Chamber and committees

Last week, Derek Feeley talked about trying to focus on prevention but being distracted because all the targets involve acute services. Has thought been given to identifying new targets that do more to identify community intervention and early prevention work, rather than all the indicators being focused on acute care? That skews the game all the time.

The Government has also provided a record-breaking settlement for GPs. What difference has that made? In relation to the investment in the innovation of GP walk-in clinics, Dundee has the Lochee health centre, which is a deep-end clinic, but every walk-in clinic takes a different approach. I know that all the pilots will be evaluated, but have you any insight on how they are going?

My questions are about waiting times, GP investment and new models of general practice.

My question is about health inequalities and access to exercise. We have discussed the tension between elite performance sport at one end and helping people to get moving at the other. In Dundee, we have a successful stroke exercise class for people who are in recovery, and Heart Space Dundee runs an amazing yoga class for people who have had amputations. The sports organisations that appeared before the committee mentioned social prescribing. What are your thoughts on a bigger role for social prescribing in access to sport and activity facilities?

Could we better track that? On the issue of following the money, is there any way of identifying the level of social prescribing that is being undertaken and ensuring an increase in that?

There is complete clarity about where we are trying to go in a shift to prevention and more community-first interventions. In the committee, we have discussed the frustrations of tagging, identifying and following the money, and the cabinet secretary has spoken about following the money, too.

We have oversight of the health boards and the financial support to them, but we do not always see where that money ends up. I am also a serving councillor, so I want to talk about how we more transparently follow the money through local authorities. COSLA has been clear that it does not want ring fencing, but are we discussing with it how we better identify preventive spend in local authorities and how they might assist in identifying where funding is going, so that we can track it from that side as well?

Cabinet secretary, I echo your comments about the Government having absolutely no reluctance to commit huge sums to health and social care in the budget. However, we are struggling with the fact that, although we continually provide more money, we do not necessarily get the performance that is required.

I have questions on two areas. First, how effective has the massive investment of between £90 million and £100 million been in reducing waiting times? How might you change that funding?

Secondly, I have questions about the investment in general practitioners. Would you like me to ask those now, convener?

What I was referring to when I said “agnostic” is that, as you will have heard, the proposals do not identify whether there will be a health lead or a local authority lead, but the First Minister said at one point that health should lead and be the governance body. I hear what you are saying about the national care service.

I know that I am coming in a lot, but I am trying to get to the heart of the issue because the reality is that we must identify funding to support prevention. I know that definitions are difficult and woolly and that there is less evidence, but we genuinely want the witnesses to give us their best thoughts and advice about how we can protect that funding.

Professor Feeley, you said that you were not able to deliver on prevention when you were in charge—I am paraphrasing. I would like to hear a bit more about what you think might have helped you to protect money for prevention in the environment that you were in, where you were the chief decision maker. My question is about tagging, protecting and moving money.

10:15

I just wanted to say that we are struggling with exactly what Gregor Muir is talking about—getting that number. However, you might have a number in relation to rehabilitation, which is about future proofing prevention. If somebody has had a stroke, we must be able to track that. There seem to be very few opportunities for anybody who has had a stroke to get physically fit. In Dundee, there is one such exercise class, but it is hugely expensive for people to get to because they have to pay for a taxi.

Is there mapping that we can do of what we are spending to help people to regain some health? Is that easier to identify in order to prevent future hospital admissions or longer-term hospital stays?

I know. When else, though? We know that it is zero to three, but where is the other intervention point? We are doing zero to three as best we can.