An independent review, chaired by Julie Hutchison LLB TEP WS, to consider and provide recommendations on changes that could be enacted to strengthen governance arrangements for NHS endowment funds.
Introduction and Background
Background and historic context
There are sixteen NHS-linked charities in Scotland, as listed in Appendix 1. Each charity is registered with OSCR, the Scottish Charity Regulator.
As at 31 March 2019, these sixteen charities held net assets totalling 301m.
The current legislative basis for NHS-linked charities in Scotland is contained in section 83(1) of the National Health Service (Scotland) Act 1978 (the 1978 Act). This gives power to a Health Board "to accept, hold and administer any property on trust for purposes relating to any service which it is their function to make arrangements for, administer or provide, or to their functions with respect to research."
The underlying legal entity of each NHS-linked charity is therefore a trust.
The charitable funds held in these sixteen charities in some cases pre-date 1978 and indeed the formation of the National Health Service in 1948. Pre-NHS philanthropy contributed to the founding of some of Scotland's oldest hospitals. In 1729 the very first Edinburgh Infirmary opened, paid for by public funds after an appeal was launched by the Royal College of Physicians of Edinburgh. The donations and legacies which supported the Royal Hospital for Sick Children also paint a picture of nineteenth century philanthropy:
"Lady Jane Dundas made the exceptionally generous donation of 6500 to build and furnish one wing of the new Hospital, naming it the Lady Caroline Charteris Memorial Wing, after her sister. Colonel W. Lorimer Bathgate, one of the Directors.endowed enough to fund the "Bathgate Ward" in memory of his sister Thomasine, and another Director left enough to fund a ward which was named the "Mackay Smith Ward" after him."
With the arrival of the National Health Service in 1948, healthcare became a universal national provision, funded by taxes. It was not however the end of healthcare-focused donations and legacies, which continue to this day and are accounted for separately within these sixteen NHS-linked charities, as required by the 1978 Act.
Set against this backdrop from the eighteenth century onwards, it is therefore clear to see that the provision of healthcare in Scotland has always benefitted from the generosity of those who make donations or leave legacies.