Gweldir speciall iawn. Welcome to the 15th meeting in 2023 of the Finance and Public Administration Committee. Apologies have been received by the committee's new member, Keith Brown, who attended our last meeting as substitute, on behalf of the committee. On behalf of the committee, I would like to put on record our thanks to Kenneth Gibson for his hard work and support. The first item on our agenda is to choose a new convener. The Parliament has agreed that only members of the yng Nghymru. I ask any member to make a nomination. I nominate John Mason. Do members agree to choose John as our convener? That's agreed. We'll do a little bit of shuffling if John wants to take the chair. I think that's us in place now. I thank the committee for my appointment and I look forward to continuing to work with you all. I also thank Michael Marra for stepping in to convene over the last few weeks as deputy convener. I hope that Keith Gibson will be able to rejoin us before too long. We will today start taking oral evidence in our inquiry into the Scottish Government's Public Service Reform programme. We will be hearing from Anthony Clark, executive director at Audit Scotland, Professor John Connolly, head of department of social sciences at Glasgow Caledonian University. And Alison Payne, research director at Reform Scotland. We had also hoped to have Dave Mokson from the SDUC but he is unable to be with us today and we may be able to get him at a future occasion. But he did submit evidence and we might refer to that. I welcome you all to the meeting. We intend to allow about 90 minutes for this session. If witnesses would like to be brought into the discussion at any point, please indicate to the clerks or myself and we can then call you in. We have written submissions from you all so we will just move straight to questions. If I can start by asking one or two questions myself. The first one was based on something that the previous Deputy First Minister John Swinney had said. He was very much leaving the idea of reform up to individual public bodies rather than trying to drive it from the centre. I wonder what your thoughts are on whether we can do that, we should do that or whether there needs to be at least some driving from the centre. Mr Clark, will I start with you on that one? It is very understandable that one would want to engage with public bodies to understand how reform can be implemented at the local level because reform needs to reflect local circumstances, the needs of communities, the different nature and configuration of public bodies, so I think that there is merit in having that local focus. Equally, it is very important that there is a sense of purpose and clarity in terms of what the Scottish Government is trying to achieve from its reform agenda. You will see from our submission that we have highlighted in previous audit reports that quite often it has been difficult to assess the success or otherwise of reform because there has been insufficient clarity in terms of what the intended outcomes were. I think that there is a need to strike a balance between local discretion and autonomy but national leadership and it does seem at the moment there is more to do to be clear about what the actual intended outcomes of the reform agenda is above and beyond the five key themes and the principles that are under being the reform agenda at the moment. I think that there is a question there around clarity of outcomes and that does require further work by the Scottish Government. So do you think that the Government needs to state outcomes and if so, what should these be? It was suggested before that there would be certain numbers of staff, for example, returning to pre-Covid levels. Yes, I wasn't suggesting that there should be specific targets necessarily if that's what you thought I was implying. I think that one of the questions that you highlighted in the inquiry was what should underpin the Government's reform agenda. My starting point for that would be going back in many ways to the Christy principles in terms of high-quality public services that support prevention, improve outcomes and put citizens and services at the heart of the reform agenda. I think that what needs to flow from that is clarity about what that means in terms of structures, what that means in terms of resource allocation and what that means in terms of the future shape of public services. It seems to me that it's quite clear that the way public services are currently configured, delivered and resourced probably isn't sustainable in the medium to long term. I think that that's widely accepted. What seems to flow from that is change is needed. My point, I think, is that there's greater clarity is needed about what that change will look like. Okay, thank you. Professor Connelly, more central direction, more local autonomy? My view would be that there needs to be a new philosophy of how we look at public services in public service reform in Scotland. I think that the idea of localism is very important and very much support localism, but I think that there has to be some supported localism as well. So central level direction and capacity within the system remains important. If we look at some of the issues or the developments that we've seen within the public sector in Scotland over the past decade, have you looked at initiatives like the community empowerment agenda and very much a heavy localism based initiative? I think that evidence is suggesting that community organisations, local government, CPPs require national level support when it comes to evaluating their contribution towards outcomes that are often set nationally but are required to be delivered locally. So I don't think that overly localist empowerment based model is particularly desirable, although it is important to have localism. It's important that local stakeholders are able to understand their position within the wider public sector and that there is capacity at that partnership level within the system because if you think about the public sector in Scotland as a multi-level polity, you've got the central government, you've also got a partnership national level but also you've got local level as well. I would be worried about there being a vacuum in the middle, so to speak, because I think that localism does have to be supported. OK, well, I'll come back to that and explore it a bit more but Ms Payne, Reform Scotland, your evidence, you're quite strong, I think, on pushing that it should be local levels making decisions, so maybe you could comment on some of this? Definitely, I think that localism is a really important thing and it's important that local circumstances and needs are taken into account that local authorities and different communities have the ability to react to their differing needs. I think that it comes back to what you mean by reform. I'm looking through the previous evidence that there was a feeling that reform was basically trying to ensure that our public services could live within their means. It was trying to react to declining budgets. What we would argue is that that's not real reform. We need public service reform and we need partnership in terms of working between the local authorities, local bodies and central government in terms of how do we radically change public service delivery, how do we meet the challenges of our changing demographics, our issues around the amount of revenue that we're raising. I think that that needs a collaborative approach so that we can have centrally set objectives and outcomes in terms of what we're looking at. Wanting to deliver but then there should be local discretion in terms of delivery and how those are met. I think that if you're looking at something like the national care service that's very much taken away from local authorities there needs to be more of a what are we trying to achieve, what is it going to do. It's not just about cutting budgets, cutting costs but actually improving delivery, improving efficiency, ensuring better outcomes for all and I think that needs to be more of a collaborative discussion at the start instead of looking at the longer term what do we want to achieve, what are the goals that we want to achieve, how do we want to reorganise our services and then look at how those can be delivered in the different areas across Scotland. Improving efficiency in one sense if the budget is limited and councils and health boards and all the rest have to work within a restricted budget in a sense does that not force efficiency? Yes but efficiencies aren't necessarily reform and I think if you're just trying to cut your cloth accordingly that's not necessarily going to give you the reform that you require. I think going back to Christie the importance of early intervention was really highlighted and I'm not sure that we've actually taken that on that we've looked at in areas such as the NHS where are the early intervention programmes that yes we have to deal with the firefighting and the costs pre-Covid and post-Covid the increasing waiting lists and problems there but those will only get worse unless we start looking at early intervention programmes how can we look at services so that we can actually start delivering preventive programmes and how we can work with others so that we can change how things operate we have changing demographics we've got in terms of the revenue we're going to have challenges with a shrinking working age population so we can't even just fiddle around with our income tax levels there are challenges in the future looking through the previous discussions that the committee have had we really need to look at the longer term I have that discussion about longer term reform and what we can do now as well as the sort of dealing with the immediately revenue challenges but actually looking to the longer term so how we can fix things now so that we're not still having this conversation in another 12 years and saying how we really need to do Christie Okay Mr Clark you come back in I just wanted to build on some of the points that Miss Payne has made really it seems to me that some of the big challenges facing Scotland at the moment such as child poverty, climate change, addressing inequalities and not things that can be dealt with by individual public bodies and one of the dangers of asking public bodies to focus on their own budgets is it might force people to just look at things that will work for them but actually want to address those complex cross cutting issues that are the real long term challenges facing Scotland at the moment so therefore I think that that does force you to think about how do you get reform as a cross public sector agenda rather than just something that's focused on by a council, a health board or a fire and rescue service and the number of things flow from that I think which you've heard from previous witnesses in other evidence sessions which are questions about how the accountability arrangements work so what are people rewarded for doing how are they incentivised to make change and reform it's not just about reducing budgets it's about improving public services we've heard people talking in the past about disobeying boundaries and that being a key driver for delivering Christie well disobeying boundaries means looking beyond your own individual organisation and yet at the moment one of the drivers of the current stated reform agenda is about individual public bodies doing what's right for them now I'm not saying that it's entirely wrong to ask public bodies to balance their books I want public bodies to balance their books I want what needs to be done properly my point I think is that there's a broader cross-cutting issue here that does require thought as part of the reform agenda OK, I was coming to you next Professor Connolly anyway because Mr Clark's led me into where I was going anyway because I'd been reading your paper on the co-production of health and social care services which was interesting and I think my question there's a whole lot that's already been mentioned but we'll explore that later as we go along we're kind of scene setting today but on the specific issue I mean yes individual organisations will be quite efficient maybe if we press their budget but would they work together with other organisations and I mean the health and social care's an example but do you think without central pressure organisations would look at joint working and co-production and more of that? I mean the health and social care partnerships I've worked with and researched with indicate to me that they're very happy to collaborate across boundaries it's having the opportunities to do so individuals within the workforce within health and social care are often really constrained in terms of capacity and that gives more reason in many ways to have some kind of overseeing leadership to allow for collaboration across boundaries When you say opportunities for collaboration or whatever are you meaning time or being allowed to do it? Time, space, infrastructure and having the leadership in place to allow for that I mean if we think about the nature of the modern public sector now there is more of a requirement now than ever before to work together because social problems have so many dimensions to them that require joined up approaches to governance and I think the history of public administration scholarship indicates that it's actually quite difficult to get joined up services right but it does require interdisciplinarity working across professional boundaries but it does require leadership in that space so when you spoke earlier about what John Swinney was saying I guess that raised some alarm bells in my mind about what would that mean then for collaboration across boundaries because I think that's becoming increasingly important in the modern world that we exist within so I do believe that structures are important localism is important but two things can be true at the same time and I think it's important to get that balance making sure that there's networks within the system and people skilled within the public sector to do collaboration that's the other thing I mean we often assume that there's just those skill sets there and leadership within the public sector to allow for that and it might be the case but when have we ever done a skills audit when have we actually looked to the workforce and said well to what extent is there opportunities to develop public service leaders in that way so I do think that long term that's something that we might want to think about is building capacity within the system in terms of the individual professions to allow for leadership across boundaries that's becoming more important OK I think we're getting more questions than answers here actually Ms Payne do you want to come in on this collaboration kind of idea? Thank you, yeah I think it's important that collaboration is from the bottom up I think there have been examples of where we have local authorities that work together but it has to be that they are coming together rather than forced collaboration I also think that there is a danger about collaboration and integration just being a kind of golden bullet almost because I mean we're on to our fourth attempt at integrating health and social care there has to be you know it's simply saying we'll push things together we have proven through health and social care it doesn't always work I think bottom up enabling people and as has been said bringing that collaborative approach from the bottom where you have shared circumstances and shared needs that can be worked together but I think being forced down a top down approach isn't the way to go OK, well thank you that's all the questions for me just now can I just say too I should have said at the beginning you don't need to touch your microphones or buttons or any of these things that will all be done for you so now I'm going to hand over to Ross Greer Thanks Thank you Just to start off with interested in some of the comments around the Audit Scotland paper Anthony and one particular line in it that said that given the trajectory our public finances are going to be on over the next couple of years small savings won't be enough if I could reword that slightly is it Audit Scotland's position that at present the Scottish Government is over committed that there are entire areas of service provision that we are going to have to cut back on to cease we can't just trim each service and reform each service to be more efficient more drastic decisions than that will be required I wouldn't use the word you've used Mr Greer but it seems clear to us that some fundamental questions need to be asked about the nature of the offer and what public services can deliver in the current context of increasing demand you know the fiscal pressures the kind of demographics and the challenges that Scotland's faced pre-pandemic around child poverty deprivation and creating a sustainable economic base for Scotland as well to try and answer your question it feels to us as though we need to think very hard about what the nature of public services are in that context and it seems to flow from that that the current models certainly need questioning the way in which we currently provide the health services reflects the post second world world war settlement the nature of disease is changing the challenges around child poverty are much greater now than perhaps they have been for many many years although we've seen progress in Scotland so we do think that there's a need to have a very first principle conversation about what a public service is here to do what should they look like who should provide them and importantly what role do communities play in that as well I think that's an message you heard from Professor Mitchell when he came to speak to you the ambitions of Christie the ambitions of the community empowerment act around bringing community capacity to play around public services and improving outcomes for communities feels like it's underdeveloped and not delivering the ambitions that we'd hoped when the legislation was passed so yes I think we do think that there's a big question to ask about what we can deliver in the current financial context if that answers your question Mr Greer it does yeah, thanks if I could ask that the other panel sent you the same question is the Scottish Government over committed relative to the financial resources that are realistically going to be available for the next couple of years Alison if you'd like to start the demographic challenges on the longer term yes we are going to have a shrinking working age population so unless we do look at how we properly reform public services how we manage what we look at our revenue then yes we're going to have an older population in many ways you can say that the NHS is a victim of its own success but as we live longer there are more demands we need to talk about how we meet those demands so I think it's looking into the longer term and I think it's important to start now having these conversations so that we can talk about well how do we pay for social care how do we pull our resources and pay for these things that we're going to have increasing demands on the reform Scotland paper is quite interesting and it brings up a lot of points that this committee and others would be familiar with particularly in relation to the NHS and the need to move away from treating illness towards prevention but given particularly the financial powers currently available to the Scottish Government limitations on borrowing powers if we're to allocate new resources for prevention they need to come from somewhere else at the moment there's not an additional sum of money we can't take it alone and do that does reform Scotland have areas that you would propose cutting from because not to put you on the spot but everybody comes to parmint saying we need to spend more money on X including prevention which makes complete sense it's much harder to get folk to propose where the money would come from I think there's a bit of different there's some different options so one example for example is that we have talked about care looking at the on-going care costs and we have said that if we were to put in a temporary increase in income tax so that we could start reforming social care now that we could actually look at reforming the proper care needs that were identified in Fili and that we've got proper social care system for the elderly but at the same time as doing that we set up a cross-party commission that brings in and that collaborative approach that others have spoken about across parties to look at well actually how do we with the demographic challenges that we're facing and all the other challenges actually ensure that we've got a proper care system that can look after people when they're older and so I think it's about yes, you're right if we want to deal with the firefighting that we've got to deal with and start introducing reform and early intervention it costs money and proper reform I've done looking into early intervention can save money in the longer term but there will be upfront costs and I think it's about being honest to that so that's one way where we've said we would increase revenue in a short term another one where I think there's ways and means that we can look at as we mentioned in the paper is around about tuition fees and there have clearly been cuts to the college and further education budgets so one way we've said is we would like to look at how tuition fees are managed is there a way of introducing a graduate cap could we use then develop systems that we could still offer free tuition if people stayed and worked in Scotland with certain skills for a certain period of time and develop different ideas if we're being honest and instead of that trying to score points of everybody but looking across the piece we can't just fiddle around with income tax and put up a whole load of new taxes on income and we'll suddenly be able to pay for everything we can't so there's that honesty with the public and saying look these are the challenges do you want an NHS that's going to meet its centenary do you want to still have all these services if so how are we going to pay for them and I think there would be a mixture of short and longer term decisions as to how we do that you're absolutely right that there's a limitation on how much we can realistically raise from income tax I don't think we're there yet but we're pretty close there's not much more that can be raised from that the STUC in their paper though they published a separate tax paper last December I believe that yes had income tax proposals in it but it also had proposals for new particularly local taxes as well as reforms to non-domestic rates so for this session it's somewhat more skeptical about solving this problem through simply raising more revenue so if you're interested in your thoughts on the STUC's proposal which is essentially we don't need to cut services we have revenue raising options that we've not explored yet well we've also not in the submission of this paper but we've published a report tax and times which talked about similar points about we have other tax-raising powers that we've not used there are tax-raising powers around wealth taxis that we could look at there are certainly other things that we could do but there are no golden bullets I think that's the sort of thing it's why you're raising the money and it's to raise if you're wanting to raise the money so you can actually implement proper reform not just carrying on and I think that we have to be honest and say more money isn't the solution to the problems facing our public services more money to enable reform proper reform is different and I think that's something that we would agree with that you could look at well how do we raise revenue so we can enable that proper effective reform that looks early intervention that looks at the sort of radical issues that Christie wanted to deal with then yes that those are perfectly we would agree with a lot of that I think simply raising money to try and maintain and keep our head in the sand we wouldn't agree with that sort of approach Thank you John, feel free to comment on anything that I've just asked if I could also ask you because I'm conscious of time I've been interested in your thoughts on the balance between quality consultation co-design in a reform process and how swift we're able to deliver it because we are simultaneously met with complaints often that there has not been enough consultation co-design etc but also that the speed of reform in Scotland is glacial in fact I think glacial is the word used in the reform Scotland paper there's currently a tension between those two things if we want that quality consultation co-design it takes longer particularly in relation to the sustainability of our public finances we don't have as long as we might want here how would you suggest we balance those competing demands I think that's a fair point I think that there are competing demands but I think that there's been perhaps a missed opportunities to get this right and I think that sometimes you do have to put up with a little bit of delay in order to actually have that vision and the systems that fall and plays behind that so I think it's worth taking the time to get it right rather than perhaps doing things on a more reactionary ad hoc basis so there are tensions and I do recognise that but I think the benefits are the costs and actually doing it properly and I think just to go back to your other point about efficiencies the way I look at the public sector reform and governance issues is around the ideas around public value so how do we know what's working and working well can we embed social return on investment methodologies into how we set up our programmes and services is it possible to actually think about how we evaluate what we do better in the early years of the SNP there was a focus on evaluation far more and I think that's kind of petered away for whatever reason and I do feel that there's now an opportunity to think carefully about how we equip public servants and those that they work with within wider civil society to evaluate better to evaluate what works we've probably all heard this idea of the what work centres and the different ways in which research tries to get into but I do think there could be more attention given to that so efficiency is important but you have to understand what it is we have to be efficient about and how to go about that so I think to me that's a call for better evaluation thanks very much conscious of time on that point of better evaluation whose role do you think that should be going back to the convener's original line of question around should reform take place within each individual public body or should we leave it up to each body should we leave it up to each local authority when it's their service provision or is this something that needs centralised and delivered in a consistent manner I think there has to be evaluation built into national agencies whereby there can be the capacity to do that so I think that there should be better evaluation and better evaluation and better evaluation and better evaluation of national agencies whereby there can be the capacity there to go and develop and train those in local areas to do these things better I think there's lots of assumptions that are made that public servants who work locally have the skills and capacities to actually evaluate effectively so I do think it does require some national training in the past the UK level used to have the national school of government could it be the case that we have a similar thing in Scotland whereby we have an academy for public servants to equip them better to evaluate what they do and the services that they provide in a collaborative way so I believe that evaluation actually isn't the responsibility of one part of the system I do think that it does need some overseeing but I do believe that if you're running a programme at local government level or within an NHS board you should be able to have the skills to evaluate the performance of what you're doing and it is a bit different from performance management in performance measurement it's actually about thinking about the outcomes of what you're trying to achieve and I think to be fair the government has over the years talked about outcomes at a broader level through the national performance framework and so on but the thing that's been missing is that capacity to be able to evaluate against those outcomes so hopefully that helps to answer some of that Anthony As Professor Calmy says it clearly has to operate at both national regional and local level in terms of the evaluation and one needs to be clear what one's trying to achieve at national level but success at national level may look quite different to success at local level and I think one of the challenges around the reform agenda and public service performance more generally is trying to make those links between what's happening at a local level to its performance at a regional and national level so the contribution effect is often quite difficult and I've got a great deal of sympathy for the Scottish Government in terms of the challenges they face in understanding how well reform is operating at those various tiers of governance it's a really important issue to get right though and it seems to me it's more important now than ever before given the pressure on the public purse we have been critical as you know around aspects of government reform where hasn't been clear what the intended outcome was and our recent NHS overview report highlighted the need for greater clarity around what success looks like in terms of getting the NHS back on track post Covid the issue in the NHS is replicated in other bits of government as well so this is an area where further progress is needed Thanks, that's all for me Thanks very much for that if we get time at the end we'll give people a chance to come back in Thanks, just from reading the submissions and what I've heard today things have picked up no clarity, pace needs to increase no targets, no evaluation no focus on prevention and intervention and an implementation gap between policy and delivering how does the Scottish Government get this reform agenda back on track because it seems quite damning so far Professor Conley do you want to go first? Thank you I think it's fair to say there are some systemic issues and you've summarised those really well I do believe that now is an opportunity and this is actually a really good example of collaboration here today with the voices of different civil society organisations who have got something to say about this agenda I do think there could be a better interface between Scottish Government and the wider academic community there's a plethora of research available in Scotland about how to do things better how to evaluate public services how to lead public service organisations there's lots of material and knowledge out there I do believe that there could be taken further advantage of but I also believe it's not just about central government, I think there's ways in which public sector bodies can come together and collaborate more and again with the involvement of the third sector as well so there needs to be almost a complete reframing of the opportunities for these different knowledge actors to come together as I said before, I think Ross Greer makes a good point about the tensions around time and delivery but if the Government is keen on a new way of doing public services I think now is the time to really get it right and having that space to do it I was just going to make the point that clearly there have been weaknesses in terms of the impacts of the reform agenda in the past, they've been well rehearsed and well reported, the Christie 10 years on commentary around the fact that we haven't really delivered on that prevention agenda and improved outcomes is well accepted but there are also some positives for us to think about as well we saw during the Covid-19 pandemic incredible collaborative working between the NHS local government, communities and the central local government relationship really focusing on trying to really improve and protect communities protect health, protect jobs and so on and so forth that happened during the Covid-19 pandemic that frankly would have been unimaginable for the two, you know people implemented changes in the space of a fortnight that would have been taken years and perhaps never even happened now I'm not for a minute suggesting that we should revert back to another pandemic but I think we should ask ourselves how was that possible what's that told us and I think what it's told us is where there's a shared desire to focus on what the bodies can do it and communities can be part of it as well I think the question that I think is really important right now is how do we continue with that focus, that collaborative leadership that energy and that dynamism at a time when there isn't that single unifying focus because the history I think of the period of pride of that in terms of the Christie was we didn't see that level of focus so I think there's a question that we should perhaps explore together people need to reflect on how do we get that energy back into the system so why do you think that happened, was it a case of there was maybe more money in the system people weren't too protective of budgets or was it more appetite to take some risks where it wouldn't be before or? I don't think money was the driver if I'm being honest Mr Lennon it seems to me that what was happening there was people recognised there was something that was a burning platform for change people accepted there was stuff that we needed to do together and in that context we didn't take more risks people made changes, did things perhaps at pace perhaps we slightly reduced governance slightly elevated risk appetites and I think we need to just pause and take breath and take stock and say how do we get the balance right between that level of energy and change perhaps a bit more rigor and structure around it perhaps a bit more clarity of purpose around it but how do we draw on those things really Mr Lennon Mr Penn did you I think there's the twin approach I think there's what needs to happen now and then it's what's looking to the longer term but reflecting on the sort of the Covid period I think there was also a great honesty with the public that these were difficult decisions that we needed to make and we worked with the public and that kind of on-going dialogue so things like the way the NHS that minor ailments was expanded that the NHS near me was developed really quickly and there was public buy-in and appreciation of what was going on and honest with the public that there's some difficult decisions we're trying to do this and we're taking you with us and that kind of collaborative approach with public services with politicians rather than it kind of being well if only we had a bit more money you know this is the reason nothing's happening if only we had more money whoever's fault it is that we don't have more money more money is this magic answer we've gone back to somehow just perpetuating that myth that that's the answer if somehow somebody else's different policies will give us more money and that will fix things whereas I think having that honesty and saying look if we're looking to the long term what do we want to do how do we want to reform in the First Minister's campaign to become elected he committed to the BMA's national conversation on the future of the NHS now he hasn't yet actually commented on that since becoming First Minister but that's an important conversation the BMA has called for other organisations saying how can we reform the NHS how can we and I think that's being an honest conversation that reform doesn't mean public or private there's so much more depth to that conversation in terms of if it's taxpayers fund dated then you have to rationalise healthcare what needs to be localised what needs to be centralised but that needs to be had in conjunction with the public we need to say well do we need all orthopedics to be done in all localities can we have specialist hospitals what needs to be done locally what can be done centrally the very fact that we've got more people going private shows that they're you know willing to travel further is there an opportunity there why aren't we having that conversation and I think it's actually also the realisation of the same people that we're going to start these conversations now we're not going to have a better NHS by Christmas or by the next Scottish election but we're having this conversation now so that in 10, 15, 20 years time our NHS is still there and so that's that and that's just one topic we've got all the other public services that we need to have those conversations with talking in that honesty that we had with during Covid where we were saying oh my god this is a shock to the system how do we address it, how do we deal with it how do we work together there was a comment I think John Swinney previously told the committee that making Christia a reality requires a collective national endeavour and I think that you know if you're looking to the long term we need that collective national endeavour that if we're wanting to reform we have those conversations, we have those honest discussions that are difficult and I think that's the thing we can't pretend there's no difficult decisions and why do you think we don't do that just now just because there's too many political red lines that people wouldn't touch something in things like tuition fees for example you mentioned earlier going back to the NHS so often the political dialogue on the NHS reform is about what is public and what is private despite the fact that the vast majority of the public's first and only interaction with the NHS is with a private sector contractor whether it's their GP, whether it's their pharmacist in fact where we've had expansion in recent years is through pharmacies, private sector contractors but yet the political dialogue is often reform means public or private and actually if you are honest with people the biggest question we get anytime we've done anything on NHS or done something around GPs we'll say oh you want to privatise GPs we're like no they're already private sector contractors if people don't have a general understanding of how the public service works to begin with how can you bring them with them in terms of bringing in reform and I think it's that sort of honesty and collaborative approach and saying you know what are the red lines but having a national discussion about those red lines and you know is it we want to maintain free at the point of use that's the red line so how do we ensure that that survives those important conversations need to be had rather than working to a timescale of an election which I say that being able to sit on this side of the desk and realise the difficulties of that but I think that's why that sort of collaborative approach across politicians that we've said on things like the future of social care having the parties work together it helps provide that I'm buying from the public as well because you can see that if the parties are working together there's political consensus around a problem we need a long term solution we're working together I'll just stick with you a second that you mentioned earlier about you know it should be localism and you know maybe view there's a couple of things we've heard actually the former finance secretary we were expecting some sort of blueprint to come back about public sector reform the former Deputy First Minister then came and said well we're going to leave it to the organisations you know it's local government or whatever we've given them that six, five themes they can go off and do their own thing what way is going to work I think I think there's a difference as well between I think the local solutions is really important and also reflecting the fact that what works in one area and what's a great local solution in one area won't necessarily work in another area and I think essentially it's important to accept that there will be differences across the country and that you know if one local authority or chooses to do something that essentially government starts trying to intervene and say we can't do that or you can't do that you're doing this and it makes mockery of the whole element of localism and different solutions and how they impact different areas so I think there's definitely room for local solutions but if it's just about efficiencies I think that's my concern about the way that the public reform has been spoken about it's just we need to deliver efficiencies to meet our budget constraints and that I don't believe is reform that's just simply trying to meet the budget constraints so it's supposed to reform our salami sites link for all these different organisations Fasr Cymru, do you have anything to add on that? Yeah, I was just thinking about your point when you made reference to the former Deputy First Minister's comments about localism I think the instinct again around localism is right and it's important but I think there's real dangers around this I think the Covid pandemic although as Anthony said there was some really excellent innovations that happened during that time but there were also some issues if we think about the challenges around health and social care the government basically admitted that they didn't understand the health and social care system sufficiently enough in terms of their response so it's all fine and well at a day-to-day level saying okay localism is fine, devolve responsibility but what if something goes wrong and what if you need that intelligence to make adequate crisis management measures could it be the case that perhaps the government becomes a bit of a hostage to fortune because of that overly devolved approach not having the local knowledge to make national level policy decision making so although localism is important and I would argue for it there are dangers with it as well and I think that balanced approach as we've spoke about is required because when the next pandemic does come along, how do you know you'll have the tools and knowledge there to put in place that adequate response Mr Clark, do you have anything to add on that or I was going to ask one last thing that we'd heard before about a local governance review and that seems to have went quite now in terms of the Scottish government it's something that is meant to be coming back but we haven't really seen and I would have thought that would have been part of the key reforms coming forward I think that we're very clear that we might promise in terms of supporting change and innovation and trying to balance that national and local dynamic really allowing local government and their partners to respond to their local circumstances giving them more power to make changes that they want to make to their services in collaboration with others you will have heard complaints from local government that it sometimes feels to councils as though changes imposed upon them and policy is imposed upon them by the Scottish government the New Deal I think is about striking that balance on policymaking I was just going to make one quick point on the previous bit of that I think we're all committed to localism and community engagement and community having a big part to say in terms of the reform agenda but I think we also need to acknowledge that there are tensions as well the whole postcode lottery question people wanting consistent services is a tension in this localism agenda and I think there's a tension between that localism agenda and the quite understandable expectation that's the whole of Scotland and that's just something we have to live with really and I think we do need to borrow your phrase Alison a bit of honesty about where that balance lies between national standards of services and local discretion that feels like quite an important issue that the Scottish Parliament, the Scottish Government and their partners have been wrestling with for quite some time but to return to your question Mr Lambsden the New Deal does feel very important in terms of potentially giving more powers more discretion to councils and their partners to deliver local responses to local challenges so we're quite excited by it and I know that the Government's very excited by it as well but should that not be part of this reform? Yes, of course it should of course it should and I think it's very difficult to see this reform being delivered effectively without that New Deal forming part of it's if you like, architecture or superstructure Thank you I suppose I hear in a pretty welcome consensus around all of you and the submissions that we've received around this about sense of real need urgency and you're all describing similar drivers as to why this should happen and so far I'm hearing a pretty comprehensive rejection of the previous Deputy First Minister's approach of saying let's get on with this that actually there needs to be some kind of intent so my question is to all of you is why is this not happening and why has it not happened Mr Clark It's a question that's probably better put to the Scottish Government than to the panel members I would reject that slightly Mr Clark part if I can because it feels to me that that's the nub of the question here what do you identify as the restrictions that are stopping this from happening? I wasn't trying to evade your question I am going to answer it I'm just making it a better place than I am to give you their rationale for where they are at the moment I think if we're being fair to the Scottish Government it takes time to work out what you're trying to do so I guess I see some of the statements that we've seen so far if you like, statements of intent in terms of the principles that might underpin the reform agenda and I think what we would expect to see with a bit more specificity around what the reform agenda might look like in terms of reshaping and remodeling of public services plans and strategies for engaging communities around the change agenda what success might look like some actual measures of success I'm not necessarily talking about specific performance indicators but at least something that one can look to and measure progress towards in terms of improvement in public services so I suspect that that will come in the medium term, Mr Marra Other comments on that I mean, I would say in time frame it's 12 years since Christy was published 12 years I suppose what I'm trying to get to is there a character in our politics and our public services and the way that we do things in Scotland that is stopping change Professor Conley Thank you, I think it has been a significant amount of time and I think it's a question of priorities but also I think it's a question about a lack of strategic grip on the issue I think perhaps there's not enough capacity centrally within government to work across boundaries to try and get this right you know, if we're going to have a new model for Scotland or a new public services model there has been opportunities to think quite carefully about that, there was a number of developments about five years ago around integration and health and social care linked to the empowerment agenda as well building on the national performance framework but it just seemed to be that a lot of the style of policy making was quite path dependent rather than taking that pause to think, okay, let's get this right and perhaps there has been a degree of policy distraction on other issues you know, maybe constitutional matters that perhaps could have been invested more within thinking about how Scotland works and how it could be more effective as its own polity so I think there's a number of political reasons but also I think there's a number of institutional reasons also I think that perhaps there's been and to be fair to the government perhaps there has been the idea from the early days that performance indicators are the way forward and that we need to hold local government and agencies to account through indicators but indicators tell you very little about what actually works and how to do things better so I do think perhaps there's been a slight misguided way of thinking about how to make things better to improve so again, you know I keep banging the drum on evaluation but I do believe that's very important and how to understand how to do things better so there's been a lack of investment in that I would say, good. In the paper that you produced in 2020 that differentiates Scotland as the acute level of policy focus upon constitutional matters leading to policy distraction that's a quote I mean, could you unpack that a little bit for us? I mean, why does that is that just bandwidth or is it something more structural? I think it is bandwidth I mean, I think there's the structures there in Scotland to do things better I mean, I did write that and I do believe that I think that, you know, when it comes down to a vision for government there's choices that you have to make whether or not you want to make sure that Scotland has the best public service that's fit for purpose for the modern economy but if there is that degree of distraction centrally on wider constitutional matters there's always an opportunity cost and that's the reality of any public policy there's opportunity cost is it the overriding factor? No is it a factor? Yes, I think it is but I do, my own view is it's about the infrastructure and the leadership around trying to get it right as I said before, I do believe there was some well-intentioned approaches there through the national performance framework the commission, the Christy commission all very important and gets to think about outcomes and think about the social problems of our time but the architecture just hasn't been there that's the key I think the electoral timetable simply means that going back to the service or honesty with the public that politicians by nature don't want to have to say well you know maybe that hospital ward might need to close maybe you won't be able to get your hip replacement just down the road you'll be better travelling a couple of hundred miles and justify that decision I think that there's a whole load of difficult decisions and I think to be fair to the Scottish Government I don't think since Christy there's been in any of the manifestos any particular great reforms set out across for public services can I challenge you a little bit on that because I wonder in terms of so for instance the approach taken to closing the attainment gap so the approach taken in Scotland to bring fence a certain amount of money was to go into pupil equity funds rather than to change the way that things were delivered where this has worked and the areas that the former First Minister went to study in London, New York there were significant policy change that public services were organised she rejected that and went for a cash injection so the other places work across perhaps more of an appetite for reform why is that choice made here? I don't think it's anything to do with Scots or our inability to take on I think as Professor Connolly said that there has perhaps been other issues that have been dominating our discourse not just the constitution but Brexit has also had that kind of talking about those issues whereas we're talking about public sector reform but that's like every single public sector area we need to look at and reform that's an awful lot of discussion looking in the longer term you can't do everything at all at once and it's not exactly a great manifesto pledge to say in 15 years time we're going to have an excellent NHS but that's the kind of discussion that we actually need to be having that sort of the twin track and that's where coming together and perhaps the committees of the Parliament can have a greater role actually in looking in that collaborative approach but how do we pick up the reforms that have been placed elsewhere what can we learn, what would work, what won't work and help push that discussion because at the moment there's plenty of discussion going on outside of politics about the BMA that's called for this national conversation people are crying out for a discussion on reform it needs that a sort of buy-in from others that yes that means there will be winners and losers and that there will be whatever the reform is there will be some things that some people don't like and we need to just actually be honest and say look if we want to protect the service or if we want to actually meet the attainment gap not like this but let's try it and also accept that on the attainment gap and how we deliver education in our schools what works in an inner city school will be different to what works in a rural area and that's okay because we have our local authorities we have democratic accountability and if local authorities choose to do something different that's okay because local people if they don't like it can vote out those local politicians but we need to be okay at saying that given around the workplace parking the debate in the Scottish Parliament should have been yes if everybody likes localism just leave it to the local authorities because it should be up to each local authority because what is decided on workplace parking in inner city Glasgow is of course different to in Murray that's okay it's okay to be different across Scotland we are a very disparate nation we have huge differences in terms of population we have spoken about already we will be faced wildly differently across Scotland we need different solutions so there is that kind of collaboration that is required about what is required in one area and others I misunderstood you earlier I answered the question around the current reform proposals rather than the Christie question and if you're asking me why we haven't delivered Christie 10 years on it seems to me that that's partly because we didn't specify what success would look like at national and local level in terms of what Christie would be in terms of improved outcomes different models of public service delivery so on and so forth so what we tried to do was overlay Christie on a whole set of existing policies priorities, governance arrangements funding models and therefore that meant that it got diffused and got dissipated and people could talk about what I'm doing Christie well what do you mean by doing Christie it became a convenient shorthand for whatever anybody wanted it to mean can I maybe push you a little bit on something you said earlier on as well Mr Clark you mentioned about the Covid response and innovation around Covid I mean I think one issue around that was perhaps around the availability of methadone available to people who have drug addiction substance addiction they could take it home and that became far more widespread rather than to attend a chemist part of my worry around that as a policy is the elasticity, it's bounced back and is there a reason that our system has pulled back from those innovations and said in actual fact we want to retreat back to the norm I suspect there are probably many reasons why that's happened Mr Marra people spoke at the height of the pandemic about build back better and to use the pandemic as a learning opportunity to do things differently I think we've seen not just in that particular policy area other policy areas people reverting back to the way things were before there are probably many many reasons why that's happened Mr Marra it's probably human nature the kind of old habits die hard it's probably I think in response to Mr Lampton we talked about the risk appetite people's risk appetite is reducing now so I think there's probably quite a lot of things going on with Mr Marra I'm not sure I could specify a single one You'll get what I'm trying to do here about the structural issues so my final question is do you get any sense that those fundamental blockages and I agree with Alison Payne I don't think Scots are averse to reform and change there's absolutely nothing in a national character the way they do things it's something in our politics and structure is there anything that's changing those blockages at the moment or that there's potential for change you've talked about increasing demand but is there something that we can have some hope that there might be a change to the political and structural setup I think we are all very hopeful and perhaps the fact that there's a new administration and that I think that's maybe again to use Anthony's comment earlier about looking at the committee that question is there hope that politicians can work together more is there hope for more collaboration that rather everybody being in one camp or another but recognising that just because you have one view on one political issue doesn't mean that you might not actually have something to contribute in another area there are areas of agreement and there are areas of disagreement and that just because you disagree in one area doesn't mean that the other person is the worst person on the earth and isn't worth listening to and I think actually trying to be more collaborative and actually as a nation having those discussions where we're willing to work together and listen and listen to each other and move forward and recognise because if we all start from the point of we want to preserve and maintain we're all starting from the same point it's just like well how do we get to that end goal I'm cautious about being too optimistic because I'm an auditor and Provency is a basic accounting concept but what I would say is I observe increasingly public bodies talking about what they need to do together not what they need to do themselves and a recognition that although efficiency isn't the whole story here if we are going to drive efficiencies best done by people looking across the system and taking a systems view so I guess I'm cautiously optimistic about that Professor Cummings nodding at that point Cautious optimism I think is correct I think absolutely I do a lot of work with health and social care partnerships through my research and do a lot of work to try and understand some of the systemic issues within the system but when I speak to chief officers and those that work underneath the chief officer there is a real appetite to do things differently to benefit the communities and to make lives better for people so there's a strong optimism within the system I think going back to what Alison Payne was saying perhaps it's about fronting up nationally and saying we're going to try some new things we're going to pilot, we're going to experiment and we're going to allow for intelligent failure potentially and make sure we learn the lessons from that and the only way in which innovation builds itself into the system is by trying new things and I believe that that's something that perhaps is missing from the current agenda at the moment Thank you Liz Smith is next Thank you Ms Payne can I take you back to one of your first answers this morning where you said and I quote that efficiencies don't equal reform I entirely agree with you on that in the context of what the Scottish Fiscal Commission has been forecasting its sustainability report where it's very clear that when it comes to health spending health increases from 35% of devolved spending in 2027-28 to 50% in 2072-73 and they are projecting that there's going to be very little decline in spending on social care and social security as in pretty grim in terms of the money that we need to ensure that we are sustainable for the future I think your answers in fact all the panel's answers this morning are very interesting about what we need to do with public sector reform but the other part of this is what we do about taxation and Ms Payne you mentioned in your submission about broadening the tax base and you gave us some suggestions about how that might happen but just as important in that is whether we have to restructure the taxation system and you hinted I think in another answer that we probably do and I just wondered if you could give us your thoughts on reforming the taxation structure certainly I think what I would start with the reform of Scotland has previously said and we continue to say that with the financial settlement in Scotland and basket as it were with income tax it's over three quarters of revenue income and it makes it very difficult to look across the board at how and the risks there about if you experiment too much you could you know the very wealthy can move and we've got I think it's something like only 1% of all income tax payers in Scotland are the top rate payers compared to 2% in England and we can do we do have powers over new taxis and I mentioned about looking at things like wealth and particularly in mobile wealth I think that's the key thing is in mobile wealth because for obvious reasons you can't shift it down south or to more competitive tax environments I think it's looking at creating a tax system in the round that can attract people I think yes we need to broaden our tax base and we also need to clearly get more working age people we need to get more people contributing to our revenue and so what we can do to create a competitive environment that brings people into Scotland but we're also looking at local government financial powers as well that we believe too much has centralised the moment so we would want business rates and council tax to be fully devolved local authorities so that they could amend them to fit their local circumstances so if one council wanted to introduce a land value tax or somebody else wanted to do a local income tax they were able to address their financial concerns and their interests in their area but yes I think that there is still a limit on what we can do and I think as you outlined the projections on health spending are scary and that's why we need to do something and so maybe there are issues around if you're honest with the public and say as we've suggested we're going to put a penny on income tax because we want to start implementing radical reform on how we pay for social care so if we start doing that now and we put together a cross-party group looking at well how do we fund it in the longer term is it some sort of social insurance that's required how do we actually fund a social care system that is fair for all and looking at different options so that are there issues around as I say a social insurance or other funding methods that we can develop to pay for those things healthcare we massively need to look at early intervention to prevent some of those things coming down the line and we haven't been able to afford to pay those the other areas looking at the powers that we have there are some discussions about the fiscal framework review now while we can't borrow for revenue costs if it's borrowing for investment is it something saying right this is a short term project can we expand our borrowing power so that we can fund some sort of and pilot and experiment with reform to see what can happen to see what we can use and to develop these things to start now so that the figures that you're talking about we're not keeping our head in the sand until we get to the sort of 2050s where it's unsustainable when we had the Scottish Fiscal Commission in several months ago giving evidence on the general sort of economic situation they were very strong in their views that there should be an old party well not just old political parties but a whole number of stakeholders involved in a tax commission that would look at this issue is that the view that you would subscribe to as well to ensure that we get at least some kind of consensus about what is economically and socially good for the country rather than what is the political agenda is that something that Reform Scotland would support absolutely definitely from an audit Scotland angle can I just ask the same thing that obviously you're not in a position of being able to advise government on policy as such but again from an economic and a social perspective so serious are the the future trends that we're having to deal with which as I said is summarised in front of me here just now do you think that the best way forward on advancing a discussion about changing tax structures particularly in line with our changing demographics is the best way forward there needs to be alignment between ambitions and funding and taxes part of that Professor Connolly do you subscribe to that too? I agree with the panel members having a conversation about tax is very important a tax commission I think would be a good idea taking it out of politics and sitting down and being honest about what the options are and the costs and benefits of each option and what that would mean for public services and making them sustainable for the future I think that it goes back to the heart of the other issues that we've been looking at today is about having a national conversation and actually not shying away from some of the more challenging areas of public policy I mean obviously there is a difference between the tax structures and the rates of tax which tend to be much more political in many ways Ms Payne you recommended when you were answering the first question that tax is something that needs to ensure that Scotland is competitive it's the best place to come to live, to work and to invest what recommendations would you make to ensure that Scotland from a tax structure basis is more competitive with the rest of the UK and with other countries indeed? I think on that one I'd come back to the first point that I made about the restrictions on the powers that they have at the moment it is only on terms of how you can be competitive I think you can make arguments about why it might be higher I think what we have found though is that to say that you're getting free tuition fees but that's coming with a problem or the other so-called freebies isn't enough to necessarily balance it out I think there's also a feeling that because we have so few at the top rate we have kind of expanded and we are targeting that middle group who are I think as challenges become more apparent there will need to be a proper conversation about universalism versus the targeted support so you could find that as more and more of the so-called taxpayer-funded perks disappear what is it that people are getting for that increased tax from here and I think what has happened over Covid is that you've got more and more people who can we're working from home so therefore you can work from anywhere Scotland is somewhere that you can work for you maybe so we want to attract these people come and live in our amazing country work from home if that's what you're doing come here therefore why would you come here what is the offer no I've also said that Scotland's talks about increasing taxes but I think if you're doing it for a specific thing like we were talking about social care I think that kind of conversation with the public saying right we're doing this for this specific purpose but equally the threshold change between the UK and Scotland the money that's been raised from that pretty much covers the small business discount so you could equally argue that what has happened up here has seen transfers between earners to businesses to small businesses now that's a political discussion but it's not really sort of saying well man in the street is paying more tax but it's meaning that there's a child payment there needs to be more of that kind of clear discussion that this is why this is what it's developing we're trying to address child poverty or we're trying to ensure that we can reach net zero or we're trying to do various things that if you can set that message whilst also offering public services that look sustainable we can attract more people to come into Scotland we can attract people to come here to set other businesses to create more working age people which will then generate more revenue which will then help us into a more sustainable position I mean just obviously one of the other findings of the Scottish Fiscal Commissioner and the Fraser Van there are all sorts of economic groups is the fact that our aging demographic is a really serious problem when it comes to the tax take as is the fact that the declining share of the working population within the total population is really serious and so I think we have to ensure that not just talking about changing tax structures which I personally believe is very important but we actually have to ensure that the rates of taxation whether that's on consumers personal income makes Scotland much more attractive than is currently the case Scotland is in desperate need of more higher paid better jobs so that people are attracted to come here and I think the balance of tax structure debate as opposed to tax rate debate is actually very important in that so your comments have been very helpful because I think the problem is urgent the very strong message from the economists that we need to act and is preferably on as cross-party abuses as we can I'll just add something quick on that I think one of the things when we've said about more powers but corporation tax legislation was passed to devolve it to Northern Ireland there's an opportunity there to if it's been devolved to Northern Ireland could it be devolved to Scotland could we use corporation taxis as a way of attracting more businesses I think it's not just devolving for it's sake but then you begin to build a basket of taxis that we can look and create more of an attractive tax environment but I think there's an opportunity with corporation tax to do that my final question is would each of you like to see not just a fiscal framework which is obviously being reformed just now between the UK Scottish Government would you like to see a fiscal framework between the Scottish Government and local authorities would that help matters yes I think it would help you got a short answer for that one thanks Liz now in Michelle Thompson thank you for being patient and waiting till the end awful big ethical order last letter thank you for joining us this morning I've got a few different questions first of all Alison I'd like to come to you we've had a very interesting discussion this morning but what we've not really touched on all that much is public perceptions and arguably the public are behind the curve and any change is either seen as it's going to cost me more or I'm going to get less in your opinion the step back from the former Deputy First Minister from the RSR and as we now know that local bodies whatever they are will look at their own efficiencies or reform accepting all your earlier comments where does the public fit in this and to what extent is the new approach a missed opportunity for really making the public part of this burning platform for change as I think Anthony said I think the danger when it's down to individual bodies I think the relationship with the public is less visible I think those who engage with those bodies obviously have a vested interest and will be more aware of what's going on but I think what we can see at the moment is that there will be issues around the local government budgets and constraints and individual cuts but there's no kind of overarching strategy so therefore the public are kind of just dealing here, there and everywhere there's no narrative and explanation of what's going on or how we're trying to build back better or how we're trying to deliver reform and I think it comes back to the fact that there is no actual reform efficiencies aren't reform it's just we're trying to cut our cloth accordingly so the only narrative and discussion with the public is well we need more money where's money coming from rather than the well things are difficult so it's not just about money it's the demographic challenges this is how we're going to start fixing it and I think we need to have those conversations in the same way that we need to have difficult conversations as to how we're going to reach net zero people's houses aren't going to all of a sudden start having get rid of gas boilers if we don't talk to them if we don't explain, if we don't set up the challenges and build that lead in time and I think the the public will understand they will want to protect they will want to ensure that these public services survive but I think it involves that if you have collaborative leadership across the parties saying and having that discussion with the public and saying well whether it's a national conversation on the future of the NHS or it's local government reform or it's other areas and saying well this is what we want what do you think and engage with them whether I'm engaging in citizens assemblies as part of those discussions bringing the public in so it's their working with and understanding the issues that we're facing that simply a constitutional question whether it's with the EU whether it's with the UK is not going to answer any of these questions these questions will remain whether within or out of the UK we will still have to face these questions so working with the public and having that sort of honesty but it has to come from the top and I think those conversations if you're looking at real longer term reform they have to start with the Scottish Government and they have to explain to the public that this is why we're doing it and we want your buy-in and both John and Anthony is that something you'd agree with that positive action too fully involve the public in matters Anthony I couldn't agree more it seems to me that changes coming whether we like it or not things will have to change in terms of the nature shape patterns of delivery of public services that inevitably means some disruption I believe to think that everybody will be happy about what the future might look like but I think if we involve people in the discussion involve them in the conversation if they have a voice in a say we're more likely to end up with a set of public services ways of delivering services that will be better suited to local communities that seems to me to never tell this to me there is a challenge I think because it can be a bit abstract public services what do they really mean I mean they mean something when you need to go to the GP or the hospital we need to find a way of making this a meaningful conversation as well and I think that's not quite as straightforward as we might imply in this conversation John, I'm hoping from an academic perspective you will be able to add to this in terms of your recommendations of how the Scottish Government if it did want to involve the public in that way what the most effective ways are of doing that Public perception is key the first experience that citizens often have with government is when they try and make a GP appointment they're told that their knee operation has been delayed or whatever and I think that it's important for them on the ground to understand that the Government is listening and they're actually going to do something so there has to be a national conversation but in order to inform that conversation there are a number of ways in which Government might want to think about that it could be through citizen panels, it could be through citizens juries there are ways in which those have been effective and a number of different issues across the world climate change, local action and climate change some key social issues so I think that there are options there but what I would say from an academic point of view is there are limitations to those deliberative forms of democracy in that it does still require leadership it requires those in power to cut through some of the debate and some of the dialogue it's being collaborative making sure that everyone understands the pros and the cons, the opportunity costs but those engagements with citizens are key to get to that point so it's not to say that you can just hand everything over to the public to make difficult decisions so that's the job of policy makers the framing if you like Anthony I wanted to ask you it's a slightly technical question but just to help furnish my knowledge of course there's rules as I understand it that we've deemed a public body and therefore is pulled into the figures which I saw in your submission the increase but I suppose it strikes me that there may well be other bodies in receipt of public spend that don't fulfil that criteria yet the majority of their money comes from Scottish Government and I'm thinking of the analogy here if you like with IR35 in the private sector the rules were applied they actually would be deemed part of the public sector are you aware that that's the scenario exists I'm not asking you to name anyway I'm just asking that as a principled question there are a whole range of bodies that receive public funding and provide public services that deliver public goods allios I guess one example grant funding to the third sector as well as an important part of the whole landscape of the services communities I suppose the point that I'm making is that with the data that we have on the strict definition of public services is that actually an underestimate of what the implications are and that therefore when we're looking at public sector reform the implications are greatly more significant I'm just trying to get a handle on that If I might approach this in a slightly different way I think that there's a strong sense of the decisions that I'm having with people in public services be it the health service or local government or indeed fire and rescue and police that some of the bodies that we've talked about allios and third sector bodies are really important players in the reform agenda and I think that they're crying out to be involved a bit more really as well and we did see a great deal of engagement support and activity from those types of bodies during the Covid-19 pandemic it seems to me almost self-evident to be part of the conversation moving forward as well Okay, thank you My last question, convener, concerns again, it's slightly more nuts and bolts By getting individual bodies to look at their own efficiencies or reforms or however you want to phrase it you're missing the opportunity for creating shared services which is a not unusual way of getting economies of scale and I'm thinking here in terms of multiple finance directors multiple HR directors and of course procurement where you can get economies of scale probably for that reason alone I was surprised that they could have stepped back from the RSRs it seems to me that with the best will in the world turkeys don't vote for Christmas so could I have some commentary about whether you agree with me that they are where you might want to start to look at if not reform I appreciate Alice in your analogy it's rather crude I don't regard it as reform but perhaps lower-hanging fruit and since you're smiling you may as well go first I think it depends on the particular bodies so for example on local authority areas where you have that sort of democratic accountability I think yes there's certainly given the size of some of our local authorities the opportunity to collaborate and I think some of them do but again I would compact my earlier point about it being bottom up and kind of those that sort of coming together yes, turkeys don't vote for Christmas and I think in some of the other areas they would require leadership so if you've not got the democratic accountability that perhaps local authorities would have there are other areas where you could look at collaboration for example could you pilot some of the areas where you have could terminus boundaries with say health boards and local authorities could you do something with say Dumfries and Galloway and look at something that could help also work and improve the integration of health and social care in that area are the things that we can pilot that would enable a sort of giving that democratic accountability into the health services working in that area but trying things in different areas rather than it being one and the same but just looking and pilot and evaluating and trying different things so yes there would be a mixture of where you could have bottom up but there would need to be some central political leadership involved final comments from John and Ante in this I think shared services has to be part of the discussion and part of the agenda we have a very mixed story of shared services in Scotland and a number of them up and running then sometimes they failed I think the heat has slightly gone out of the shared services agenda over the recent years there was some interesting work published recently by the improvement service in Solace which was a future operating model for local government that was very clear I think that they felt that councils and their partners should be agnostic about who provides services and that's not just agnostic about whether it's a council or a health board it's agnostic about whether or not the best model is public or private provision well that feels quite important if we look beyond the boards of Scotland to England and other parts of the UK things like the combined mayoral authority in the north of Tyne and if you look at what's happening in the Manchester mayoral region as well it seems to me to show that there is real potential gains to be had in terms of that sharing of expertise, sharing of capacity Professor Connolly talked about capacity being an important bit of leadership and improvement there must be something in this but as with Alison he can impose a model on different places but there is also a need for some leadership from the top final comment I think that there's also an opportunity to look at the roles within the public sector around those issues around shared services because it could be that the workforce themselves has to think more carefully about how to do shared service how to be innovative in the public sector you know what the skills that are required earlier I talked about workforce development and opportunities for public servants to actually enhance their skills when it comes to leadership at their level are we making big assumptions that you know individuals can just go ahead and do that okay go and share your services and just get on with it well actually it might be a good idea to do some kind of audit of the skills that are there and the development opportunities that could be put in place to enhance the public sector towards shared services so for me the way I look at this is more about that capacity at human level in terms of occupations and careers within the public services so that we do equip the modern public managers for the nature of society that we've got just now final comment convener I know I've still got some time but I think it was yourself John that mentioned culture and innovation I mean there is a tendency with some people that reform the public sector means less of it but the same structure and the same culture and the same behaviours when really and you distinctly made that comment about innovation final kind of thoughts from you all how on earth because at a change level it's extraordinarily difficult in any organisation to change culture and empower people but have you got some final thoughts about that it's the kind of how you would go about that it's quite a challenge for some other countries I think bringing in opportunities for individuals to learn from each other in terms of innovative projects that have happened I mean there have been innovative activities across the public sector particularly around the digitisation of some services the opportunities to work on social innovation perhaps bringing in third sector organisations to work collaboratively so I think for me it's about having the discussion about allowing that to happen skills around innovation are important but at the same time you have to see that in the context of the particular environment so for instance within the health and social care setting you can have those that are expected to integrate within health and social care that are employed by different organisations or on different pay grades they might also have different professional silos and I think those are the things that have to be unpacked at a local level to allow for that dialogue around innovation to take place Alison I think the cultural things definitely is an issue but I think it also depends on the specific sector area and there will be different solutions in different areas I think we've got the changes coming to the education bodies coming soon and that one of the big things has been there needs to be a change in culture you can't simply replace the name of the body and it's going to somehow be a new body and there's an opportunity to look at what happens there and working with teachers working with the sector and I think it's what will be right for the new education bodies won't necessarily be right for an integration between health and social care but it's working specifically on those areas with the sectors involved with the people that work wider and feed into those bodies and trying and failing and learning I think there's a lot of innovation taking place in Scotland at the moment and I think it sometimes gets underplayed I think one of the issues is it probably is operating in small pockets rather than at scale when I look at how public services are delivered in Scotland at the moment compared to when I joined Audit Scotland in 2003 they're really quite different in lots of areas there is a leadership issue here I think about creating an environment where people feel able to innovate and test and the risk appetite thing as Conley talked about earlier is important and my sense is that people that work in public services they know that things are going to have to change they're not naive they see the budget proposals they know what's going on in the health boards councils and executive agencies and I think getting them involved in the process of deciding what the future models of public services are drawing on their knowledge and expertise is really really important Thank you very much Have you touched on today that you feel we should have asked you about or you wanted to say that you haven't had the opportunity to say? No? We're all looking quite happy, that's good Well if I can thank you all very much indeed I've certainly found that fascinating very helpful and this has been our kind of scene setting for this enquiry which we're going to be continuing with so we'll be continuing to take evidence on the Scottish Government's public service reform programme at our next meeting and that concludes the public part of today's meeting the next item on our agenda which will be discussed in private is consideration of our work programme Thank you very much


What may seem as a subtle pastime may turn into a deadly hobby. Welcome to World's Best Videos, we've combined the list of people who died playing video games, let's get into it. Gamer Brian died after playing an online game called War of Tanks for nearly 24 hours. Brian was raising money for a Make-A-Wish Foundation during his marathon. When he stopped to take a smoke break, he had a massive heart attack and died. According to a friend, Brian did not slept for 22 hours and was drinking a 5 hour energy and red bull to stay awake. Two Tywinese men died from long and difficult gaming marathons. The first was a 38 year old man who was found dead after playing video games for 5 days straight in a small internet restaurant in Taipei. The second was a 32 year old man who died from a heart attack after playing for 3 days straight. Employees at the small internet cafe didn't discover that the person was dead for hours. He had been no sleep face down on the table during his gaming marathons but when workers found him unresponsive, they finally sent for help. A Tywinese man collapsed and died over the weekend after playing Diablo III for 40 hours straight. The 18 year old man entered an internet cafe in southern Taiwan around noon on Friday, booked a private room, and played for almost 2 days without stopping to eat. On Sunday morning, an employee of the cafe entered the room to check on the man and found him resting on the table. After awakening the man, he collapsed and was pronounced dead at the hospital. In 1981, a man, Jeff Daly, popped a quarter into the robot killing machine to score an alleged 16,660 points. Moments later, he collapsed and was pronounced dead of a heart attack. There was a similar death less than a year later when Peter Bokowski pushed himself to beat his high score. Shortly after putting his initials for a second high score, he fell and died of a heart attack.  The reason for the blood clot was due to him not taking breaks to stretch throughout the 12 hour session. Lee was an industrial boiler repairman before getting a deadly starcraft addiction. He spent all of his time gaming, so much that he became malnourished and sleep deprived costing him his job and long time relationship with his girlfriend. Lee had reportedly told his friends and relatives that he was about to stop playing and return home only moments before he closed his eyes and fell off his chair. He was later pronounced dead at the nearby hospital shortly after. The final cause of death was heart failure caused by exhaustion and dehydration. Well that concludes the video guys, hope you guys did enjoy it and if you did remember to smack that like button, let us know in the comment section below what you'd like to see next and if you haven't already subscribed please do subscribe to keep up with the world's best videos.