Health Inequalities
The next item of business is a statement by Shona Robison on the report of the ministerial task force on health inequalities. The cabinet secretary will take questions at the end of her statement and there should therefore be no interventions or interruptions during it. I give her a moment or two to get settled into her place.
I inadvertently just gave the minister a title that I understand is not yet hers to take. I meant, of course, that the minister will take questions at the end of her statement.
Thank you for that very temporary promotion, Presiding Officer.
I am delighted to announce that the Government is publishing today the report of the ministerial task force on health inequalities, which I have chaired since last October. The Cabinet Secretary for Health and Wellbeing and I have said repeatedly that reducing Scotland's shameful inequalities in health between the wealthiest and the poorest is our top health priority. This report, "Equally Well: Report of the Ministerial Task Force on Health Equalities", will put us on the road to real improvements.
I thank my six ministerial colleagues who took part, the Convention of Scottish Local Authorities, NHS Scotland, the third sector and the research community, who have worked creatively together. The task force's work also reflects consultation through the "Better Health, Better Care" action plan last autumn and, more recently, with front-line staff, third sector organisations and young people.
The Government accepts and will implement all the task force's recommendations. Indeed, action has already started. One of the task force's strengths has been to align with the development of other Government strategies and frameworks, ensuring that they all work together towards improving health and reducing inequalities. There are clear links to the joint policy statement on early years and early intervention, which was published by the Government and COSLA in March, and to the smoking prevention action plan, the alcohol misuse consultation, the drugs strategy and the forthcoming obesity action plan.
It is widely agreed that inequalities in health are mainly due to underlying causes and not primarily to what health services themselves do. We heard evidence on that from an international audience in Edinburgh back in April. We also heard from Europe and across the Atlantic that no country has yet achieved a genuine and effective cross-Government approach to addressing those underlying causes, which are, primarily, children's start in life, adults' low income, lack of employment and poor physical and social environments.
The task force embodies that new way of working across Government and across sectors. Together, we have set clear priorities, focused on the health outcomes to be achieved and put real emphasis on delivery. Change can and will happen now through joint delivery at national level and through local authorities and their community planning partners.
Scotland's health is improving, but there are stubborn and unacceptable differences between rich and poor. For example, in the figures for healthy life expectancy for men, a 10-year gap exists between the national average and the figure in the most deprived areas. We will not achieve our overall purpose of sustainable economic growth if such gaps persist.
In January, we set out the task force's priorities for reducing inequalities in health and wellbeing: children's very early years; reducing the burden imposed by mental illness, and improving mental wellbeing; continuing to tackle the big killer diseases and the direct risk factors for those diseases, such as smoking; and the linked problems, particularly for younger men, of drugs, alcohol and violence.
The task force ensured that actions on all those priorities are informed by scientific knowledge of how children's brains develop and how their earliest experiences shape their physical and psychological development. Their interactions and relationships with parents and carers are vital to their future health and their capacity to learn and thrive. Evidence tells us how poverty, deprivation and chronic stress lead to poor health and premature ageing. The task force has been rigorous in using such evidence, which marks out its thinking as different from the thinking behind previous Government strategies in Europe and beyond.
Turning round Scotland's health inequalities will take time and will require sustained effort by all the agencies involved. The task force recommended how Government, local authorities and their community planning partners should manage and report on progress in the medium as well as the long term. That will be part of the new relationship between central Government and local government, underpinned by the national performance framework and the single outcome agreement approach.
Until now, we have mainly targeted health inequalities that are based on where people live. That is not sufficient, however, to tackle unacceptable poor health across Scotland—in rural areas as much as in some of the most deprived urban neighbourhoods. The task force has been clear that action is needed across the whole population. Diversity, and who people are, matter as much as where they live.
The task force found that an enormous amount of action is already taking place to reduce inequalities in health, funded through the global budgets that are allocated to health boards and local authorities. Those are very significant public sector resources, addressing many of the critical factors that influence health—there is £11.2 billion for health and wellbeing this year, and £11.1 billion for local government. For example, funding is improving people's chances of decent employment, making access to green space easier, anticipating the risks of illness, and supporting people to reduce those risks.
Within those global sums, specific amounts contribute directly to tackling health inequalities and their underlying causes. The task force report identifies £1.8 billion over three years to 2010. That includes the fairer Scotland fund, which is used locally to tackle the root causes of poverty and unemployment; more than £120 million to address alcohol misuse, and a similar amount for drug problems; £56 million for improving Scotland's diet and levels of physical activity, and for combating obesity; and £42 million for tobacco control. All those sums are being used to reduce inequalities in health; they will have a positive impact on the health of the next generation. There are also promising initiatives such as keep well, which has given 35,000 people a health check in the most deprived communities in Scotland. We are also investing £97 million to phase out prescription charges in the three years to 2010. That will be of particular help to people who suffer inequalities as the result of a long-term illness.
Much of the action that the task force recommended can be achieved within existing public sector budgets. However, it is clear that, too often, our services are not reaching those who need them most. That requires the redesign of public services, from education to social work, so that services work better together to meet their clients' most challenging needs and requirements. The report discusses improving client pathways or routes into, through, between and eventually out of the whole range of services. If clients who are already living with poverty and all the associated problems can be better supported by the public services that they use, that will reduce stress, improve the way in which families function, and lead to better health and wellbeing in the longer term.
We will therefore support the task force's proposal for a number of local test sites, in which clusters of public services will be developed, with a particular focus on improving clients' health and wellbeing. Test sites will address complicated issues such as giving children the best possible start, preventing violent behaviour among young people and improving chances of employment. What will make those test sites unique will be public services working together, with input from their clients and from front-line staff, using evidence and understanding of how clients' interactions with services affect their wellbeing.
New Government funding of £4 million in the next three years will support those test sites with information, evidence and continuous improvement techniques. Changes to services will initially be made within the resources that are already available locally. The test sites will, however, explore where further investment may be needed in the longer term to help shift the emphasis of services from dealing with the effects of health inequalities to addressing the underlying causes. That will help to support longer-term resource plans, both nationally and locally. We expect to learn a great deal from the test sites and will set up new ways to do that. We are clear that we need to influence service change elsewhere more effectively than has previously been achieved. The community planning approach will continue to give us the overall framework within which the test sites and the learning from those will operate.
The task force recommended areas in which specific new action and improvement is needed, within the global resources that I have described. It put its main emphasis on giving children the best possible start in life by improving antenatal services and support for families with very young children. The Government will therefore adopt recommendations to improve intensive support for families that are most at risk of health and other problems. That will start in pregnancy and continue through the school years. With NHS Lothian, we will explore implementation of the nurse-family partnership approach, to give intensive support to young mothers. We will also work with four national health service boards, including Ayrshire and Arran, Forth Valley and Lothian, and their partners, to strengthen school nursing, and the wider school health resource, especially in the most deprived areas. Work has already begun and will accelerate in the autumn. We will provide £7 million of new funding over three years to take forward that important work.
Learning in school supports better health. The curriculum for excellence will highlight the importance of health and wellbeing, alongside literacy and numeracy. The task force emphasised encouraging young people to remain in learning and training after the age of 16, to boost their future chances of employment. That is also being taken forward through curriculum for excellence.
The task force identified key links between poverty and poor health and proposed how Government and public services could help to break that cycle. Employment has huge potential to improve people's health and wellbeing. The task force recommended measures to engage more of the business community in the healthy working lives award scheme that supports healthy work and workplaces. The task force wanted more employers to open up job opportunities for people claiming health-related benefits who are able to move into work. The NHS has led the way in doing that, and other public sector employers should follow its approach. Health services such as vocational rehabilitation will work more actively in conjunction with other local organisations that are supporting people into work. The Government will refresh its healthy working lives strategy to take account of the task force's recommendations and Dame Carol Black's report on the health of the working age population.
Physical and social environments and services have the potential to improve health and wellbeing. The task force is keen that children and young people should benefit from their environment, through safe and healthy surroundings. As a result, the Government is making £4 million of funding available to the Lloyds TSB Foundation for Scotland's inspiring Scotland programme, to lever in further resources from philanthropic sources to improve play opportunities for children most in need.
I referred earlier to increasing inequalities in deaths from drugs, alcohol and violence, particularly among younger men. The task force heard how those risks to health and wellbeing link up with children's early years, family circumstances and the environment in which people live. We are particularly concerned with prevention and early intervention, and in seeing strong leadership for joint working locally. Those aims are reflected in the Government's recent policy statements on drugs and alcohol.
Health services can do more to anticipate and prevent health problems. That is why future keep well checks will also identify and then support people with depression and anxiety. The task force report identifies a number of particularly vulnerable groups, and its recommendations will improve their access to health services. For example, the Government will lead the development of a framework for regular health assessments for people with learning disabilities across Scotland.
The task force's approach has been to build on the evidence and the good things that are already going on and to look for consensus about new action that will help with the difficult and complex factors that are responsible for Scotland's health inequalities. The Government will continue to collaborate with local government and a range of organisations in the public, private and third sectors to implement its recommendations. We shall produce an implementation plan by the end of 2008 to turn the recommendations into specific action with milestones and timescales.
Producing the plan will not prevent action from going ahead. For example, we want the test sites to be identified this autumn and, as a result of the task force's recommendations, we are making available new resources from health and wellbeing budgets—which I have already detailed—to back the test sites and developments that will be of particular benefit to children.
Real progress on reducing Scotland's health inequalities will come about only in the longer term, but we want to be accountable for reporting progress along the way, so the Government will review progress on implementing the task force's recommendations during 2010. The task force will reconvene to examine the review and identify any further action that is needed at that point.
Scotland's health inequalities are unacceptable and the Government will not tolerate them. The task force has faced up to the problems and used the best evidence to develop a radical approach that stands a real chance of success. We do not underestimate the scale of the challenge but, if we address it whole-heartedly, we can drive a generational transformation in Scotland's health and wellbeing.
The Government accepts the task force's recommendations and looks forward to working with others to put them into practice to make the people of Scotland "Equally Well".
The minister will take questions on the issues that were raised in her statement. We have around 30 minutes for questions, after which we will move to the next item of business. I remind members that all contributions should be made through the chair.
I promise to do my best to do that, Presiding Officer, although I know that I fail from time to time.
I thank the minister for the copy of her statement. I am sure that there is much of interest in the report, and I make a request—which I am sure will be accepted—for further debate on the report in the Parliament after the recess, so that we can test exactly what is in it, extract the substance and debate it.
I am sure that everyone recognises that any action to tackle health inequalities is welcome and that we should all support determined efforts to prioritise our consideration of it. The minister referred to the budget, which is substantial. It is proper that we question how such substantial funds are marshalled towards tackling inequalities and producing real and effective outcomes. As I understand it, the minister has said that £1.8 billion is directed towards inequality measures. What new moneys that the Government has introduced are specifically directed towards tackling health inequalities? Does the minister agree that health board expenditure should be disaggregated so that we know what is spent in deprived communities and what it is spent on?
What work was undertaken, in compiling the report, with equality organisations—specifically those that are concerned with disability, race and gender—and what input did those organisations have to the recommendations?
I support the minister's conclusion that we should not wait until we can implement the full report but that we should take action where we can. Therefore, when will the Scottish National Party Government implement its manifesto commitment to provide free fruit for pregnant women?
I thank Margaret Curran for those questions. I am very happy to have further debate on this subject—and I accept that the report is fairly lengthy. We will bring forward the action plan, which will detail the implementation, later in the year, after the summer. I am sure that there will be ample opportunity for Margaret Curran to probe the matter further.
On the point about the £1.8 billion, page 49 of the task force report shows an extensive breakdown of the funds. They include a great deal of new money that the Government has put in. Much of the drugs strategy and alcohol misuse moneys will be geared towards tackling health inequalities. I am sure that Margaret Curran will appreciate that much of the brief interventions roll-out will impact directly on people who suffer disproportionately from the impact of alcohol misuse. The detail is there for members to see.
On the question of health board funding being disaggregated, boards are expected to ensure that the way in which they spend their money in each area is reflective of local needs and takes into account the levels of deprivation in their areas. The cabinet secretary and I probe health boards on that when we conduct annual reviews, to ascertain exactly what the boards are doing to tackle health inequalities. I can assure the member of that.
There was widespread consultation with a number of organisations, which I would be happy to list for the member if she wants. I can write to her with a list of those organisations. Part of the announcement on the obesity action plan covered the £19 million of funding, a good deal of which goes towards nutrition and food support for pregnant women and children under five in the most deprived areas. The member will hear more about that when I launch the obesity action plan in the very near future.
I thank the minister for the advance copy of her statement and for the report on health inequalities, which we broadly welcome, although it will take some time to examine the document thoroughly.
The minister has given a commitment to strengthen school nursing. Will the minister confirm the SNP manifesto commitment to double the number of school nurses? I also wish to ask about the obesity action plan. Will the minister ensure that there will be equality of access to those services throughout Scotland? On mental illness and improved mental wellbeing, when will the "evidence of what works" be known? When will it be applied, as outlined in recommendation 50 in the task force report?
Given that it is more difficult to identify deprived areas in the Highlands and Islands and other rural areas, how will the keep well health checks benefit people who are suffering from depression, stress and anxiety and who live in remote and rural areas?
I thank Mary Scanlon for her questions. As I outlined in my statement, and as she will see from the report, the task force's recommendation is that the school-based health resource should be made up not just of school nurses but of other health professionals too—including mental health professionals and physiotherapists—to ensure that the package supports the needs of children in the broadest sense. We have accepted that recommendation. Work is proceeding to test how that model will work. A lot of work has already been done to ensure that the model is tested well, with a view to rolling it out.
As far as what works in mental health is concerned, Mary Scanlon will be aware that there have already been a number of developments in respect of access to psychological therapies to reduce reliance on antidepressant prescribing. We know that a disproportionate percentage of people in our more deprived communities are being prescribed antidepressants because of the stress and anxiety that they face due to the underlying causes of their health inequalities and poverty.
As I said in my statement, we want to extend the keep well programme, which currently focuses on cardiovascular problems, the associated factors and its underlying causes. We will extend that focus to include anxiety and depression so that we can pick up those problems earlier in our most deprived communities.
Mary Scanlon mentioned remote and rural areas. As I said in my statement, tackling health inequalities does not involve identifying just people who live in deprived communities in urban settings; it also involves picking up smaller pockets of deprivation in rural areas. The well north programme is a good example of work that is designed to do that. More detail on exactly how that will be done will come out in the near future.
I thank the minister for the advance copy of her statement and also for the report. As the minister said, the report is based on sound evidence. It is the sort of thing that we have come to expect from any report that is associated with our chief medical officer, Dr Harry Burns.
We welcome much that is in the report. In the short time that is available to me, I will hasten through the report to the section on delivering change. I do not wish my comments to be misconstrued, because the Liberal Democrats are anxious to encourage the delivery of services through co-ordinated approaches. However, I am puzzled by the minister's claim that the test sites will be unique because public services will work together. I do not wish to be picky about that, but Liberal Democrats have been trying to promote and encourage the development of community planning partnerships and community health partnerships.
If I have a slight concern about the report, it is not about the principles but about how the minister will develop things before she delivers the plan. I ask her for an assurance that we will not end up with test sites, community health partnerships that do not work terribly well, and others that work well but wonder whether they are part of a test site. I do not want to exaggerate the danger of that, but the best community health partnerships are already operating close to where the minister wants them to be. In the west of Scotland, where we have the Glasgow centre for population health, the community profile gives them a basis—
You must come to a question, please.
I would like an assurance that we will not end up going against the thrust of the report. I do not think that the test sites will be unique, but they are a basis upon which we can do much better.
I can give Ross Finnie that assurance. He is right to say that joint working is going well in many areas and is delivering benefits to those who receive services. The report, however, will take that work on to a new level. The learning networks will consider how to redesign services across the board so that they have better reach for the most deprived and vulnerable people and those who suffer the greatest health inequalities. That has not been done before in such a comprehensive and planned way.
We will work closely with COSLA to identify the areas in which want to go a step further and are keen to take the work to the next level. That will prove and demonstrate what can be achieved. I hope that I have assured Ross Finnie on that point.
We come to back-bench questions. As always, if members keep their questions short, sharp and to the point, we will get in everybody who wants to be brought in.
I welcome the interaction between cabinet secretary portfolios. I advise the minister that during the summer recess, in the light of the report and other evidence, the Health and Sport Committee will determine the remit for its inquiry into health inequalities. I note that the implementation plan will be available at the end of 2008. That information will be useful to us in timetabling.
I refer to page 19 of the report, and particularly to the point about antenatal care. I recall that the chief medical officer advised the Health and Sport Committee that we should start tackling health inequalities in the womb. What initiatives is the minister considering for the identified test sites—in additional to those that encourage good nutrition, which she has already mentioned—to improve the wellbeing of the mother and unborn child?
Christine Grahame makes an important point. When I talk about support in the early years, I include the period before the baby is born, so I include support to pregnant women in the period up to the birth and beyond. Age zero to three has been identified as the critical time at which bonds are formed or, if they are not, at which damage is done.
That is why we want to take forward the nurse-family partnership—pioneered by Professor David Olds at the University of Colorado—which has worked effectively in America and in some parts of England. It is an intensive programme of home visits to young mothers by highly trained nurses, which aims to improve pregnancy outcomes and child health and development. It is important that it also aims to improve families' economic self-sufficiency by encouraging the aspiration to get into employment, by ensuring that doors are opened and by supporting families in accessing the services that are required to take that forward. Instead of dipping in and out of families' lives at times of crisis, the service is about supporting families from the very early stages and throughout their lives. Participation in the programme is voluntary—families have to sign up to it—but we believe that there is strong evidence that the approach can work.
We need to study the report in detail. No one can disagree with the general thrust of it. I have about 100 questions, Presiding Officer, but I know that you will allow me only one, which is really an extension of Ross Finnie's question. Where does the joint future agenda lie within the new proposals, and where do initiatives such as family centres, sure start and home start lie? Has the Government still abandoned the policy of providing nursery places for two-year-olds in deprived areas?
I realise that that is more than one question, Presiding Officer.
It was better than 100 questions, Dr Simpson.
In my statement, I talked about other linked strategies, which we have already started. The joint work with COSLA on the early years framework is well advanced. A key focus of that work will be targeting of additional services for zero to three-year-olds. That work is progressing well, and the plan of action will be made available in the autumn. It will fit well into the recommendations that the task force report makes on that front.
I strongly welcome the statement and its recognition that inequalities in health are due mainly to underlying causes and are not the problems solely of the health services. However, does the minister recognise that, among the health and other professionals who care daily for those who suffer from health inequalities, there is an immensely valuable pool of knowledge and experience, including knowledge of measures that could improve outcomes? Does she acknowledge that the current organisation of primary care services disadvantages those who work in that field? Will she consider discussing measures that will remedy the situation with people who work in the front line, such as the members of the Lothian deprived interest group?
I am aware—as the task force was—that there are good examples of local projects and services. Many of them feature in the report. However, the problem has been that a good idea here perhaps never sees the light of day there. Part of the learning networks' job is to consider best practice and what can be maximised to achieve the best outcomes for people and to encourage people to share knowledge and practice throughout Scotland. That is the work that we are doing on the test sites.
Ian McKee also mentioned primary care. We are committed to finding a more equitable basis for core funding of general practice—we have made no secret of that. We will endeavour to continue to work with general practitioners to ensure, for example, that future changes to the GP contract work for, rather than against, practices in deprived areas. I give the member an assurance on that.
There was nothing in the statement about tackling specific health inequalities in rural areas, where it costs five times as much to deliver the most basic health services. Will the minister give a commitment today that a remote rural area will be included as a test site, so that the unique challenges for service delivery in such areas can be focused on?
I am sure that Rhoda Grant will appreciate that the test sites have not yet been finalised. We want variation in the areas in which we will do the testing. If we are going to have learning networks, we must make sure that the learning from those networks can be spread to other similar areas. What works well in an urban setting might not be the same as what would work well in a more rural area.
I refer Rhoda Grant to the answer that I gave to Mary Scanlon. The well north programme looks at the needs of the rural population and applies the principles of keep well and anticipatory care to rural areas, and considers the appropriate way of delivering anticipatory care in such areas. As the detail of the well north programme is rolled out, I hope that Rhoda Grant will welcome it.
I welcome the statement, particularly the allusion to the need for greater focus on men's health outcomes. Will the minister confirm what assessment has been or will be made of the negative consequences that might arise from the proposed transition from what has been national and universal health provision to a targeted approach—which I understand—in which, for the first time, some people are to be excluded as an act of policy, for example in respect of routine access to health visitors?
We must ensure that our universal services provide the level of support that people require. Surely, after everything I have said about widening health inequalities, every member, no matter which part of the chamber they sit in, will agree that such inequality is not acceptable. That is why we must make sure that our services are redesigned and refocused so that we can begin to address the lifelong inequalities that people suffer in Scotland, here and now. We can do that only by making sure that support goes to where it is most required. That does not mean that people who require support are no longer going to get it. It is often those who need it most who are least likely to get it. That is not acceptable and we are determined to address it.
Given the nature of the constituency that I have the honour to represent, I am interested by the minister's reference to strengthening school nursing. What measures are being proposed? Will it include a significant rise in the number of school nurses, particularly in constituencies such as mine, in which a large number of schools are scattered far from each other?
As I said earlier, the first thing we want to do is test that the initiative will deliver what we want it to deliver, so it will initially be introduced on a small number of sites to check out the make-up of the health team, the type of work in which it engages and how it relates to staff in the school and other staff in the community. We want to work all that out before we roll out the project.
However, we are absolutely committed to ensuring that additional resources go where they are required. That is why the school health resources will initially be focused on our areas of deprivation, where we know school-age children require support. We want a continuum of support from the pregnant mother, to zero to 3 years, through to nursery and on to the school years for the most vulnerable children throughout their lives. We believe that that will lead to better outcomes for them in their teenage and adult years.
The minister will be aware of the damage that alcohol misuse does to individuals and communities across Scotland. In launching the Government's consultation on tackling Scotland's drink culture, it is clear that targeting cheap alcohol and its availability is to be made a priority. What impact will ending deep discounting of alcohol in off-licences, particularly in supermarkets, have in tackling health inequalities?
The evidence tells us that price is closely linked to consumption: the lower the price, the higher the consumption. That is why we are proposing to tackle deep discounting in the ways we laid out in the consultation earlier this week.
We also know that people from our most deprived communities suffer greater alcohol-related harm. They are seven times more likely to die an alcohol-related death. There are many complex issues around comorbidity, but we know that the people who live in the 20 per cent most deprived communities are about six times more likely to be admitted to hospital as a result of alcohol misuse than are people from more affluent areas. There is a clear link: that is why, if we can get the alcohol strategy right, there will be a disproportionate benefit for our most deprived communities.
One word is missing from the report: "Glasgow"—or perhaps I should say the phrase, "west central Scotland". The statistics that underpin the report and the work that has been done by Harry Burns and Carol Tannahill are excellent, but their focus is strongly on the particular conditions that exist in Glasgow, and their underlying causes. Do we need a strategy that focuses on Glasgow and the surrounding areas and that takes account of the particular issues that exist there? Do we not also need to reflect that in the resource allocations?
The Government—
Briefly, please.
Recommendation 68 of the report states:
"The Government should protect current resources targeted at reducing health inequalities and consider the need for further investment".
It seems to me that that problem is particularly focused in west central Scotland and Glasgow, and we need to know what the minister is going to do about—
I call the minister.
I am surprised by what Des McNulty has said, particularly given that Carol Tannahill was an adviser to the task force and gave us much of the evidence on which the report is based. Every part of the report is relevant to tackling deprivation in the city of Glasgow and the west of Scotland.
Without tackling the deep-rooted health inequalities in Glasgow and the west of Scotland, we will fail in our duty to tackle health inequalities. I can assure Des McNulty that a clear priority in tackling health inequalities is to ensure that we tackle inequalities in Glasgow and the west of Scotland.
The minister's statement made no specific mention of the role of GPs in areas of social deprivation. In Rutherglen and Cambuslang, there is one GP for every 1,600 people. However, more affluent areas with greater life expectancy have a higher number of GPs per head of population. What steps will the minister take to ensure that additional GPs are allocated to areas of social deprivation?
I hope that James Kelly heard my earlier response to Ian McKee that we are committed to finding a fairer basis for the core funding of general practice. We want to work with GPs to ensure that future changes to the GP contract work for, rather than against, practices in deprived areas.
Let me remind James Kelly that we were not in power when the GP contract was designed, but we are clear that we want to improve it. That is why funding for the new Scottish enhanced services programme—£20 million in 2007-08 and 2008-09—has been specifically targeted at deprived areas, using the Scottish index of multiple deprivation. We have been especially keen to allocate resources to reflect needs in deprived areas, but there is certainly more work to do and we will pursue that vigorously.
In her statement, the minister emphasised early years intervention, but I did not hear any specific mention of breastfeeding support and promotion. Does the minister agree that breastfeeding is critical to improving health from the start? Can she provide detail on how the low rate of breastfeeding can be improved in deprived areas especially, but also throughout Scotland?
I point Elaine Smith to page 22 of the report, which states:
"NHS Boards should improve breastfeeding rates in deprived areas and among disadvantaged groups. The Government's new infant nutrition co-ordinator will concentrate efforts on reaching these groups."
That is one of the task force recommendations. Breastfeeding is clearly an important aspect of early years intervention and the support that we give to new mothers, particularly young mothers. A lot of good work is already going on in that domain, but there is clearly more to do. Elaine Smith can be assured of our commitment to doing it.