SERIOUS concerns about the finances of three NHS boards have been flagged up to Holyrood by Scotland's official public spending watchdog.
The bungled introduction of new technology at phone line NHS 24 - a project which is running more than £40 million over budget - is among the issues highlighted by Auditor General for Scotland Caroline Gardner in a series of hard hitting reports.
Unsustainable spending in NHS Tayside, which needs to save £27m to stay in the black this year, and a gap between the cost of services and the budget in NHS Highland are also raised.
The reports have been placed in the Scottish Parliament under a legal clause known as "section 22" which allows Audit Scotland to flag up issues spotted in their scrutiny of public accounts.
It is not the first time NHS 24's struggle to bring in a new system for handling patient calls and information has been highlighted in this way but last year legal action about the process prevented many details from being discussed.
Now Audit Scotland has criticised the way the new technology was procured, saying NHS 24 made the same mistakes as other public bodies - such as the Crown Office - when placing their order.
The issues they highlight include flaws in the contract with the supplier, the setting of unrealistic time scales and the team in charge lacking experience. According to the report, the personnel overseeing the project - known as the Future Programme - changed five times in five years.
The report says implementing the new system, once due to go live in June 2013, had to be postponed indefinitely "due to the new system's failure to meet critical patient safety performance measures such as the ability to function with multiple users at an acceptable speed."
However, the report adds that the suppliers Capgemini disputed that the application was not meeting the requirements specified in the contract and it later emerged that performance measures were missing from that agreement.
The new technology is finally being introduced this month, but only after a highly experienced programme management team was scrambled last year.
The total cost of the Future Programme has risen 55 per cent to £117.4m compared to an original estimate £75.8m. Continuing to use their old technology much longer than planned has on its own cost NHS 24 £450,000 a month.
Loans from the Scottish Government worth more than £27m have to be repaid by the board, with the repayments already expected two years later than originally agreed.
Audit Scotland comment that it will be "very challenging" for NHS 24 to meet its financial targets going forward.
Ian Crichton, new NHS 24 chief executive, said: "We fully acknowledge the findings in the Auditor General's report. It outlines a series of weaknesses dating back to 2011, relating to NHS 24's management of IT procurement, programme management and the governance of its technology renewal project.
"Delays in this major IT programme have led to a significant increase in costs. During the past 16 months an expert team, led by the Future Programme Director, has been working hard to bring the project back on track."
He added that patient satisfaction rates with NHS 24 are high and the Section 22 report also noted that patient service had not been affected by the issues.
NHS Tayside has also required loans from the Scottish Goverment to break even - three years in a row. Ms Gardner said the board's key issues included overspending on workforce and prescription drugs. The board also owed staff money having under paid them during holidays and had difficulty selling disused buildings.
Shona Robison, health secretary said: “The Scottish Government takes the publication of reports from the Auditor General for Scotland very seriously. We welcome the additional level of oversight and scrutiny, in addition to our own, and continue to work with the health boards concerned to address the issues raised."
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