The Scottish executive must do more to prove that increased health spending is delivering value for money, an official spending watchdog has said.

In a report published on Thursday, Audit Scotland said that some important health targets were likely to be met.

But it sounded a sceptical note about whether an extra £1.7 billion of funding over the next three years will deliver significant improvements.

Deputy health minister Tom McCabe accepted there was a "need for better information to monitor delivery of health care".

And SNP health spokesman Stewart Stevenson called for greater clarity on where the extra funding was going.

Audit report

Audit Scotland said that the extra cash was likely to help the NHS in Scotland meet some of its key targets, including the majority of waiting times targets and plans to reduce deaths from cancer, heart disease and strokes.

But auditor general Robert Black said the Scottish executive "must do more to demonstrate that increased funding and new ways of working are actually benefiting patients".

In a wide-ranging report on plans to overhaul service delivery north of the border, the watchdog said the health department finds it difficult to demonstrate what effects these changes are having, whether services are actually improving or how much is being spent on them.

"The NHS in Scotland spends about £7 billion each year and this is due to rise to £8.7 billion by 2006," said Black.

"The public needs to know how well this money is used. Our report makes a start but the health department must close the information gap.

"It is important that it can demonstrate that the extra money is delivering better care for patients."

The study also raised questions over the executive's ability to control healthcare costs.

It pointed out that 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 and the rising cost of drugs.

Further questions were also raised about what improved services will be delivered as a result of new pay agreements.

"The health department wants pay modernisation to deliver high quality services to patients," said the auditor general.

"But it must identify and measure what improvements it expects to see as a result of this investment."

Report welcomed

Responding to the findings, the deputy health minister welcomed the emphasis it placed on health improvement.

"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," said Tom McCabe.

"Scotland already has one of the most highly developed clinical information systems in the world. And information is now published on how many patients are seen at nurse-led clinics and how many procedures are carried out on out-patients."

He added that the NHS Information and Statistics Division had been ordered to "further improve coverage and quality of management information" in some key areas.

For the SNP, Stewart Stevenson called for clarification on how money is being spent in the NHS.

"While it may be reassuring to hear that an increasing amount of money is being spent on the NHS in Scotland, what we are still unsure of is how this will truly benefit patients," he said.

"The auditor general has recognised that there are holes in the system and that there is an information gap surrounding the overall performance of the health service.

"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."