that, but as the committee knows, I think my mother passed away and that meeting had to be cancelled, so I'll be meeting them shortly and again I'll be happy to report to the committee in more detail once I've had the opportunity to discuss that with them. The Scottish Government's director of internal audit is due to report to us on 4 June on her review of actions taken by Scottish Government eHealth and Health Finance, because I thought that we needed to have a separate look at that and the adequacy of what we had done. Those are the main things that are in train at the moment, and I'm happy to go into more detail with Christine should that be helpful. You've not missed anything, but it might be helpful to clarify, because, as you say, there are six pieces of work under way. The eHealth issues that Grant Thornton looked at and the endowments issues are to me separate issues that are all related to the position Tayside, but they're separate. Grant Thornton's review was the Scottish Government, eHealth, NSS and Tayside. What we're doing as a result of that is the follow-up on the actions that are required for all three parties. Although there are lots of pieces under work, three of them are about the follow-up for Tayside in more detail and financial governance, the follow-up on NSS and their controls and the follow-up in Scottish Government. Three of those pieces of work are really the follow-up from that report. We then had the endowments issue, and we took the opportunity to ask Grant Thornton to broaden the piece of work that they were doing on the initial eHealth work to include a review of the board side of the endowments issues. Grant Thornton can't, within his work, look at the role of the trustees and the appropriateness that's for Oscar to do, but I think that that felt to us that that gave us a really good belt-and-braces approach to the full aspects of the role of the non-executives as members of Tayside NHS Board, while Oscar looked at the role as trustees of the endowment fund. I realise that, if you look at them individually, it looks like there's a lot of things in there that are joined up. If you think that some of them are following on from the first piece, then the endowments work, if that helps to clarify at all. At the end of that, we can consolidate all of the actions and make sure that we've got a comprehensive approach to how we tackle this going forward. Let me just pick up on one of those reports, the Oscar report. I'm just a little concerned. I wrote to David Robb, I think, last week, asking for clarity on timescale on this, because, of course, we're hearing back from Grant Thornton next week on Tuesday, 15 May. David Robb in his letter said that, at the current stage of the inquiry, it's not possible for us to set a particular timescale, and he goes on to say that he would expect to be in a position by 31 May to report to the committee on the inquiry's progress and its future direction. Given that the endowment fund issue was the thing that precipitated the change at NHS Tayside and the huge public interest in that, I'm a little concerned about the lack of clarity over timescale and how that is going to progress. Do you share that concern? Well, clearly, I would like to see as much information as quickly as possible. It's important that, in terms of public confidence, we resolve those issues in a way that is transparent and speedy. However, Oscar is operating independently under its own legislation, but I can assure you that we are keeping in close touch with Oscar. I know that Christine spoke to the chief executive yesterday, and they know very clearly that we are anxious to see material from them, including any recommendations, as quickly as they can feasibly do that. However, as with other public scrutiny bodies, Audit Scotland and so forth, we can't direct them. It's their matter to decide the pace at which they will do it. However, I will say, and again, I think that this is on the record already, that we have offered to fund any backfill within Oscar if they need to release people to do this work. We are clear that, should the chief executive decide that additional resource would help, I am willing, as accountable officer for the NHS, to fund any costs that he faces. Therefore, we are doing everything that we can to support Oscar, but clearly they must maintain their independence from us. That's good to hear, because, in terms of public interest, the Oscar report will be one of the key reports that the committee receives. I would like to start just by clarifying the current status of the previous CEO. You mean Leslie McClay? Yes. Ms McClay is off sick at present. What are the financial implications for the NHS of that? Well, any person who is an employee of the NHS in Scotland will have, within their normal terms and conditions, the prospect of being paid for being on sick leave. She is signed off sick by a doctor, and we must accept that. As anyone else would be, she will be paid her current salary while she remains on sick leave, up to a point in time at which time any person, without reference to specific individuals, would go on to half pay, and then they would go on to no pay over a defined period of time. What is her current status within the NHS? She remains an employee of NHS Tayside. But not CEO? That's correct. She's not the accountable officer. That is Malcolm Wright. Can you just clarify for the public record, Mr Gray, what the CEO's salary is? I can get you it. I could give you an estimate, but I'll get you an accurate statement. It will be in last year's accounts, but I can get you it. I would like to turn to the Grant Thornton audit terms of reference. The internal audit in NHS Tayside is EY. In the case of NSS, the internal auditor is KPMG. You said, in previous remarks, that KPMG was carrying out an internal review of NSS. Why isn't EY similar to NHS Tayside? Just to clarify, I understand that the internal auditors in Tayside were brought in to do a particular piece of work for us at a point in time in a diagnostic under financial position. It's a consortium, an internal in-house NHS consortium, called FTF, that provides the internal audit services in NHS Tayside. That's a little bit different from my understanding. When you say an internal consortium, what does that mean? Internal auditors are either external audit firms that are commissioned for boards, or they can be in-house employees of the NHS. FTF is a consortium that is employed by NHS FIFE and provides audit services through service-level agreements to a number of boards in Scotland. It's an in-house team that provides that internal audit services. So it's an internal audit team? That's correct. That was not what I understood previously. Erinson Young was commissioned by us when Sir Lewis Ritchie did the initial review of Tayside to give us an independent due diligence of the financial position in NHS Tayside, but they are not the internal auditors of NHS Tayside. The internal audit function that operates out of NHS FIFE. That's correct. Do they provide audit services elsewhere in the NHS? They provide audit services to NHS FIFE, to Tayside, to Forth Valley, and they provide a service on a combined basis for NHS Lanarkshire, where they provide oversight to the in-house team in Lanarkshire. Across the country, they have a mix of different audit providers. Every board commissions their audit individually in their internal audit. That particular in-house group, how are they structured? What is their composition? Are they a separate company, or are they simply a division? They are employees of NHS FIFE. I can get you more detail, if you like. It's an in-house team, and it works on a service-level agreement, but they follow the same code of contact for any internal audit. It's not uncommon that the Scottish Government has an in-house internal audit service. Does the internal audit group say that they work on an arm's-length basis, the same as, for example, EY or KPMG, in terms of providing the internal audit function? When you say an arm's-length basis, they provide a service to agreed terms for the board. I can get you any details of that that you would like to see. I don't have it to hand, but it's been an arrangement, a long-standing arrangement, within the NHS for a number of boards. The board negotiates with that organisation to receive a specified audit? Yes, to the same standards as all of the NHS. The same internal audit accounting standards would apply to any public body, and they apply to T-Sidus. They do it everywhere else. Are they in terms of the internal audit uniform across the NHS? The standards to which the internal auditors operate are uniform. The board would have a procurement process, so if you were using a firm such as KPMG or Anderson Young, you would tender for services for a period of time. An in-house team is an equivalent to using an external firm. Do they take part in tender procurement? I can follow up with details of what the arrangements are within T-Sidus, but it's an arrangement that covers more than T-Sidus. It covers three or four boards. Was there a particular reason? I'm looking at different layers here. We seem to have been throwing a lot of money at auditors. You've got your internal team, you've had EYN, now we've got Grant Thornton, and I'm looking at the terms of reference here for what the review is going to do. It all seems a bit airyferry to me, an assessment, an opinion on the design of the new control measures. We will ensure that processes are in place, clear descriptions and purpose of allocations. All this should be in place already. You have people coming in again and again looking at processes. What I would like to see is who did what when. Where is the responsibility lie? Where is the investigation that is going to bring that out? I assume that processes are right, but processes don't all—even if you follow the process and tick the box, it doesn't mean to say that you're going to come up with the right answer. Where is the review that's going to give dates, times, what happened, who did what, who was responsible? You're asking in terms of the endowment in particular or more generally? More generally. Something went wrong. The assumption seems to be that the process may have failed. If the processes are in place, you'll get the right answer. That's not always the case. In this particular case, something went wrong. Maybe deliberately, maybe not, there was certainly misreporting. How did it happen, dates, times, who did what when, who was responsible? In relation to the endowment in Tayside, Oscar will give a report on that. It will be for him to decide what goes into that report. What I can say is that there is a substantial body of documentation that has been shared with Oscar, including minutes of meetings and background paperwork. I've seen some of that and I'm perfectly clear that it tells you exactly on what dates things were done and who was present and so on and so forth. I don't think that there's likely to be a difficulty in establishing the facts of the matter. Indeed, I think that they're probably fairly clearly established. What about the misreporting? I mean, NSS, this review will not cover that. No, it won't. That's why I'm intending to meet chair and the chief executive of NSS, as I've said, to review what they've produced by way of an internal review by KPMG. I will discuss that with them. I haven't read it, Mr Beattie, so I can't answer your question because I came back to work this morning. I accept that Oscar obviously has his own area to look at. He will come up with the answers to that, but there's far more fundamental failures here within the system. I don't see the investigation taking place that's going to bring out exactly what went wrong and why and who. What we've got is we're looking at designs of controls, we're looking at processes. That's not going to bring out the information that's needed. There's already been work done on the NSS and eHealth and Tayside transfer of funds. That's separate from the endowments, as Christine has explained. I think that we do know fairly clearly what happened in what sequence in that setting. Where's the document that lays all that out? We can provide that. I think that it's something that we'd be interested to see. The Grant-Launton report did that. I don't know if you feel that that's sufficient, but the Grant-Launton report did set out the sequence of events. The KPMG internal audit in NSS does that in more detail in relation to the involvement in NSS. I think that it's important that the internal auditors do folk. They have a role to play in the lines of defence in an organisation. It's right and proper that the internal audit looks at the control environment and the ways in which you can assess the actions of individuals and system management in the system and then provide that independent shooting. I take quite a lot of comfort from the extent to which the remit does what we need it to do. It's not a review into individuals performance, it's a review into the control environment in the organisation. That's what we've set out to do with the work. I think that we need to be clear that it's not looking at people and what they did. Colin Rai is the point about internal audit. You've clarified that it is an internal consortium. That came to light in Hella McArdal's original report in the Herald newspaper regarding the endowment fund issue. I'll read something to you. The journalist source said, it's easy to threaten internal auditors with the suggestion that they will lose the contract if they rock the boat. They are treading the fine line between it being employees and independent arbiters. This source had said that internal auditors from NHS Fife and 4th Valley had questioned how endowment fund cash was being used, but they were warned that they risked losing their contract with NHS Tayside unless they backed off. It was unsubstantiated and reported in the newspaper, but I ask you to follow on from what Colin Rai was saying. Is it a concern to you that this has been said that an internal consortium—as you say, I assume that it is in use all across Scotland in the NHS—can so easily, according to the source, be threatened with losing their contract by speaking out? Is this something that you're concerned about? Anyone who threatens anyone in the NHS is breaching the values of the NHS and the terms and conditions of their employment. If that has been done, it is utterly wrong and completely unacceptable, so I wish to place that on the record. If the work that we're doing with Oscar shows that inappropriate pressure was put on internal audit, then that is something that will be dealt with. It is not acceptable. The only way that these things can function is if people are able to do their professional duties without fear of censure or losing their jobs, so I am very clear about that. If that is something that does not come out, Mr Gray, in the report, do you think that you gave the commitment at the start of the committee meeting that you would commit to looking at the issues that perhaps do not come out of the reports? If there are issues that are not covered that remain of concern to us or to the committee, we will pursue them. Bill Bowman has a short point on the issue specifically, and then I am going to bring in Willie Coffey. I just referred to my register of interests. KPMG is mentioned in the papers here. I used to be a partner in KPMG, but of course I had nothing to do with any of this work. Coming back to Colin Beattie's point, on the scope of the review of Grant Thornton, I took some comfort from the section under financial governance that says that the work will include the circumstances related to the retrospective use of endowments and the circumstances in relation to the use of the deferred expenditure. That, to me, did not just mean the process of who did what when, but why somebody did something. I just want to be clear that if that is not in the report, you will look to what I would call the root cause. Somebody did something for a reason. The timeline is just the timeline. The protective measures that you may put in place are the protective measures, but until you get back to why that happened, what caused that, I do not think that we have the full situation. Can you undertake that if that is not in the report, you would look to see that? We want to understand the root causes, Mr Bowman, because we do not want that to happen again. It is about as simple as that. Okay, so I will put that point down and see what is there. I also clarify that I have been in contact with Grant Thornton about the work that they are doing and I am clear that they are looking at internal audit reports, what risks were flagged, how they were followed through, differences between drafts and final reports. I do expect that the allegations that were made will be the fact that we will be looking at internal audit reports. Internal auditors are being spoken to by Grant Thornton, so they will be interviewed. They will put their point of view. Great, Willie Coffey. Thank you very much, convener, and good morning to you both. The issues that have come up on NHS Tayside have come up, whereas we understand that there have been robust systems of internal audit, scrutiny, risk management and so on already in place. The reports and investigations that have been carried out just now, and we do not know what they are going to say. However, I can guess that they will probably point at systems and processes in tightening up and things like that. At the moment, is your view that the systems and processes that we have are effective enough because we are here and these issues have been brought to our attention? Are they effective enough, do you think? And if not, what would you be planning to do at the moment to change things at the moment or tighten things up so that we have a better chance of catching some of these issues before they occur? Unless you are correct, minister Coffey, I am going to assume that you are asking me not just about Tayside but more broadly. Yes, you are. I think that the committee has already made points about that you can have all the systems and processes in place, but still things can go wrong and that generally has more to do with culture and leadership. However, the way to absolutely be certain that something will go wrong is not to have the systems and processes, it is that guarantee that something will go wrong. We want to make sure that we learn from this. I have already indicated that I do not think that we have necessarily got adequate separation in the governance of endowment funds as separate from board funds. We have a strong intention to proceed further with that. I think that there will be things to be learned from what has happened in Tayside that will be of more general applicability and I think that we will want to be together with everyone who is involved in providing assurance on risk and the audit of board funds in reviewing any lessons that we can learn. However, I do not want to lapse into any kind of platitude about lessons that will be learned. I think that what has come to light in Tayside has been the result of a systemic failure to address the underlying funding issues in NHS Tayside and what I mean by that specifically is that there have been assumptions made about asset sales that then did not materialise. There has been what was done on the endowment funds and I want to come back to that very briefly in a second, if I may. There is what was done in terms of the transfer of eHealth funds. Those are approaches that provide short-term relief. They do not provide a long-term sustainable financial solution and that is what Tayside is now addressing under the new leadership that it has but did not address systemically over a number of years. That raises for me, as the accountable officer, a question about whether there were more things that I should have noticed and I am taking personal responsibility for that. That is one of the things that I want to review in those reports. Were there signals that I should have picked up as accountable officer or if there weren't, is there something that I can do with the support of Christine and our external auditors to make sure that those signals are brought to the surface in a clearer way earlier so that we can do something about it? Specifically, I will be looking for assurance that I, as accountable officer, can better fulfil the role that I have, because the evidence before us suggests that there were things that should not have happened and that we were not alert to them. Why I said that I wanted to come back to the endowment point was, again, to move us away from this lessons-learned theme. NHS Tayside board has decided and agreed to repay from resources into the endowment fund. I think that that provides a very clear signal that they do not believe that the process that was followed was the right one. You said that, perhaps, there were signals that you should have picked up or that should have been picked up, but the Auditor General has done section 22 reports on NHS Tayside for the last five years now. The chief executive and chairman came to you, I think, for the last five years looking for brokerage. My take on that was that those signals were there in terms of the long-term sustainable funding situation at NHS Tayside, so why were they not picked up? The two things that I was referring to were, one, the use of the endowment funds and, second, the use of the eHealth funds, where there are things that I could have picked up on earlier and I want to know if there were and as yet I don't. In general, there is something about the way in which we address boards' financial sustainability, and that was part of my response to Mr Coffey. I want to be clear that, if there are other things that we could know that we did not, we find a way of knowing them. You are absolutely right that the Auditor General has done section 22 reports. I have already mentioned the issue around asset sales that did not then materialise. We can say very clearly that we had picked up at least some of the signals well over a year ago when, on 29 March 2017, we asked Sir Lewis Ritchie to go in with the Assurance Advisory Group, so I am not saying that we did not hear anything and that we did not do anything. At that point, Tayside, over a year ago, escalated further on our ladder of escalation. I am simply trying to be as honest and straightforward with the committee as I can that, if there are more things that we can learn, I am not in defensive mode. Hindsight is a marvellous thing, but the committee took evidence in Dundee a year past Christmas, and it was only last March that it escalated and Sir Lewis Ritchie's report was commissioned. Do you think that action by your directorate should have been taken earlier on the situation at NHS Tayside? As you say, convener, Hindsight is a marvellous thing, but we did set up the Assurance Advisory Group. That did not happen in a day. I do not want to be facetious, but I did not decide on the morning of 29 March to put it in place and announce it in the afternoon. That took some time to do, so you can be assured that we were carrying a range of concerns early in 2017 that led us to that point. We did listen, obviously, to the evidence given to the committee and what the committee thought about it. I think that that was an appropriate in proportion to the response and the circumstances. I am going to bring Liam Kerr in on this point, and then Ian Gray. Just very briefly, if I may, good morning. You talked, Mr Gray, about the endowment funds, and I suggested that the actions of the new board would suggest that there has been some misuse, if I can put it that way. Is not there some ambiguity in the guidance around the use of the endowment funds? If so, or in any event, how confident are you that this practice is not happening throughout other boards with perhaps the same consequences? I have asked for assurances from all the board chairs, via the chairs of the endowment committees, that retrospection has not been applied. As I said earlier to the committee, I have not had the opportunity to read all the letters yet, but I will do. I understand that they provide assurance that there has not been a similar action taken in other boards. Given the prominence that this issue has, I can be very confident that this will have been taken pretty seriously. No doubt, but just to press the point, is there ambiguity in the Government guidance? I do not think so, but again, if we discover from the work that Oscar is doing that we could clarify in any way we will, I think that it is worth remembering that in order for the retrospective payment to be made, Tayside had to suspend its constitution, so I think that that was a fairly significant step that other boards have not taken. The convener referred to previous session 22 reports from the Auditor General and the Auditor General. Annually and across the board on the NHS, in an earlier evidence session on those issues, she made the point that she has repeatedly warned about the risk to financial sustainability of the board, but not just the NHS board. In her view, the risk of a focus on achieving short-term financial objectives rather than long-term financial sustainability, she talked to her about a failure to resolve fundamental underlying problems. That rather implies that the Auditor General thinks the fundamental underlying problem lay with the requirements placed on NHS Tayside rather than what they themselves did. What would your reaction be? My initial reaction would be not to try to decide what the Auditor General thought. That is what she said. What I was saying was that there was an underlying issue with financial sustainability that Tayside sought too often to fix by short-term means, and that is why we put the Assurance Advisory Group in other steps that flowed from that. I think that the issue that presents in Tayside, which has broader applicability, is the importance that we attach to the pace of transformational change in the NHS and in the wider care system. It will be evident to the committee that, for example, in Tayside, they had undertaken to do some work on prescribing, which would release some funds, and that did not happen at the pace that they expected, and that had to be revisited. I sent the Deputy Chief Medical Officer to support them with that. What was happening was that a series of short-term fixes, instead of sustaining a pace of transformational change that would be needed and remains needed in order to deliver the necessary financial sustainability. All of the health boards in Scotland are going through a process of transformational change. That is necessary because of where we are, because of the demographic trends in the country, because of the changing patterns of demand and treatment, and the opportunities that we have to treat people in better and different ways and to access things digitally rather than people having to come into surgeries and hospitals. I would say that the key response to financial sustainability lies in the transformational changes that we are pursuing. The rate of that is important. Let me approach the same question from a slightly different angle. We have talked about a series of inquiries and investigations into what happened at NHS Tayside, what went wrong and to a degree that was responsible. To quite a significant degree, a number of those involved have, in a way, been found accountable already, the chief executive, the chair and arguably the finance director who retired earlier than expected. Those investigations are looking at what happened and what was done and what was wrong and what should have been done differently. A possible explanation would be that NHS Tayside and the board had been asked to do something by the Scottish Government and by the health and social care directorate, which was simply impossible. The task that they had been given was impossible because they did not have the resources available in order to deliver the service that they were required to deliver. Is that a possible explanation of what has gone wrong? It is theoretically possible because I would be a foolish person to say that a thing is impossible. However, if an accountable officer is asked to do something that is impossible, the first thing that they ought to do is say so. That would be true in the health service, that would be true in any other service, that would be true of me as an accountable officer in the Government. If I was asked to do something that is simply not possible, I would be required to say so. The Auditor General is suggesting that the current system in the NHS does not make it possible for the NHS to achieve financial sustainability into the future. Is that not something that you should be looking into? Perhaps what has happened in NHS Tayside is a signal that there is a systemic problem wider than just that board. The NHS in this country, as in every other developed country in the world, will not be financially sustainable if it does not transform. To that extent, I agree with the Auditor General. If we carry on doing what we are doing, that is not financially sustainable. Transformation is essential. What other boards—I do not think—let me avoid too many double negatives. Other boards are not in the situation where they are having information concealed from the board by the finance director. Other boards are not in the situation where they are applying retrospective funding from endowments. There are a number of things happening in Tayside, which we did not consider acceptable. As you rightly said, there has been persons held to account for that. There are some substantive differences of material fact in Tayside that make their situation somewhat different. A number of other boards are seeking brokerage in order to balance their books. That is absolutely correct. Interyear transfers of money is a sensible way to balance a £13 billion budget. I would be very surprised if we came to the conclusion that not allowing us to manage money across the year-end was a good thing to do. Audit Scotland makes a number of important points about multi-year funding. That affects what we are doing here through brokerage. In terms of what has happened in NHS Tayside as it has tried to balance the books, you seem quite confident that those kinds of things—not necessarily exactly the same things, but those kinds of things—are not happening in other boards. If you have taken that opportunity to check that, to survey it, to look for it. I will ask Christine to come in in a second. Christine meets the finance directors monthly. I meet them monthly with the chief executives. I can absolutely assure you that the issues that have emerged in Tayside are well understood by the chairs in conversation with the cabinet secretary and me, the chief executives and the finance directors. I think that there is no doubt in anybody's mind whatsoever that, if similar issues are extant in any other board that we will want to know about it. Have I surveyed it? We have done what we have done on endowments. Clearly, we have written to all the boards and got our responses back, but I think that it has also been made clear by me in person to the chief executives that there is acceptable accounting practice, which I expect everyone to follow. If there is any suggestion that that is not followed, there will be further action taken. I assure you or anyone that there is nothing happening in any board anywhere in a system of 156,000 employees with a budget of £13 billion. I would be foolish to say that there is nothing happening anywhere, but we have taken very serious steps following this to assure ourselves as fully as we can about what is happening. Audit Scotland is taking these issues very seriously. It is entirely a matter for Audit Scotland to decide what it does and does not include in its audits. I am perfectly clear about that, but I cannot imagine that it will be overlooking the circumstances that have arisen this year. I would like to develop the points that Ian Gray has just been making. It seems fairly plausible that no one seems to have gained from this in terms of personal gain or anything like that. If NHS Tayside is not doing what has been going on out of any kind of malice or mischief, then the other conclusion is that they are doing it out of need. If I am right on that, then, as Ian Gray moves, the issue with NHS Tayside is one of financial sustainability. We have then looked at years of management changes. We have had transformative talks since I think about 2001. Still, I believe that NHS Tayside is 1 per cent below NRAC funding, and it has, as Mr Gray identified earlier, a much bigger cost base. The narrative that we have here is local management is the problem. Local management is carrying the can. Is there a possibility that we are isolating NHS Tayside? We are isolating the form of management to distract from a wider narrative of underfunding and long-term failure in the system? I would like to think that the committee would accept that whatever flaws I have, cowardice is not one of them. If I thought that I had done wrong in this, I would take responsibility for this. The NHS is under pressure here in Scotland. I am not in any doubt about that at all. I do not think that anybody is. That is why we have developed a transformational change approach. We have not simply said on a piece of paper that we are going to transform but that we have regional leads. We have a regional structure coming in in the sense of regional delivery. We have local delivery plans for each of the health boards. We have a new and developing approach to recruitment. We have a workforce plan. We are addressing the issues that we face as comprehensively as any health service in the developed world. Every health service that I know of struggles to recruit in some specialties. Every health service that I know of would be delighted if it had more money. Every health service that I know of that is competent is transforming. That is what we are seeking to do. I think that I will stop there and be happy to answer more questions. However, I would not accept the proposition that we had somehow made a scapegoat of the leadership of a particular board. Before we come back to the transformational change, Mr Gray asked about the brokerage in other boards. Are you able to elaborate on how many other boards are going to need brokerage this year or next? Yes, I can. We can give that in writing to the committee. Christine, do you want to go over that for the committee? This current financial year's position will yet to be settled, but we can say what has happened for last year and what we see in prospect for this year. For 2017-18, the year is still subject to the annual audit process, but we have formally agreed brokerage with Ayrshire and Arran and with Highland. We have an addictive figure of £12.7 million for Tayside, but we are awaiting confirmation from the chief executive on that and subject to further discussions with Audit. Ayrshire and Arran's £23 million and Highland's £15 million, so just over £50 million for 2017-18 is where we stand at this point in time. The difference is that Tayside has a cumulative position because there has been brokerage since 2012-13, which is around £45 million cumulative. It is in a different position. The point that you make about enrack funding is that Tayside was an enrack gainer until 2017-18. There are changes in the formula. Tayside flipped into a board that was below parity and received additional funding. It is not in a similar position to some boards that have been below parity for five, ten years. The notion of underfunding is just to be clear that Tayside has received their fair share based on the formula funding for the board. There is nothing that I can see that would suggest anything that is disproportionate to Tayside from other boards. In the enrack situation, I just came into play in 2017-18, Tayside received £8 million of additional funding as a result of the formula change. It is worth being quite clear on that point. Just something that arises from that. Again, to be clear, you say that NHS Tayside received its fair share of enrack funding. Does that imply that NHS Grampian has not received enrack funding for some considerable time? As you know, there are a number of boards that our approach has been to having boards within 1 per cent, so nobody is less than 1 per cent from their funding target. We have moved that to 0.8 per cent. I am trying to differentiate for that Tayside has not been in that same position as boards like Grampian or Lothian have done. As we have discussed before, the cost per head, the proportionate share of spend on things such as workforce and drugs has been disproportionate in Tayside. There is some evidence to back up the argument that the underlying cost base of Tayside has not been resolved in a sustainable recurring way over that period of time since 2012-13. Thank you. Mr Gray, going back to the transformation. You said that transformation is essential, and I think that we can probably all understand that. What evidence, I think, that the public will want to understand or at least have confidence that transformation is happening and is going to happen at the pace and the scale that is required? Do you have any key milestones, if I can put it that way, as to what will show that this is happening? Yes. I think that the best evidence that the public can be given is what is in place, because we can promise to do things. At the moment, in Highland, for example, instead of travelling long distances, people are having their consultations by video link, supported as necessary locally by clinical staff. That is actually begun to happen. That is not tomorrow or next week. That is happening now. Similar things are happening in Ayrshire, where, for example, if you live in Cumnock and suffer from cardiac obstructive pulmonary disease, lung disease or heart disease, you can be supported at home, whereas before you would have had to be admitted to hospital. There are some very significant transformations already in train in the integration of health and social care in West Lothian. There is a react team that now goes to the houses of elderly people who would otherwise have had to be admitted to hospital. We are spreading those good practices across Scotland. I am not going to give you a great long list, but we can provide detail to the committee if it is helpful. As I have indicated, we have put in place a three-part workforce plan in consultation with COSLA and others, which I think is very important. We have added to the recruitment of GPs, we have said that we will add 800 mental health professionals into the staffing, we have done work to enhance health visitors. We are doing this. It is not all a future prospect and people can see the reality of it on the ground, but we have to keep this moving. I am very happy if the committee would find it helpful to provide you with a detailed update on the transformation plans. We have had the regional plans in from the three regions and also from the national boards. If the committee would like an update on that, I am more than happy to give it. I think that that would be beneficial. The one final thing is sticking with the transformation. You mentioned earlier about the financial position. You suggested that part of the difficulty is that a lot of what has been going on is about short-term financial management, rather than long-term financial sustainability. I think that we need to shift that focus. Is that happening? Will it happen? What needs to change overall to allow a long-term financial sustainability view to take root? I think that one of the things that needs to happen goes back to points that Mr Beattie and others were making at the beginning about why did this happen, as opposed to what processes do we have in place. We need to make absolutely sure that individuals who are concerned about things have a way of raising them, which they genuinely believe will be effective and not cause them any difficulty. We have done some work on whistleblowing, but that is a very far away end of the spectrum. I would hope that we would rarely have to get there, but it would be safe for people to do so if they did. What has become evident in the way that we have looked at some of the issues around Tayside is that there were some people who were concerned, and Ms Marr has made reference to concerns by internal audit, for example. We need to be absolutely sure that if people have concerns, they are able to raise them. We also need to be absolutely sure that we do not include optimism bias in our predictions. That is one of the issues that beset the situation around prescribing in Tayside. They were absolutely right about what they were trying to do, but there was optimism bias in the point by which they said they could do it. We need to weed that out. We also need to accept that sometimes change is hard. It will involve us discussing with national and local politicians changes to the way services are provided in order to do something better. That may also involve stopping doing something that happens at the moment. The problem that we sometimes beset ourselves with is that we lead with the negative rather than the positive. Instead of saying, this is what we can provide, and here are the changes that we need to make in order to provide that, we start with the, here is what we are going to have to stop doing sentence, and that gets people off on the wrong food. I think that we need to get better at being clear about what it is that we are going to do, and that is why I have given you some examples of things that are actually happening, as opposed to things that might happen. We need to get better at being really clear with folk. I mean citizens as much as anything else about what can be done. I generally find the citizens of Scotland to be fairly sensible and very bright lot to understand very clearly what is put in front of them if it is done properly, and I think that we just need to get better at that. Mr Greta, on that point, what NHS Tayside is doing on prescribing paracetamol undermines the Government's policy of free prescriptions? No, I do not think that it does. I certainly do not think that it is intended to. Alex Neil Paul, can I go back to the very first question that Colin Beattie asked, just to clarify the position of the chief executive. My understanding, and I think that the understanding of the committee, is that the chief executive was dismissed as chief executive. Is that right? No, not exactly, Mr Neil. I will explain the process for the committee. On escalation to level 5 on the ladder of intervention, I met the chief executive to inform her that that was the decision that the cabinet secretary had taken. Just to clarify, to dismiss her? No, no, to escalate to level 5. I also informed her that the consequence of that would be that her accountable officer status would be removed, so that does not cause her to cease to be an employee of NHS Tayside. So that stops her being chief executive? Indeed, it stops her being chief executive. So what date was that? Thursday 5 April. I have a timeline in here again, which I am happy to share with you. I met her on the Thursday afternoon and explained that the cabinet secretary's decision and the consequence of that. She understood what I had said to her. Christine was also present for part of the discussion and asked that she be allowed to go back to Tayside to let her own team know, and that undertook to revert to me the following day. I thought giving someone 24 hours to reflect on that was not an unreasonable thing for me to do. The morning of the following day, that is the Friday, the medical director of NHS Tayside Dr Andrew Russell contacted me to say that Ms McLey had been to her doctor that morning and was signed off sick. So when I spoke to her, she was not off sick, but she was signed off sick by her doctor the following morning. So as of the Friday, was she no longer the chief executive? That was the effect of the decision, and we put that formally in writing. That is when Malcolm Wright is appointed as the accountable officer. At what point does she technically, at what hour of which of those two days, she should technically stop being the chief executive? Well, technically, when I wrote to her, the fact of the matter was established on the Thursday afternoon. Right. So how do you get dismissed as chief executive and remain an employee? If anybody is dismissed from a job, you are dismissed. No, if your accountable officer's responsibilities are removed, you can no longer function as chief executive, but in order for a person to be dismissed, there would have to be a process going through, and that is, again, standard employment practice. And so she remains an employee of NHS Tayside. But you may remember, when I was the cabinet secretary, a similar situation for different reasons arose in Grampian. That's correct. And the chief executive was dismissed. No, he retired. Ah, he retired. Well, I mean, he went, but he retired. He retired. And I did not remove his accountable officer status. He decided to go. He decided to go voluntarily. So what job, if Ms McLees is still with Tayside health ward, so what is her job today? Well, at the moment, she doesn't have a job today because she's off sick. But when she is able to return to work, then we will agree with her what her future employment status should be, and that, again, will be done appropriately. For the interests of transparency to the committee, I should make clear that Ms McLees' representatives are in touch with us, but I can't say more than that just now. Can I ask, if I'm a nurse and I get, you know, I'm not up to the job and I'm told I'm not up to the job and I'm going to be dismissed as a nurse, I'm not offered any other alternative employment in the national health service. Is this great rule just applied to chief executives? Well, since I don't yet know what's going to happen, I can't answer that question abstractly, but if you're an employee of the NHS and you're taken through a disciplinary process and dismissed, that's quite a different thing from being told that your accountable officer status has been taken away. Even if someone does go through a process, it is not impossible for them to be offered another role at a different level elsewhere in the service. What won't happen— Is it not one rule for chief executives and another rule for everybody else? No, it's the same employment contract. How many nurses who are sacked for not doing the job then got offered to stay on? Well, I can't say, because I don't know. I think that what I would say is that it's important that we go through a proper employment process with every employee. I do know of situations in which an employee who has not been able to fulfil one role has, nevertheless, been offered an alternative role that better meets their skills. The examples that I know anyway have all been in senior positions. It seems to me that we've got a two-tier system if you're in a senior position, even though you've not done the job properly in the view of senior management in the board, then you can get offered another position. Possibly at protected salary? I don't know. But if you're down the line, if you're a porter or a nurse, that doesn't happen to you. You're off the premises, more or less, right away. Well, that's not the right way to run a health service, is it? The right way to run a health service is to observe people's terms and conditions of employment, and that's what we're seeking to do in this case, as we should in every other one. What's the process from here on in then? Presumably, the disciplinary process can only start when Ms McLean returns to work, for example. That would be correct. Depending on how seriously she is, she could theoretically be offered a year, and still is that right? That would be the same for any other employee. For any other employee, after a year off L, you would normally then have your contract terminated. I would need to check on the specifics of all the contracts, but that would be my general understanding, yes. Presumably, you come to some kind of severance arrangement. Again, that would all depend on the circumstances. I can't say without access to specific circumstances. You can see the concern that there is here, where somebody is being dismissed from the job that they're in. It appears to be possibly getting offered alternative employment, possibly getting a severance payment, and possibly before any of that happens, it could be offset for up to a year at tax sales expense, obviously. I'm not saying that that's employment law, but I realise that. However, those circumstances create a lot of cynicism among other employees in the health service, particularly those who are further down the rung. You don't get this kind of treatment, and yet senior people are getting favourable treatment, as they would see as favourable treatment. I can't comment without specific detail, Mr Neil. A person who is off sick is entitled to their terms and conditions, and I can't really go beyond that. For clarification, obviously, as the accounting officer is chief executive, you hold two positions—chief executive—and you're a member of the board. I take it, Ms McLean, that you're no longer a member of the board. That is also correct. Can I just move on to one other subject? Obviously, we've been talking about section 22 for the past five years. We've had a lot now of external auditors. At the moment, we've got two or three reports going on being carried out by large accountancy companies. How much money over the past five years, including the current investigations, what's the total cost of all of this being? Is that financed by out-of-the-budget of NHS T side or out-of-the-scorched Government's own budget? I think that I gave to the committee last time I was here a figure of £211,000 for the EY work that was done. If the committee would like an update on the cost of the various reviews, I'm more than happy to provide them, but clearly I can't do all of that until they're finished. You'll know how much contracts are worth, obviously. What would be very helpful in just a list over the past five years of all those external work commissioned as a result of the problems in NHS T side? Who did what when and how much did it cost to taxpayer? If it's a current contract, what's the estimated cost? I realise that, in terms of expenses and stuff, it may not be absolutely accurate to the penny because that hasn't been completed, but I think that order of magnitude of the cost of all of this would be useful for—we are an audit committee, so we should be looking at those things. That would be no problem. Just for clarity, Mr Gray, on a separate issue, but for NHS T side, there is a new review of the CURSE view unit that's just about to start. Just follow on from Mr Neil's point. Will the cost of that review be met by NHS T side, or has that been met by the Scottish Government? I think that the chairman of NHS T side announced that, so his expectation would be that T side would meet the costs of the review. I will follow up on the issue of the endowment funds again. I want to refer back to the initial report in the Herald newspaper by Helen McArdal, and this is an issue that I've been concerned about since this story broke. The journalist source said that the actual sum signed off was £4.3 million, and when I say signed off by the board for transfer into the endowment fund, it goes on to say that although only £2.71 million was spent of it in 1314. My concern, Mr Gray, is that if £4.3 million was signed off, was £4.3 million transferred from the charity pot into the core funding pot, or was it only the £2.71 million that was transferred? I raised the issue with Malcolm Wright at the NHS T side MPMSP briefing a week past Friday, and Bill Bowman and Liam Kerr both heard me raise it on the record. Malcolm Wright, the chairman of NHS T side, said that the £4.3 million figure did not mean anything to him. I'm concerned that that £1.6 million that's not been spent might still be in the core spending budget having been transferred from the charity endowment budget. Can you give me any clarity on that? We've followed that up and Christine can give you some detail. We anticipated that it might come up. We've asked for a formal position from the board, and I'm still waiting for that, because we've looked at it in detail, to clarify the total level of potential bids. If you like, it went to the endowment committee at the beginning of the process, which was closer to £6 million, so possible propositions could be funded from the endowments. The endowments committee made decisions on some of the things that are feeling appropriate and others are not appropriate. The accounts for the endowments show that there were two figures quoted. One was £3.6 million of funds that were approved, and two points seven were retrospective. We've asked the board to confirm the value, and they've been doing due diligence on those figures. Am I understanding verbally, I'm still waiting for it in writing from the board, so that they understand that the total sums that were transferred from the NHS board expenditure to endowments in that year were £3.6 million, but I'm waiting for that in writing. That's where we are just now. I don't expect it to be 2.7, I expect it to be higher, it seems like it's in the region of 3.6. What the board is looking at is whether any of that was expenditure that then took place in the following year. We want to make sure that we have one number and that we understand the total, so that's where we are today with the figures. Okay, so there are two questions on that. I think that you just said that you transferred from NHS core funding to charity. Would it not be the other way round? Well, I guess that it has the same effect as whether the expenditure sat in the books of the accounts and funding transfer. I think that what they did was to transfer the expenditure to endowments, but the point is how much of the financial position that the year end was was then charged to endowment funds. It looks like it's more than 2.7. It's around £3.6 million, but the board is clarifying that for us just now. Okay, let me see if I understand that correctly. We're still waiting for board confirmation that 3.6 was spent. Is it possible that more than that was transferred and is still sitting in the wrong project? That's what the board is clarifying. If they're understanding today that it's £3.6 million, there are different categories of endowment funds, or restricted funds and general funds, and they needed to look at both together. We've asked them to clarify the total amount and whether anything was expenditure that then took place in the following year, in 2014-15. We'll get the total picture of the board very keen to get that clarified with us too, and they'll write to us formally with the position on that. We've asked them to make sure that their endowment auditor is comfortable with that figure too. For me, that's a really key point because the whole endowment issue was a breach of public trust. If there's any uncertainty about how much money was transferred, where it's sitting, for the people, especially the nurses, who go out and raise this money for Ninewell's hospital and for other hospitals around, I think that that needs to be really clear about how much money was transferred, how much was spent and how much is being repaid. Can you tell me, Ms McLaughlin, of the six pieces of work that are being done, which piece of work will outline that? The work that Grant Thornton is doing, to be clear, will be the bit that looks at what. If you think about expenditure that has already been recorded in the accounts of the board, then it was a decision to be able to seek funding from endowments for it, so Grant Thornton's work will look at what is in the accounts of the board and what expenditure was transferred to endowment funds. To be clear, I expect Grant Thornton's work to be able to clarify that position. What I've asked for is that the endowment fund auditor verifies that figure, particularly if it's different from what was in the accounts at the time. Will Grant Thornton report on Tuesday? The report on Tuesday will be a draft report into me on Tuesday. Will that be made public? I would expect, as with any report, to have a period of review for another week beyond it, but certainly no more than that. All the reports that we would expect to be made public from this work, but I would expect to be a week beyond the date, given that it's the date for the draft report. It's Tuesday next week. I was just about to say that, Mr Neil, the cabinet secretary is coming to the committee on 24 May, and we had anticipated having the Grant Thornton report on 15 May. I think that I would certainly anticipate that. I will certainly undertake to have it turned around as quickly as we can. The draft is due in and Tuesday off next week, so I can let you know at that point in time what the turn around period will be to close that off before the committee appearance on 24 May. Just so that I'm clear on this, you said that the board was writing to you with clarification on that issue. I suppose that we will have two pieces of evidence. What Grant Thornton makes of the transfers from endowment to core expenditure and what was spent, what was transferred and where the money is currently sitting. We will also have the reply from John Brown, chairman of NHS Tayside, to you, Christine McLaughlin, with details of that as well. Is that correct? That's correct. Okay, and can that correspondence be made available to the committee as well? The default position is that all of this correspondence would be made available to you. Thank you. When do you expect to receive that reply? To be honest, I'd hoped to have it before coming today so that I could give you a firm position, so I expect it any day. I would hope to get it today or tomorrow. Do you know what kind of processes they're using to look at this? Is it internal audit, or have they brought in someone to help them to clarify what's happened with the money? The finance team has been going through all the transactions that went through the finance ledger in that period, so that they can do that review. Yes, they've had their own internal audit to look at it as well. It's really important that the endowment fund auditor looks at it, too, because it needs to correspond with what was in the accounts, and if it doesn't, I think that we'd really like to understand the reasons for any discrepancy on it. Is that the same endowment fund auditor who was in charge when the constitution was suspended and this money was transferred? Is that satisfactory? On its own, probably not, but with those other pieces of work that will get us to the bottom of the issue, it shouldn't be a hugely complicated piece of work. There were around 30 transactions that were agreed to be funded from endowments in that period, so they literally need to look at every single one and understand what expenditure was agreed to be transferred to endowment funds. In the scheme of a board dealing with £700 million of expenditure, that should be relatively straightforward to follow those transactions through, but the final piece of assurance that I'll get is from the Grant Thornton oversight of that work. I agree with you that it should be relatively straightforward, but it should have been relatively straightforward from the start that this money should never have been transferred. I'll only be satisfied once we've got the figures in front of us, and we know that there is no charitable funds resting within NHS Tayside's core budget. That's why I'd rather have one figure and agree what that figure is, rather than have something that moves. It was important to give the board the time to make sure that it does that full review, but I would expect it to be here tomorrow. Another point on this topic. Mr Gray, you said in response to a question from one of my colleagues earlier that I think that you had anticipated some sort of separation in the future around trustees of the health boards and the endowment trustees. A couple of questions about that. It seems from the evidence that your department has gathered from around Scotland so far that it seems to be working well in other places. Are you concerned that the rules might change just because of this issue in NHS Tayside, which I think has occurred of a lack of governance suspending the Constitution? Secondly, if you were to put in changes, are we then going to see effectively two boards in health boards, one to manage the endowment funds and one to manage core business? I think that you are right to first of all to ask the if it isn't broken, don't fix it question. However, I think that there is an issue here of public confidence, and I think that the way to address that is to ensure that there is visible separation. I think that what we don't want is to create some enormous additional bureaucracy around all of that, so I accept that as an important point. Clearly, people who are employed by the board and some of the non-executive members of the board may still be required to attend the meetings of the endowment committee. I wouldn't propose to take them all away from that as support to you. However, having that visible independence is important. It is really important that we use the opportunity to re-emphasise that the Constitution of Endowment committees is set up in a way that makes sure that ministers can have no influence over what they decide. That is the case at the moment, so that is not some future proposition, but I think that that has been lost in all of this. I want to make it as clear as I can to the public that those endowment funds are entirely separate and free from any potential conflict of interest. Certainly, in terms of applying the Nolan principles, it is not simply enough that there should be no conflict of interest, but there should not be a perception of one, either. I want to avoid that perception. The point that you have made about the importance is that the public attach to seeing that money that they have donated is spent in ways that they would expect only adds to the strength of my view that working with Oscar, we ought to make that separation as clear as possible. You are going to wait for Oscar's recommendations on that, really? We will certainly wait for them on that, although I do not think that if Oscar believed that some detailed work is needed on things that they find that we need to wait until all the detailed work is done, I think that there is a decision of principle here, which is the separation of the endowment oversight from the oversight of the board, bearing in mind all the points that you have made. I think that we should just get ahead with that, frankly. I do not see any reason to wait around on you. I agree, Mr Gray, and that is the impression that I got from the cabinet secretary in the chamber when she gave her statement as well. Can I ask one more question on that? I asked the cabinet secretary that day that she made her statement. To do a skills audit of the board of NHS Tayside. I think that she said that the current chairman, John Brown, is already undertaking that. In what form do you expect to receive that back? Presumably it will not come under any of the six pieces of work that are going on. Is that going to be reported to you separately? Yes, it will. I think that that is something in terms of the public record that we have to be thoughtful about. I do not think that it would be routine to place on the record an assessment of individuals. As I think that I have said in response to questions at committees before, we do not generally conduct individuals appraisals in public. There will be two parts to this. One will be the non-executive component of the board and the chairman's assessment of that. As I made clear to the board on the first day that John Brown was there and when I went to meet them, I expect any incoming chair to do that, to make an assessment of the capability and capacity of the board as a whole, not least for succession planning purposes. The second part of that, of course, is the capability and capacity of the executive members of the board. That would be routinely delegated to the chief executive to do that. I can give the committee assurance that both I and the cabinet secretary have already discussed those matters with the chair and the chief executive, and we will expect to hear from them before I think the end of June on what their assessment of all that is, not least because, if we do require to carry out further recruitment, then we will want to do that expeditiously. You said that not a lot of those appraisals can be made public. What information will the committee get about that process so that we are satisfied that it has been done and looked at properly? I do not want to pre-empt what John Brown and Malcolm Wright do, but what I would expect to be able to tell the committee is, A, that the process has been completed and, B, that, if it has concluded that some recruitment or additional resourcing is required, what that is. Mr Gray, the transfer of endowment funds was made back in September 2014 and it only came to light in April 2018, that is three and a half years later. I think that part of the issue for that is the lack of transparency. If anyone wants to go online and look at health board papers for any meeting, you will find well over 100, often into 200 pages and it is extremely difficult to make head nor tail of what is being talked about at the board. It is my opinion that those papers are designed to obfuscate issues. It is very difficult for politicians, journalists or any member of the public, to know what is going to be discussed at the health board. Is that something following the suspension of constitution transfer of funds that you are concerned about? Have you made any recommendations to health boards to try to make those papers a bit more understandable? I think that, first of all, I acknowledge that some of the papers that I have seen are opaque, so I will not argue about that. It will be important that, as part of learning from that, we try to make things a bit clearer and simpler. If I may express a view form of experience that agendas with 15 or 20 items on them will not lead to the conduct of particularly successful businesses, we should try to keep that simple and keep in the forefront of our minds that, while I am accountable directly to Parliament, we are accountable to the public for how we spend the money that they give us in their taxes. We ought to be clear about what we are doing with them, so I do not object to your point. Do members have any further questions? Relatively, I hope that they are straightforward. On board members, are all board members equal? Do they all have the same legal responsibility for the actions of the board? There are executive and non-executive members. They are jointly and severally accountable for the board, but their accountability runs from the chair to the cabinet secretary and from the chief executive to me. If you are on the board and something happens like this, you presumably cannot stand back and say, well, I am there because I was appointed by a local authority or I am a representative of some faction. Do the board members realise that they are all jointly and severally liable? I would hope that they do, and as it happens, I have a meeting with a wide range of non-executive directors on Monday, the 14— I suspect that they might. I think that it is a point that perhaps when we have issues like this coming up that they perhaps realise that it is a group or a collegiate situation. Indeed, although it does not detract from the point that individuals are accountable for their own actions, which I think is perhaps crystallised somewhat in taste. You need to watch out for who is sitting next to you then, perhaps. Okay, Liam Kerr. Briefly, Mr Gray, the convener talked about the senior management, and we talked earlier about transformation and how we move to the future. The committee has been rather concerned on a general level about boards and the constitution and the talent within that and what it is doing. Obviously, we are in a situation at the moment where we have a reducing pool, if you like, of clearly very good quality senior management, but taking on a number of different roles. The question is, what is the Scottish Government doing to ensure that the leaders of the future are coming through, are being recruited and those who aspire to those roles are being groomed for them, if I can put it that way. Are you thinking about the health service in particular or the wider public service in general? I will put the health service to you in your current role. We have now developed a leadership development programme, because I think that we have had some way to go in having a proper succession planning and talent management approach in the NHS in Scotland. That programme is now developed in place and up and running and supported by something called project lift, which is intended to work in a way that brings on people from within the system and beyond it into positions of leadership. I am pretty clear that that represents a considerable step forward from what we had in the past. If the committee would find it helpful, I am happy to share brief, not long and opaque details of that programme and how it works and who is engaged in it. I want to make the point, however, that fits within a broader leadership development programme that the permanent secretary has been sponsoring with some determination to ensure that we are developing senior leaders across the whole of the public service in Scotland, not just exclusively in, if you like, organisational silos. Forgive me that I should have asked this earlier when I was asking about adequacy of internal audit systems and processes. The letter from Colin Sinclair NHS national services referred to a report to that board that says that it highlighted specific areas of possible risk that would benefit from additional internal audit attention during 2018-19. The board agreed that those have to be implemented immediately. If you cannot tell us what those are now, could you write to the committee and tell us what those are and what the significance of those additional measures are? Certainly. I will intend to cover that in my meeting with Elizabeth Ireland and Colin Sinclair, which I mentioned had had to be cancelled because I wanted to understand more about that myself and how they were proposing to respond to those. I know that they have taken it very seriously. I have already had that assurance from the chair and the chief executive, but I just want to understand more clearly what those areas of risk were, whether they have general applicability or whether they are specific to NSS. I will certainly write to the committee following that discussion with them. I thank you both very kindly for your evidence this morning. I now close the public session of the Audit Committee.