Chamber and committees

Ms Harper is absolutely correct. She mentioned the undoubted linkage between housing and good health; another example of a policy area in which health and social care is probably the greatest beneficiary is our action to address child poverty. We know that poverty is one of the greatest determinants of poor health, not just among children but for people’s long-term health trajectories. Work on that is being done across Government: a Cabinet sub-committee on child poverty, of which I am a member, is leading on looking at how we ensure that cross-portfolio attention is given to those areas, so that there is not a pot of money being spent in one area of Government without looking at the wider benefits that that brings.

When we have a difficult fiscal environment, it is critical that we understand where decisions are being taken that can have a multiplicity of benefits across other portfolio areas. Housing is one such area, and addressing child poverty is another. As another example, we are looking at the climate change plan and working our way through the environmental factors that drive poor health. We work collaboratively in all those areas across Government.

With respect to Mr Sweeney, I would extend that to the increases in employer national insurance contributions, which are having a significant and very damaging impact on the ability of service providers in the social care space to conduct their work. We have provided pay uplifts to recognise and support the fact that, as I have already set out to Mr Whittle, in a competitive economy with a working-age population demographic that is set to decline, we need to ensure that we have competitive rates of pay not just in social care but in other public sector spaces so that we are able to access staff as best we can. Moreover, the care home rate is set by COSLA through negotiation with the system, so there are other cogs in the wheels that need to be considered such as income and the route by which social care is provided.

I recognise the challenge of meeting pay costs—of course I do, and it is why we are providing this increase and asking employers to provide the statutory elements. We will, of course, do what we can to continue to discuss the implications of the decisions that have been taken, and we will seek to ensure that the social care sector continues to provide its incredible service to families across the country.

Again, I make the point that visa threshold decisions are made not by us but by the UK Government, which perhaps partly illustrates the reason for the reduction of around 80 per cent in health and care visas over the last year that we have data for. We think that that is detrimental to our sector in Scotland, and we want it to be reversed. We also want, if not the policy levers, then better collaboration to allow us to attract and retain people in Scotland.

The member is correct in his assertion that there are displaced workers across the UK, and we have sought to target them through the investments that we have made in visa support, which the First Minister has announced the extension of. I have received the correspondence from Rachel Cackett of the CCPS; I and Mr Arthur engage with her regularly, and we will continue to engage with the sector on the impact of this issue and on whether any mitigations can be brought forward through the decisions that have been taken.

It is, as Mr FitzPatrick set out, incredibly difficult to do that, because it is difficult to measure something that you have prevented.

That said, I think that Mr Whittle and I have a similar ideological philosophy with regard to the power of sport, for instance, and we understand the mental and physical health benefits that come from expanding people’s ability to be physically active. Therefore, another area that I would point to when it comes to preventative spend is the sport budget, which we have expanded by £40 million this year.

I should also say that, last week, Ms Todd and I had discussions with the Scottish Football Association about how we make best use of the summer of sport initiative, which will run this summer alongside the Commonwealth games and the football world cup, which the men’s team has qualified for. That is a huge opportunity that we can take forward, and it will be incredibly beneficial, but, crucially, it has to be a long-lasting and sustained intervention that will support people to continue with sport. I think that Mr Whittle will agree with me that sport is an area of proven preventative intervention.

However, as I have said, it is difficult to measure the things that you have prevented by the very nature of the fact that you have prevented them.

I understand that concern. We are looking to build a recurring programme. The first objective is to build on the Commonwealth games and the summer of sport and ensure that there is a response to what we hope and expect to be considerable enthusiasm among people who will want to emulate the sporting stars that they will see in Glasgow. The funding to build the programme will be recurring, and whether it is offered during term time or during the holidays, we will continue to work with governing bodies such as Scottish Swimming to make it as accessible as possible.

I recognise the challenges around accessibility. In my earlier answer to Emma Harper, I talked about the differential impact of child poverty on outcomes in health and wellbeing, and access is another area where the poverty premium applies. We will continue to work with Scottish Swimming and others to ensure that the services that are being provided are as accessible as possible.

We have been exploring in depth how we balance the public health interventions that we need to make with providing increased choice. In some cases, such as food, nutrition and alcohol, choice is being curtailed, which is making it more difficult for people to make decisions about how they sustain themselves. As Ms Whitham will be aware, we are taking forward public health interventions such as minimum unit pricing and measures in relation to high-fat, salty and sugary foods, because we recognise their impact on health and wellbeing in Scotland. There are considerations—of course there are—around the wider economy, but that flips both ways. As a former economy secretary, I say that we struggle to have a growing and successful economy if we do not have a healthy workforce. Ensuring that we have a balanced approach means that we are able to take the necessary interventions that protect health but also sustain a healthy workforce that contributes to economic activity. That is the overarching approach that the Government is taking to the good food nation plan and our public health measures in improving accessibility and choice for people when it comes to their eating choices.

I have good engagement with Ms Gougeon, who leads in this space. I believe that the legislation gives us an opportunity to do that, and I would be happy to provide more detail to the committee in writing as to the monitoring that we expect to put in place and the decision-making infrastructure that we have around some of the public health interventions that we are seeking to make.

Good morning. I thank the committee for the opportunity to discuss the 2026-27 health and social care budget. It delivers a record £17.6 billion for front-line national health service services, £2.4 billion to support the vital work of general practitioners, primary care and community services, and more than £2.3 billion of support for social care.

The budget was presented to the Scottish Parliament following constructive engagement across the chamber, led by the Cabinet Secretary for Finance and Local Government. It has been developed through effective engagement and negotiation across Parliament to build broad support. We will continue to work with all parties in Parliament to secure agreement on its provisions.

Our health and social care services still face challenges and that is why we will continue reform, focusing on prevention, reducing waiting times and improving access, and on shifting the balance of care to communities.

Overall, the budget provides almost £22.5 billion of investment in health and social care services. There is more than £17.6 billion for health boards, which provides a real-terms uplift of 1.8 per cent, with spending across the NHS rising by nearly £5 billion by the end of this parliamentary session—almost doubling our commitment to increase front-line spending by 20 per cent. There is more than £2.3 billion for social care, which delivers our commitment to increase funding by 25 per cent or £840 million. It supports an uplift to adult social care pay, as well as improvements to wider terms and conditions for workers.

The £2.4 billion for primary care includes support for recruitment, retention and capacity and provides more than £98 million in additional funding in 2026-27, which is part of our historic three-year £531 million deal secured with general practitioners. There is also a further £36 million to establish new high street walk-in GP services. Fifteen walk-in service centres will be established, with services focused on urgent, on-the-day primary care needs, similar to the care provided by GP out-of-hours services. It was my pleasure to visit the first pilot site, the Wester Hailes healthy living centre, as part of the budget week.

There are funds for investment across the NHS estate, which will enable us to progress priority hospital replacement projects, embark on a primary and community care infrastructure investment programme and undertake targeted maintenance and equipment replacement.

Importantly, there is an additional £40 million of investment for sport and physical activity to support opportunities for people across Scotland to be more active.

I am in no doubt that we have an NHS in Scotland that, after the profound shock to the system that was Covid, is recovering. This is a powerful health budget that, notwithstanding the on-going challenges, will enable our health services to do more, and to do it better.

With my colleagues, I am happy to take questions from the committee.

Walk-in GP services are an important policy priority for the Government and will add flexibility to allow people to be able to access GP services. They are not about displacing or replacing core services, which is why the record funding increase that is going into core GP services is so important. We aim to broaden the primary care front door that is available to people. Walk-in services are about offering more flexibility and trying to avoid people going to the wrong places for their healthcare needs. The funding that we have attached to walk-in GP services will predominantly be for staffing. Depending on the chosen sites, there will also be a need for some interventions, wherever those sites are.

Ms Whitham’s question allows me to speak about some of the work that has been done to support child and adolescent mental health services and the additional investment to support children who also have a neurodevelopmental condition that requires diagnosis and treatment. It is about expanding the opportunities in that side of CAMHS. We have done a significant amount in core CAMHS and have significantly increased staffing. As a result, waiting times have been brought down and CAMHS standards across Scotland have been achieved for the first time over the past year or so.

We are now looking to make additional progress in an area that we—as well as the committee—recognise poses a particular challenge, which is neurodevelopmental pathways and providing support for children and their families in achieving a diagnosis and also with regard to treatment.

Ms Whitham knows this well, but it is important to stress that, even without a diagnosis, our policy framework is geared towards supporting people based on their need as opposed to their diagnosis. However, I know how much importance families attach to getting a treatment pathway through a diagnosis, and we are attempting to support that with additional investment.