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NHS Highlands chairman: ‘Organisation isn’t broken’

University chair Gary Coutts
University chair Gary Coutts

Anyone who follows the news these days would be forgiven for thinking that NHS Highland is broke. It isn’t.

But no one should think that, because we have a budget of £728million for this financial year, we are rolling in money. We aren’t.

Health boards must operate within financial constraints, and like our colleagues across Scotland we find the business of balancing the books a constant challenge.

That we did so last year was due both to a huge effort by everyone in NHS Highland and, ultimately, to the £2.5million brokerage we received from the Scottish Government.

That was money we have to pay back, and we must do so while continuing to develop and improve the range of services we provide people in Highland and Argyll and Bute.

At yesterday’s meeting of NHS Highland’s board, our director of finance, Nick Kenton, forecast that the board would break even at the end of the financial year.

However, he also explained that, based on the first three months of this year, there was a potential projected overspend of £15.6million.

Forecast break-even but a projected overspend – that sounds confusing, but it simply means we have to take actions if are not to end up with an actual overspend. And I am absolutely confident that we can do it, without compromising in any way on patient safety or service delivery.

That obviously requires some explanation.

It’s important to recognise that our finance director’s projections were based on the first three months of the year.

That means we have time – though I wish we had more – to get things on an even keel. And we are doing so through a range of robust initiatives throughout the organisation.

These are too numerous to list, but here’s a flavour.

We are working to reduce unnecessary expenditure on drugs. We are striving to reduce our use of medical locums, in part by providing safe and effective alternatives. We believe we can make big savings by more effective procurement of equipment. And we are convinced we can make better use of the high cost surgical services and skills which are delivered across four main sites in Highland.

Some of these measures – and there are many, many more – will bring immediate benefits; others will take some time to be reflected on our balance sheet.

It’s just a pity that when our balance sheet shows at the end of the financial year that we have achieved break-even, it won’t show that the care we provide continued to improve.