Health, Social Care and Sport Committee
The Climate Change Plan (CCP) is a strategy document which outlines how the Scottish Government intends to meet carbon emissions reduction targets across all portfolio areas and sectors of the economy.
A draft CCP, covering the period 2026-40, was laid on 6 November 2025 for a parliamentary scrutiny period of 120 days. This scrutiny period ends on 5 March 2026.
The Net Zero, Energy and Transport Committee led cross-committee scrutiny of the draft CCP. Their report was published on 27 February 2026 and goes into much greater detail regarding the overall scrutiny and content of the draft CCP.
The Health, Social Care and Sport Committee provided additional scrutiny by focusing on aspects of the draft CCP that engaged the Committee's remit. This report therefore presents a more focused look at the draft CCP as it relates to health and social care policy.
The Scottish Parliament’s Conveners Group set scrutiny of net zero as a strategic priority for committees in the current session of the Parliament.
The Net-Zero, Energy and Transport Committee is the lead Committee scrutinising the plan. A wide range of organisations submitted responses to a call for views on what should be in the draft CCP, which closed in September 2025, and the Net Zero Committee conducted further engagement through the Your Priorities platform which ran until 25 January 2026.
Given the cross-cutting nature of the Plan, a number of other committees are involved in its scrutiny. A co-ordinated approach was taken to ensure effective and broad-ranging scrutiny, including the sharing of evidence, in order to co-ordinate a response to the Scottish Government. Aside from the Net-Zero, energy and Transport and Health, Social Care and Sport Committees, other committees undertaking scrutiny of the Plan include:
- Economy and Fair Work Committee
- Local Government, Housing and Planning Committee
- Rural Affairs and Islands Committee
- Citizen Participation and Public Petitions Committee
- Constitution, Europe, External Affairs and Culture Committee
There is an online SPICe Hub on Climate Change which includes details of Scottish Parliament Committees’ scrutiny of the draft Plan. The Hub provides links to blogs relevant to the Plan such as related policies, proposals and sector summaries.
The CCP is a statutory document setting out the Scottish Government’s policies and proposals to reduce GHG emissions across major sectors to meet net zero targets (mitigation policies). It is not required to set out actions to prepare for the impacts of climate change that are already happening or expected (adaptation policies) - these are covered in the Scottish National Adaptation Plan.
Scotland is legally required to reach net zero GHG emissions by 2045, as set out in the Climate Change (Scotland) Act 2009 and subsequent legislation, five years ahead of the UK's overall target. Net zero means achieving net-zero total emissions compared to 1990 levels, by reducing emissions and offsetting any remaining GHG emissions through methods like tree planting or technologies to capture carbon emissions.
GHG emissions included in Scotland’s net zero target include anything emitted within Scotland’s borders (territorial emissions) - transport, buildings, waste, land use etc.- including emissions produced in Scotland from health and social care infrastructure and transport. It does not include the emissions embedded in goods and services used by the Scottish health service, if these are manufactured or delivered in other jurisdictions. It will include these emissions if the manufacture or delivery occurs within Scottish borders. For example, the emissions from drugs manufactured in Scotland are included, regardless of whether they are used in Scotland, but the emissions from drugs manufactured elsewhere but used in Scotland, are not included. This approach is consistent with international reporting requirements under the United Nations Framework Convention on Climate Change (UNFCCC).
The draft Plan is presented as being necessitated by, and having the purpose of addressing, the health risks associated with climate change:
Scotland’s changing climate also poses growing risks to households and businesses through physical damage to homes or assets, health and safety risks to employees and customers, disruption to supply chains, reduced access to finance or insurance coverage and increased risks to employee health and safety.
Under the Climate Change (Scotland) Act 2009 (as amended), the CCP must set out policies and proposals for reducing greenhouse gas emissions across all major sectors of the economy. Health and social care is not one of the sectors required to be covered, although some elements of health and social care emissions will be nested within the sectors ‘Residential and Public Buildings’ and ‘Transport’, which are required by the legislation.
The draft CCP also identifies a number of health benefits from policies and proposals to reduce emissions in other sectors, including: cleaner air, warmer homes, healthier food, health-promoting natural and built environments, high quality public services and fair work:
The policy actions set out can also protect people and communities from the health harms associated with fossil fuels and, coupled with effective adaptation, prevent many of the anticipated health impacts of climate change. Health benefits from cleaner air, warmer homes, healthier food, health-promoting natural and built environments, high quality public services and fair work in a thriving economy can be immediate. The CCP will support delivery of Scotland’s prevention-focused Population Health Framework, wider public service reform agenda and the ambitions of the Scottish Government to build a fairer, greener and healthier Scotland.
The Population Health Framework (PHF), published in June 2025 states that ‘a just transition to net zero’ is among Public Health Scotland’s commitments in supporting health and wellbeing. Under intended actions in the area of food, environment and nutrition, it states that actions will include:
... supporting wider government priorities such as Good Food Nation, Scottish Dietary Goals, food security, malnutrition and the just transition to net zero to support reducing inequalities.
NHS Scotland
A policy for NHS Scotland on the climate emergency and sustainable development (DL (2021) 38) was issued by Scottish Government to Health Boards in 2021. It sets out the aims and associated targets relating to sustainable development and climate change for Health Boards to work towards. The Climate change duties draft statutory guidance states that further details will be provided in a Health and Wellbeing supplement in due course.
The NHS Scotland Climate Emergency Strategy 2022-2026 sets out actions directed at achieving the aims and targets in policy DL (2021) 38 and is based around five priority areas: sustainable buildings and land; sustainable travel; sustainable goods and services; sustainable care: sustainable communities.
To co-ordinate efforts, the Scottish Government has established the NHS Scotland Sustainability Action Programme. It provides strategic oversight and support for NHS Scotland to achieve net zero targets and embed sustainability across all areas while maintaining patient care standards. Progress is reported in Annual Climate Emergency and Sustainability reports.
NHS Scotland has committed to use renewable heating systems by 2038 for all NHS-owned buildings, to become a net-zero organisation by 2040 or earlier, and aims to achieve a net zero supply chain by 2045. NHS Scotland’s emissions are estimated to exceed 1.7 million tonnes of CO2 equivalent annually.
The World Health Organization reports that the health sector overall is responsible for 4.4% of global carbon emissions.
As part of its scrutiny of the draft CCP, the Committee held three evidence sessions, with a focus on the potential co-benefits for health of emissions reduction, and potential impact of the draft Plan on health and social care services.
At its meeting on 13 January 2026, the Committee took evidence from:
Professor Jill Belch - University of Dundee and Royal College of Physicians of Edinburgh
Professor Peter Scarborough - University of Oxford
Due to technical difficulties on the day of the meeting, two additional witnesses - Professor Ruth Doherty and Dr Andrew Sudmant - were unable to contribute orally but were able to provide written evidence after the meeting.
The Committee then took further evidence at its meeting on 20 January 2026, from:
Jane Miller - the ALLIANCE
Dr Joanna Teuton - Public Health Scotland
Finally, at its meeting on 10 February 2026, the Committee took evidence from:
Professor Sir Gregor Smith - Chief Medical Officer
Philip McLean - Head of NHS Facilities and Environmental Sustainability
Wendy Rayner - Lead NHS Scotland Circular Economy Adviser
One of the core themes from both oral and written evidence was the significant health impacts associated with emissions and the scale of potential co-benefits from mitigation.
More information on what is meant by "co-benefits" can be found via the SPICe briefing on climate change and its impact on health. However, "co-benefits" are broadly defined as follows:
... a term used to describe the range of positive or beneficial outcomes that result from an intervention, including indirect ones. In the sphere of climate change, examples would include policies which aim to reduce carbon emissions but also have beneficial effects for public health or the economy.
In written evidence to the Committee, Dr Andrew Sudmant highlighted that actions to address emissions from buildings and transport can yield particularly large social and health gains, often exceeding direct financial benefits, including through improved air quality, reduced exposure to cold homes and enhanced physical activity:
…when we apply standard United Kingdom appraisal methods to mitigation in buildings and transport, the monetised social benefits, including public health related pathways, can dominate the overall economic case for action… the social benefits form the large majority of total benefits, and include quantified pathways such as physical activity, indoor air quality, excess cold, road safety, congestion, and noise.
Witnesses also argued that health and inequality outcomes should be made explicit in the Plan and that these co-benefits should be integral to policy appraisal and budget decisions, rather than treated as secondary considerations.
Dr Teuton argued that the CCP cuts across the building blocks of health and, in her view, should be more explicitly treated as a public health intervention in the Plan:
If we can create policies that reduce emissions while maximising health benefits, and if we can consider potential risks to health and equity in the design and the delivery of those policies, they will produce good outcomes with regard to emissions reductions and meet some of those very significant health challenges that we have in Scotland such as the very low levels of life expectancy, and health inequality.
Dr Sudmant made a similar argument in his written submission to the Committee, stating:
... the magnitude and distribution of co benefits means that health and equity are not peripheral outcomes, they are a central determinant of whether policy represents good value for Scotland. Only a minority of benefits from climate actions are financial, while the majority are social benefits, meaning that a Climate Change Plan framed only around carbon and direct financials risks systematically undervaluing interventions that improve wellbeing and reduce future service demand.
Public Health Scotland argued for a ‘health in all policies’ approach, in which climate measures are designed and delivered to reduce emissions while maximising health gains and safeguarding equity, thereby contributing to improved life expectancy and reduced health inequalities. Dr Teuton argued that this could be done using a place-based, community wealth-building model.
Jane Miller from the ALLIANCE also underlined the important role of social care within the wider prevention agenda:
Social care is often quite neglected in the climate discourse; the sector does contribute emissions, but it also addresses those impacts by serving people in their communities. Therefore, we would want the role that the sector plays in that wider picture to be recognised when we consider climate impacts.
Inequality was a central theme in evidence. Jane Miller described the disproportionate effects of climate change on disabled people, those with long term conditions, unpaid carers and lower income households, and stressed the importance of designing mitigation measures to avoid widening existing health inequalities.
Dr Sudmant similarly emphasised that co-benefits vary significantly according to place and population, and argued that targeted, data driven implementation is critical to ensuring equitable outcomes. Witnesses highlighted that rural and island communities face distinct issues, including limited public transport, reliance on private vehicles and differing patterns of exposure and benefit, and that these differences should be explicit in the Plan.
Air quality was also a major theme in evidence. Witnesses observed that the draft CCP does not fully address important pollutants such as ozone and ammonia, both of which have demonstrable health effects. They also noted that indoor air quality is insufficiently covered in the draft Plan, particularly in relation to the interaction between insulation, ventilation and the risk of cold, damp and mould. The need for monitoring frameworks to ensure that improvements in building performance do not inadvertently worsen indoor air quality was highlighted repeatedly.
Diet, food systems and agricultural emissions were discussed extensively, building on the Committee’s ongoing scrutiny of the Good Food Nation National Plan. It was clear to Members that the two plans overlap, at least in the context of public health.
There was disagreement on the potential impacts of reducing meat production and consumption on health, diet, the economy and the environment. The Committee also heard differing views on ultra-high/ ultra-processed foods (UPFs), which were focused on the impact of UPFs on health and the environment, including on GHG emissions, biodiversity, and obesity and other non-communicable diseases.
There was consensus however on the complexity of the food system from production to consumption, and witnesses were clear that the draft CCP does not adequately acknowledge or address this complexity or the role of food and food production in meeting climate and health objectives.
Another recurring theme was the need for stronger governance, monitoring and accountability mechanisms. Witnesses argued that the draft CCP lacks quantifiable metrics in many areas, making it difficult to track delivery and outcomes.
Dr Sudmant, among others, suggested that health and social cobenefits should be explicitly embedded in appraisal and budget processes, with place-based data used to guide prioritisation and ensure that benefits are realised where need is greatest. Witnesses also highlighted the importance of embedding public health expertise in planning and evaluation structures across Government.
Communication and engagement also emerged as significant issues. Dr Teuton and academic witnesses stated that current public communication about emissions reduction does not convey the local, immediate health benefits of climate action and can lead to disengagement.
Witnesses recommended clearer, more accessible messaging, stronger community involvement in design and delivery of emissions reduction measures, and more emphasis on the lived experience of the individuals and groups most affected. They stressed that inclusive communication and coproduction are essential to ensuring fairness, legitimacy and broad uptake of climate measures.
Having heard extensive evidence in the first two evidence sessions regarding the wider public health impact of climate change and climate action, and how this is reflected in the draft CCP, the Committee's focus then turned to greenhouse gas (GHG) emissions specifically associated with the NHS and its estate.
The Chief Medical Officer reflected on climate considerations in his 2023 - 2024 annual report, ‘Taking Care’, arguing:
… the most significant long-term threat to human health remains the climate emergency and its impact on planetary health. It is clear to me that health and care professionals globally must use our trusted position and influence to help us mitigate and adapt to the planetary crisis with greater urgency.
He further highlighted the interconnected nature of population health challenges and the need for urgent action to address climate change, setting this in the context of healthcare, and drawing a connection with what he saw as being the four key challenges for population health:
I remain optimistic that we can meet the four concurrent challenges to population health in Scotland: the ongoing threat of infectious disease; widening health inequalities; the need to create a more sustainable health and care system; and the need to address the planetary crisis.
In oral evidence to the Committee at its meeting on 10 February 2026, the CMO expanded on comments made in these reports, emphasising again the importance of a preventative approach:
... the type of care that is the most harmful to the environment is care that is not necessary. Taking a much more balanced approach to prevention in the first place and treating that as our priority is the very first step that we have to take. Taking a national approach to improving prevention will not only help us with the impacts on planetary health, as it will clearly have an impact on human health as well.
The CMO further acknowledged that the draft Climate Change Plan recognises the need for a cross-cutting, cross-portfolio approach to addressing health inequalities arising from climate change, expanding further that:
...one of the biggest changes that I have seen has been about ensuring that we have an all-Government, all-sector approach to prevention, and that we are making that coalition ready to act in a mission-style way. There is a strong evidence base that we have been able to play into the work of the population health framework, which tells us where we have to intervene. In the conversations that I have with the organisations that will be charged with delivering progress on the issue, I now see and hear about a much greater degree of understanding and willingness to become fully involved in that agenda for the future.
The CMO and his supporting officials also highlighted current efforts to achieve a net-zero NHS estate. Concerning the estimated cost of achieving that goal, Philip McLean told the Committee:
Our low confidence estimate is £700 million of capital. We do not have a great deal of confidence in the methodology that was used to develop that estimate, because it is based on high-level net zero road maps that were prepared for health boards some years ago. To improve our estimate, we are supporting health boards to prepare detailed site-level decarbonisation plans.
He further added:
The estimate that I provided also does not take into account the planned measures’ effect on the revenue budget. Many of those measures will lead to lower costs because they will result in savings to the revenue budget. Such measures include the installation of LED lights and upgrades to building management systems, both of which have short periods in relation to the return on investment, which means that, within a few years, investing in that change will have been cheaper than not doing so.
Philip McLean also explained that this estimate does not take into account how much of the cost would need to be paid for by the public sector, before adding that work was underway to improve the accuracy of estimated costs and to develop a financial model that gives a better understanding of the impact of decarbonisation on the NHS.
Links between transport and NHS decarbonisation were also addressed, mainly in terms of patient and staff travel to and from from the NHS estate. The CMO acknowledged that more work needed to be done in this area but told Committee that some progress had been made by specific health boards. He gave examples such as assisting staff by offering more sustainable travel options, and putting in place initiatives such as cycle-to-work schemes and discounted bus travel.
He continued:
NHS sites are ultimately either a destination or a starting point for a journey, and collaboration with local authorities, regional transport partnerships and transport companies is therefore essential. That collaboration is happening, but it is fair to say that there is still more to be done. At a national level, NHS Scotland Assure engages with all seven regional transport partnerships, and, at a local level, health boards meet with their local regional transport partnership.
Questions were also raised about measures being put in place in the area of food procurement and to reduce food-waste in the NHS. The CMO responded:
I am aware that there are a number of different workstreams on procurement, and food sits right at the heart of that. I think that procurement is split into nine different subject headings. It has been shown that the majority of food procurement is provided by local suppliers. The situation with pre-prepared meals and delivered meals is different, as no Scottish supplier is able to supply those to the required specification currently.
However, as I said, there is good evidence that food is procured as locally as possible. That is good for the environment, because there is no travel cost. It also makes sense that it is provided as close to the hospitals as possible from the point of view of supporting local communities and socio-economic development.
Philip McLean expanded on this point, stating that the amount of food consumed within the NHS that is produced in Scotland varies from framework to framework but that 100% of milk and dairy products, 80% of butcher meat and meat sundries and 70% of vegetables consumed in the NHS are produced in Scotland. On the issue of food waste, he told the Committee:
...food waste continues to be an issue in NHS hospitals, although there has been some progress. In 2023, Zero Waste Scotland assessed 14 health boards and found that all had reduced their food wastage compared with the baseline year, which varied for each health board but was in the period 2015 to 2017. Zero Waste Scotland assessed that six health boards had reduced their food wastage by more than 33 per cent.
Action to reduce the use of single-use plastics in personal protective equipment was also raised. The CMO and officials stated that a lot of work is being done in this area but that ultimately:
Plastics is a key material stream for us and one that we feel should be valued. That is particularly pertinent, given that the NHS is in possession of very high-quality polymers in the products that we buy.
Wendy Rayner further stated:
As part of a larger circular economy data project, we have worked with suppliers to identify the types of plastics as well as other materials used in products, and we are linking that data to procurement system data to support future segregation as well as demand modelling. That will support the waste and resources industry in putting in place plastic collections as well as increasing the recovery of high-grade plastics in the future.
Finally, at United Kingdom level, we have co-commissioned a project that brings together people with expertise to assess opportunities and requirements for a move away from single-use items, where appropriate, ensuring at all times that patient safety and the quality of care come first and that such a move can be compatible with resilient, sustainable and cost-effective healthcare.
Asked to what extent clinicians have been engaged to develop innovative approaches to reducing emissions, the CMO cited the National Green Theatres Programme - which resulted from a group of clinicians invested in making changes at a local level who were then able to disseminate this good practice across the country to support more sustainable delivery.
The CMO also commented on the importance of data, and how differing bodies hold and use data, making particular reference to Public Health Scotland and its methodology for producing reports which, in turn, informs data modelling. He concluded:
Data is king, but we still have a bit to go before I am comfortable with how we use it in this country. I would like to see much more availability of data from general practice, in particular, but also from community care, and I would like it to be fed into our overall system, to support our understanding of how the system itself is functioning. There is also the opportunity for it to be used appropriately to inform research. As I have said, data is the starting point here.
The Committee has heard extensive evidence on the potential co-benefits for public health of action to reduce carbon emissions. However, the Committee would like to see greater detail and more explicit explanation in the Plan regarding how climate actions across portfolios will acknowledge and serve the wider public health landscape.
The Committee also concludes that health outcomes and impacts on health inequalities should be made more explicit in the Plan, and that these should be integrated into policy appraisal and budget decisions.
The Committee further highlights evidence that a "health in all policies" approach should be taken in implementing the Plan, whereby climate measures are designed and delivered to reduce emissions while maximising health gains and reducing inequalities. In this context, the Government should explore innovative approaches to implementation, such as the use of community wealth-building models.
The Committee is concerned that the draft CCP fails to fully address the significant impact of certain pollutants such as ozone and ammonia, or the specific public health impact of poor indoor air-quality. The Committee echoes calls from witnesses for improved monitoring frameworks and action in these areas, and considers that monitoring should track both indoor and outdoor air‑quality outcomes to ensure that improvements in buildings and transport deliver - rather than risk undermining - health and wellbeing.
The Committee also notes a widespread view that the draft CCP fails to sufficiently acknowledge or address the complex role of food in meeting climate and health objectives. The Committee highlights concerns raised in its report on the proposed National Good Food Nation Plan about the risks of taking a siloed approach, and reiterates its call for the Scottish Government to set out more clearly how it will lead work to foster improved cross-sector and cross-portfolio collaboration.
The Committee notes stakeholder concerns that the draft CCP lacks quantifiable metrics in many areas and that this could lead to difficulties in tracking delivery and outcomes. It therefore calls for stronger governance, monitoring and accountability mechanisms within the Plan. These should include clear indicators of health, wellbeing and equity impacts alongside emissions outcomes, reflect place‑based variation, and embed public‑health expertise in the design and interpretation of these metrics so that co‑benefits and risks are properly captured and used to inform appraisal and budget decisions.
The Committee recognises calls for clear communication and engagement on issues arising from the plan - particularly by implementing more accessible messaging, encouraging stronger community involvement in design and delivery, and placing greater emphasis on lived experience of individuals and groups most affected by climate change measures.
On the issue of decarbonisation of the NHS, the Committee welcomes the preventative approach highlighted in evidence by the CMO. In this context, it would welcome a broader emphasis on prevention of health harms in the CCP as a whole.
The Committee welcomes evidence that a growing number of health boards are implementing sustainable travel schemes and options for patients and staff, and encourages further sharing of best practice in this area. The Committee notes that health boards should maintain momentum in collaborating with other authorities and providers to ensure that large hospitals are treated as sustainable, connected transport hubs for people attending appointments as well as visitors.
The Committee recommends that NHS Scotland further strengthens its approach to sustainable procurement by setting clear expectations for reducing food waste, supporting sustainable and locally‑produced food where possible, and phasing down avoidable single‑use plastics while maintaining patient safety. The Committee further recommends that NHS Scotland improves the quality and integration of procurement data to support robust monitoring, circular‑economy approaches and transparent assessment of progress across health boards.
On the subject of innovative approaches to reducing emissions, the Committee acknowledges the work done by the National Green Theatres Programme and welcomes further dissemination of similar good practice across the country to support more sustainable delivery.