Chamber and committees

It will go into three main priority areas. One is waiting times. The second is capacity—front-line staff and increasing the capacity of the delivery arm. The third is wider healthcare system reform. It is trying to tackle that point on waiting times, which are not where we need them to be. Also, the capability of an organisation is its competence times capacity, and our organisation is competent, but the capacity must be increased. That is going into those two main delivery areas.

I do not know whether Scott Mackay or Craig Maidment would like to say anything in addition.

On the financial situation for next year, the picture that you paint is exactly the one that I see, and is exactly what I tried to explain to Ms Stafford about the stark reality of the block grant not keeping pace with the need and demand for public services in Scotland, especially post-Covid.

10:30

The situation this year is challenging. As I outlined, if we were not using ScotWind as a backstop, if we were not looking at other backstops and if we were not using the SEND consequentials in full, we would be looking at a path to non-balance. Legally, we cannot do that, and we as a Government will try every alternative to avoid that.

On the situation for next year, we are making investments and funding allocations in health this year to target the capacity that I outlined to Ms Haughey, and we will come back with the figures on that if they are available in the health portfolio. Although that is being targeted on capacity and reducing waiting times, I anticipate that day-to-day costs will be relatively similar in 12 months’ time, because some of the prevention spends that we are putting in place and the reforms that we are introducing in relation to the two-health-boards consolidation will not materialise within a 12-month context. We are looking at costs within the 12-month period on day-to-day spend continuing to be a reality next year.

I am not quite sure of the question.

We find ourselves in a challenging situation in relation to the vital healthcare services that we want to provide. The uplift to £22.5 billion for health and care is providing an all-time high for that portfolio budget.

If I understand your question right, you are asking about the £500 million allocation for renewable energy transition coming from ScotWind.

Most of the SEND consequentials have gone to the health portfolio. Every week, when Government ministers come to the chamber to answer questions, a significant number of those are to do with health. I am sure that everyone around this table acknowledges the importance of the issue from conversations that we have had on doorsteps with constituents.

Health is the Government’s number 1 priority, and it is important that we match that with adequate funding and transfers within the year to deal with a challenging financial context that involves inflationary pressures in the health sector and an increasingly dependent and ageing population with complex health and social care needs. The Government must be prudent in order to match the number 1 priority of health with the appropriate resource in terms of finance.

The second issue, which you have identified, is the structural change that must come. That is why we have very clearly set out in the programme for government the reforms to health that will be required. As I noted in my opening remarks, that represents the largest change since 1999 in how we deliver health, education, justice and public services right across Scotland, and involves reducing our health boards from 14 to two, with a bespoke situation for the islands.

The Government has a commitment to have a healthy nation, and, to deliver on that, we must follow that up with resources and meet pressures within the year. As you alluded to, we must also have one eye on the future in terms of the structural change that we need to see. There have been several reports on the upfront savings that will be required in the next three years from health boards and on the wider restructuring that will happen in this parliamentary session in order to deliver those savings.

There were two questions there. On the £20 million, are you referring to your previous question on the real living wage?

Again, there are several questions within that. Let me take them in turn, because it is important for me to give some flavour of how I view SNIB.

SNIB was set up five years ago to be a patient investor and to take risks that other financial institutions are not taking. It is important to view its investments as a portfolio. In any investment profile, there will be both losses and gains, and, of course, losses will materialise and crystallise more quickly than longer-term uplifts. The funding for SNIB concludes in 2030, and I anticipate that, given the typical profile of investments of this nature, the equity-to-debt ratio will begin to increase and more of the investments will start to bear fruit.

It is important to answer your question about the independent nature of SNIB. It is wholly proportionate and fair for SNIB to act on its own due diligence and to take its own decisions, independent of Government ministers. Those in charge of financial institutions such as SNIB or the National Wealth Fund have a different risk appetite from those of us who are involved in public finance, where contingency and backstop safety nets are always baked in. The private sector takes more risks and I have said many times that I come from a background in industry, and I want that culture to be injected into Government.

SNIB currently benefits from the fact that it is set up to be at arm’s length from ministers, and it is important to consider the benefit that SNIB has created across Scotland. It is operationally profitable in terms of covering its running costs. Yes, we have had £79 million in losses since its inception, but it is able to finance some of those losses because, operationally, it is profitable. It has created 3,300 jobs across Scotland. It has benefited more than 300,000 people and has had a positive uplift in that regard. It is responsible for £983 million of mid-market housing, £400 million of supply chain and direct contract investment, and £150 million of research and development investment. Further, on climate change, it has been responsible for drawing down about 230,000 tonnes of CO. In addition to the projection regarding the increase in the equity-to-debt ratio as we go towards 2030, the wider ripple effect of SNIB shows that the Government has been entirely right in the approach that it has taken. I look forward to seeing the success of SNIB as it transitions towards 2030 and beyond.

Yes, it is.

I am unsure what your question is.