The NHS needs to give out more information to patients, says Mr Black

Audit Scotland has found that NHS Scotland is likely to meet the majority of targets on reducing waiting times.

The auditors also found that there was little explanation on how specific targets were achieved.

Deputy Health Minister Tom McCabe agreed that the NHS must improve the coverage and quality of management information on spending.

Auditor general Robert Black said: "The NHS in Scotland spends about �7bn each year and this is due to rise to �8.7bn by 2006. The public needs to know how well this money is used."

'Quality services'

Scotland still suffers from high death rates in areas such as cancer, heart disease and strokes, in comparison with the rest of Europe.

But while targets for reducing death rates from these big three killers are likely to be met, more needed to be done to cut coronary heart disease.

The report found increased funding and new ways of working were benefiting patients.

In particular, it found that medical advances were changing the treatments that patients received and more people could be treated in community settings rather than in hospital.

The health department wants... to deliver high-quality services to patients, but it must identify what improvements it expects to see as a result of this investment Robert Black Audit Scotland

Headline figures in NHS spending in Scotland rose from �6.1bn in 2001/02 to �7.2bn in 2003/4 and �8bn in 2004/5.

However, much of the increase in funding will be taken up by cost pressures such as the UK-wide pay modernisation initiatives for consultants, GPs and other NHS staff.

Mr Black added: "The health department wants pay modernisation to deliver high quality services to patients, but it must identify and measure what improvements it expects to see as a result of this investment."

Mr McCabe agreed health boards needed to give out more information.

He said: "We have made it clear to the NHS information and statistics division that they must further improve coverage and quality of management information."

While Mr McCabe welcomed the effects of modernisation and increase in funding highlighted in the report, he said more information would explain how new facilities and practices were affecting patients.

He said: "The report recognises significant changes in healthcare delivery, falling death rates for cancer and coronary heart disease and improvements in waiting times.

"But it also identifies a need for better information to monitor delivery of health care in order to quantify the benefits of higher spending and the increasingly rapid changes in clinical practice."

NHS reforms cannot be achieved without investment in the workforce Dr Bill O'Neill BMA Scotland

Tory health spokesman David Davidson acknowledged "investment has been poured into the NHS", but said waiting lists had continued to rise.

He said: "One of the major reasons why Scotland's waiting lists and waiting times have become a national scandal in recent years is precisely because the service, under this government, is not patient-centred but instead is controlled, directed and dictated by ministers."

Scottish National Party health spokesman Stewart Stevenson said: "There clearly needs to be a further explanation about how targets that the executive has set will be achieved, otherwise it will be almost impossible to say for certain whether the overall performance of the health service has improved."

Dr Bill O'Neill, Scottish secretary of the BMA, said the report had questioned the value for money provided by the new contractual agreements.

He said: "NHS reforms cannot be achieved without investment in the workforce.

Better care

"It is no longer acceptable that doctors be expected to work extra hours for the NHS for free."

He said improved terms and conditions would improve morale, which would in turn lead to better recruitment and retention of doctors and better care for patients.

And he agreed with the report that simply recruiting more doctors was not a solution.

Dr O'Neill said: "Any plans must go hand in hand with a review of how we deliver services, particularly in the most remote and rural communities in Scotland.