Chamber and committees

Pam Duncan-Glancy has a brief supplementary question before we close the session.

If there is time at the end, we can pick that up again.

Yes—we are very much aware that we are a panel member down.

David Belsey said that students are studying part time because they have to work, but I wonder whether we could tip that on its head a little. The world is now very different in terms of flexible working and how people learn and live. Do you think that having more flexible courses might be more beneficial for colleges in getting more people to come in? That would put a more positive spin on the opportunities that flexible learning and courses offer.

That is okay.

Audit Scotland’s report “Scotland’s colleges 2023” stated that

“further ... staffing reductions ... could severely erode”

colleges’

“ability to deliver a viable curriculum.”

David Belsey has spoken about that a bit. The SFC has said that 21 per cent of staff could be removed from the sector by 2025-26. What assessment have you made of the current staffing situation? What action do the Scottish Government and the Scottish Funding Council have to take to help colleges in that regard?

Who would like to go first?

We understand all that, but 70 per cent of colleges’ expenditure is made up from staff, so people are the most valuable resource. There is a mismatch there. The colleges will have to make some really challenging decisions—they do not have the money coming to them, so they have to consider all their resources and, unfortunately, those in the college sector will have to make decisions about staff.

Do you not feel that the unions are a bit out of touch in managing and understanding the pressures that are on leaders in our college sector across the country as to some of the challenging decisions that they have to make? As hard as it is, in the financial environment that they work in, with the lack of flexibility that they face, they have to take such decisions.

Good morning and welcome to the 18th meeting in 2024 of the Education, Children and Young People Committee. We have received apologies from Stephanie Callaghan.

Our first agenda item is pre-budget scrutiny of the 2025-26 budget. In this session, we will take evidence from the university and college sector and will focus initially on college funding.

I welcome our first panel. Mark MacPherson is audit director at Audit Scotland, and David Belsey is assistant secretary at the Educational Institute of Scotland Further Education Lecturers Association. Thank you for joining us and for the written submissions that you provided ahead of the meeting.

We will move straight to questions from members. The first comes from my colleague Pam Duncan-Glancy.

The ministerial team has given its full backing to the low-emission zone in Scotland’s capital, which might also reduce traffic volumes and tackle congestion across Edinburgh.

Will the Minister for Agriculture and Connectivity give his backing to a project that is estimated to remove half a million cars during the central belt rush hour—a project that will be more beneficial to achieving our net zero goals than Edinburgh’s low-emission zone—and build a station in Winchburgh?

Will the member take an intervention?

The spending is not ring fenced. If the NHS in England chooses to contract a private provider to provide a service, the money still comes to Scotland as a consequence. It is not allocated in the manner that the member is saying that it is.

Our NHS is an incredible national asset—I do not think that anyone doubts that—but it continues to face growing challenges. The SNP’s consistent attempts to blame its NHS failures on the UK Government lack credibility; after all, it has full control over healthcare. However, here we are, with more than 840,000 Scottish people waiting on an NHS waiting list. In March 2024, almost a third of patients had to wait for more than four hours in A and E. Just 71.1 per cent of cancer patients are seen within 62 days. Since the SNP promised to increase the number of GPs by 800 by 2027, GP numbers have decreased by 42. Right now, there are more than 4,000 nursing vacancies in NHS Scotland. In 2023, NHS staff faced around 31 assaults a day.

I could go on, but we have heard those statistics many times before, and I am sure that we will hear them again in this debate.

The only way to bring down the waiting lists is to be more efficient with the resources that we have or to create more capacity to do more. Just imagine what we could do if we could do both.

Here is what I mean by being more efficient. I recently spoke to a surgeon who operates across two different hospitals. In one hospital, the theatre is staffed with tens of nurses and operating department practitioners, and they deal with two cases, or maybe three if they are lucky, on a list. In the other hospital, there are far fewer staff in each theatre, but on one list, they can deal with six to eight cases. Faster patient turnarounds and fewer delays between cases is more efficient. Imagine how we could bring down waiting lists if that was compounded with increased capacity.

It is blindingly obvious to me that the decision that the SNP Government took to stop all new capital investment in our NHS will be catastrophic. The SNP Scottish Government appears to favour short-term solutions that will have devastating long-term consequences for our NHS. As Jackie Baillie said, we were promised 11 new regional treatment centres that were intended to bring down the waiting lists. Now, the Scottish Government website mentions only four.

In addition to those treatment centres, dozens of NHS construction projects across Scotland have been stopped. Vital projects in Lothian have been postponed. Those include a new cancer centre, a new eye hospital and a national treatment centre in Livingston. A GP surgery in East Calder that is crying out for a new facility has been all but abandoned. That is before we talk about community hospitals in and around the area closing. With a growing population and diminishing resources, the new chief executive of NHS Lothian has a real challenge ahead of her.

Let us focus on preventative healthcare for a moment. Right now, for every £1 that we spend on our NHS, we spend just 2p on public health. Investing in prevention has substantial benefits in reducing patient demand and costs, as does early diagnosis and treatment. That keeps treatment costs down, it results in far better patient outcomes and it gets people back to work, with a far better quality of life. We need to greatly increase spending on public health interventions if we are to make prevention the overall strategy for our approach to healthcare. We all know about the success that the smoking ban had in the immediate aftermath of its introduction.

Arthritis and other musculoskeletal conditions affect a third of Scotland’s population—that is, 1.7 million of us. Just last week, figures were published that showed record NHS waiting times, with trauma and orthopaedic waits forming the single largest cohort: they make up a third of all waits.

I am one of those 1.7 million, and I am far too young to be getting new knees just yet, but I have been in chronic pain and on a significant level of medication to manage that pain. That medication is not free; it costs money. Yesterday, I went to the GP for the second injection in my knees, so I have now had them both done. Almost immediately after my hyaluronic acid injection, I experienced a significant reduction in pain, I have increased mobility, and I am not taking the medication any more, which will have many health benefits.

Here in Lothian, there are very long waits for such joint injections. I have been very fortunate to have a GP who can do them, and I want to give a thank-out to Dr Graeme Parry in Colinton surgery. I met a physio who told me how important a role physios can play for people with arthritic joints, yet the Chartered Society of Physiotherapy has highlighted a worsening workforce crisis in physiotherapy, with record high vacancy rates and one in five physiotherapists considering leaving the profession. It is a key profession for getting elderly patients who are stuck in hospital more mobile and able to function themselves, which would free up hospital beds and appointments and make space for other activities to take place.

For those who really want to talk about preventative spend, I want to speak about a rare and incurable genetic condition that affects spinal motor nerves, which is called spinal muscular atrophy or SMA. Unless it is caught early, it results in progressive muscle wasting and weakness. With approximately one in 16,000 British babies born with SMA, the case for adding it to the screening blood spot tests for all newborns is obvious to me. I notice that Mr Doris is in the chamber—I know that he, too, cares passionately about the condition. Yes, that test will cost money, as will the treatment, but the cost of round-the-clock care for someone with SMA is around £500,000 a year, so surely that fits both financially and philosophically with the principle of preventative medicine.