Chamber and committees

We are talking a lot about the structures. That is right, but we are looking at the budget, and I have a couple of questions about that. Professor Feeley, you mentioned the increase in funding for social care by the end of the previous session. That was achieved, but it is still not enough. Given that your review was five years ago, where do you see the figures going in relation to the change? I note that inflation has had a major impact.

Another key issue for me is whether we are doing enough to measure demographic change. Professor Knapp mentioned other aspects of social care, and I note that there is additional expenditure on housing and other things. If we consider where the budget was five years ago and where we are now, what do we need to do? You talked about challenging the Government on unmet need, but do we need to talk more about demographic change not just over the next five years but over the next 10, 15 or 20 years? What are your views on where we have moved over the past five years and where we are now?

I know that that is a huge question, but I am interested in hearing your views.

I will ask a question on budgeting; it is probably for Forbes Dunlop or Gregor Muir. You get your budget from the Scottish Government from year to year. We will talk about facilities later, but we have talked previously about coach development and general development in sport. With a year-on-year budget, what issues arise in how you look at strategic development over five or 10 years, for example?

In our pre-budget discussions with ministers and the cabinet secretary, one of the key issues that we will be speaking about is how we can look at longer-term strategic development of sport in Scotland when budgets are on a year-on-year basis. What challenges do you face? Ministers would need to speak to the UK Government about giving reassurance for a three-year or five-year budget. What are the issues around that?

I think that it would be hard to look at the strategic development of sport over the next number of years. We had the summer of sport, which had additional funding. However, outwith that, it is about getting by, year on year, without the strategic development piece. That is the bit that concerns me.

11:00

Forbes Dunlop, sportscotland’s estates review said that an investment of £15.5 billion is required over the next 25 years. That is a big figure. This takes me back to the point about year-on-year planning. One of the roles of the committee is to challenge Government by saying, “If that is the amount that is needed, how are you going to achieve what you need to achieve with that?” How do we prioritise that? You say that you will need £15.5 billion over 25 years, but is there a piece of work in which you say, “In year 1, we need to do this, and in years 1 to 5, 5 to 10, 10 to 15 and so on, we need to do that”? What level of work do we need to do in terms of saying to the Government, “This is what the estates review is telling us, so what is the plan over the next 25 years and what are the priorities?” We need to look beyond one parliamentary session and into the next five or six sessions.

It also comes back to Jack Middleton’s point that if we want to produce elite stars and increase participation, we will need that level of capital investment. How do we prioritise that? How do we get the Government to say how it will prioritise that over the next five, 10, 15 and 20 years?

Have you had any formal reply from Government on that figure of £15.5 billion over the next 25 years?

Yes—it is about the interim arrangements. We have heard about the success of subnational planning and the difference that it has made. What focus do we need in the five to 10 years before the benefits of preventative spend start to kick in?

Jack Middleton makes a good point in saying that it might take five or 10 years for benefits to emerge. When the cabinet secretary appeared before us, one of the key issues that we discussed was the success of subnational planning. In the interim, before we go from 14 health boards down to two, what do we need to do on subnational planning? That is about resource but it is also about more procedures taking place. This is an open question. What can we do to have that focus before we move to two health boards and before we see the benefits of preventative spending in five or 10 years?

The system design at the start is important, but so is how we monitor it going forward. We can say, “Okay—this is the system and this is what we’re doing”, but how do we monitor that? We do not want to be here in five or 10 years’ time saying, “We looked at this years ago when we redesigned it.” What are the fundamentals? Richard, this question may be for you. Where are the key metrics that we need to look at? It is not simple, so how do we ensure that the whole-system approach is working? A year after the reforms come in, what will the committee need to do to see whether they have worked? Will we need to look at it regularly? How will that feed in? I know that this discussion is a bit like asking, “How long is a piece of string?”, but will you comment on that?

I know that we have limited time left in this evidence session, but one of our key themes is drug and alcohol deaths, so I want to ask about that issue. The key statistic, which is really scary, is that the rate of drug deaths in the most deprived areas is 15 times higher than the rate in the least deprived areas.

There are a couple of key issues for me. The first relates to the role of national frameworks, such as the population health framework, and the second relates to the effectiveness of the current delivery framework that we have in place, with drug and alcohol partnerships. My question is about the national approach versus the local approach. As is mentioned in the committee’s papers, the use of drugs is higher in areas such as Glasgow, Dundee, North Ayrshire and Inverclyde. My question is about the population health framework and local delivery versus national delivery. This is still a key issue for us, given that the statistics from last month showed that there had been another rise in the number of deaths. What are your views on that? The committee will be doing more work on the subject, but can you give a broad overview?

I think that I have already asked the question, convener.

I want to explore that point a bit more. You are right in what you said about primary, secondary and tertiary care, but we have all touched on the need for a whole-system approach. How do we embed a preventative approach across the whole system? Given that some parts might work better than others, that is a particular challenge. We are almost talking about a one-size-fits-all model, but how do we ensure that it fits the mix of urban and rural areas that we have in Scotland? That is complex.

Have you done any work on that? You have looked back at what has happened, but we need to think about what could happen in the future. How do we ensure that a whole-system approach that takes account of regional differences is embedded in what we do in relation to the preventative agenda? We could do good work in some areas, but that will fall by the wayside if we do not take a whole-system approach. That is the crux of the challenge. We need to ensure that that is embedded across the sector.