Chamber and committees

We are at the stage of formulating the budget, but we will consider very carefully the recommendations that have been made by the Standing Committee on Pandemic Preparedness. The work that Professor Morris leads is very significant in making sure that we have the necessary level of external challenge. Obviously, there are other elements of challenge; Parliament and this committee are principal elements of challenge in that respect. That external challenge is to ensure that we have in place the necessary arrangements. We will look very carefully at the standing committee’s recommendations as we make decisions on the approaches that we will take. In this financial year, we have forecast expenditure of around £485 million on all aspects of activity in relation to Covid; we will reflect on the report’s points as we consider the composition of the budget for the next financial year.

I suspect that we all face the same dilemmas, because nobody ever has more money than they require. Prioritisation always has to be undertaken, and I suspect that other countries probably do not find it any easier than we do to stop spending money on one item in order to spend it on another. My statement to Parliament on 7 September was a very clear example of the process that I am going through just now; I am having to exercise a very challenging judgment about prioritisation.

A lot of the thinking that needs to be done has, in fact, been done. It was largely done by the Christie commission all those years ago. I therefore do not think that we have a question to which we do not know the answer; I think that we do know the answer, and the answer revolves around prevention and early intervention.

If I translate that into the questions that Mr Whittle put to me about the role and approach of the health service, it is about an approach that is much more about encouraging people to live a healthier lifestyle and to be active in addressing their weight and how they manage any conditions or experiences that they have. All of that is a crucial role for the health service. We know all that about approach; indeed, that is reflected in our wider public health policies, where we have measures around minimum unit pricing of alcohol, for example, or advice around dietary issues. All those kind of questions are part of our agenda.

Covid has, in essence, given us the opportunity to face up to that. It is almost a turning point moment, where, because of our experience in Covid, we all think that we can and should do things differently. It is almost a prompt or reset moment. The Covid recovery strategy was designed to provide the vehicle for that to happen. Elements of that strategy show that a fundamental part of it is a lesson from Covid that, if we deliver person-centred public services, we will make more impact on individuals and are likely to deliver better outcomes. That was our experience during Covid.

For example, during the pandemic, because of the restrictions, households that faced difficulties were not able to be contacted by the multiple agencies that would normally be knocking on their door to offer them support. What we deduced during that period was that people, in fact, liked that, because they built up a relationship with the one trusted person who was coming to their house. Instead of someone turning up and saying, “I’m from the council and I can offer you this” and another person turning up and saying, “I’m from the health service and I can offer you that”, that one trusted person turned up and had a conversation in which they said to people, “What do you need? How can we sort things out and make things better for you?” That might have been about food or access to particular public services—whatever it was, basically, people had a better experience.

The Covid recovery strategy is designed to get us into that mindset and that mode of delivery. The programme board that I chair along with the president of COSLA involves representation from a range of different public services, and is designed to help us to drive that agenda. The pathfinder approach that we are taking in Dundee and Glasgow is providing very good learning about how that can be done.

I suppose that God loves a trier.

It is clear that we must continue to make provision; we cannot consider provision to have been satisfactorily addressed. There will be continuing commitments to what I describe as the precautionary regime that we have in place. We have an enhanced level of biosecurity and PPE use today, compared with pre-pandemic times, so that will have to be sustained fiscally. We will have to retain sufficient intelligence-gathering capability to give us the confidence to address the issues that the committee addressed with Professor Morris.

I will not be pinned down on particular numbers today because there is a lot of work yet to do, but the committee can expect that there will be continuing provision to support Covid measures that must be of a scale that enables us to be confident that we have in place measures to protect against a resurgence or mutation of the virus.

In that respect, Covid has not become part of the firmament of society yet. Many other viruses and conditions are routinely handled in our public services provision, but Covid is still in a category of its own. Therefore, funding will need to reflect that.

All those things are joined up. Mr Rowley and I have probably talked about this issue as much as we have talked about any other issue over recent years.

The data on Tuesday demonstrates that we have congestion in our A and E departments. That is partly because of the congestion in our hospitals in general. It is not straightforward to get people out of A and E departments into other parts of the hospital, if they need to stay there, or to send them home, because they might need care to support them at home. We have challenges relating to the availability of care packages in our communities. Those challenges are not because of a lack of money, but because of a lack of people. There is low unemployment and there are staff shortages in the care sector.

In partnership with local government, we have just taken the decision to substantially increase pay for low earners in the local government sector, and I know that that issue matters very much to Mr Rowley. That is one of the measures to try to boost the attractiveness of many such occupations so that we can attract more people, expand the number of care packages that we can provide, and provide more care and support to individuals. All of that is interrelated, and some of the work that we are undertaking is designed to improve the attractiveness of those professions so that, as a consequence, we have more people around. That will help to boost morale, with people feeling less tired—exhausted—by the work that they have to do. As a consequence, the system will attract more capacity and will therefore be able to handle more cases more efficiently.

The common theme, though, is that all of that has to be paid for. We are simply trying to use the resources available to us to ensure that the system is well supported financially to enable it to operate efficiently.

A very careful risk judgment must be applied, but it is not the only risk judgment that has got to be applied across a range of different projects within the public services. Given the experience that we have had between 2020 and 2022, nobody would thank us if our level of pandemic preparedness was not adequate for the challenge. Lady Poole is convening a public inquiry into the pandemic, and one of the questions that she will explore is pandemic preparedness. That will involve looking at what Government was doing before Covid struck. A global pandemic was one of the top risks in every annual risk assessment that the Government has ever produced—it was right up there. The question is: to what extent are you prepared for it?

Therefore, my answer to Mr Fraser in the earlier part of the evidence session was designed to say that there are certain things that we will be doing operationally at a routine level that are now stronger than our provision was pre-pandemic. I would say that PPE provision and biosecurity measures are in that category. Some surveillance arrangements will be stronger than they were in the past. If that is all done and we do not have a pandemic, we could be exposed to criticism for spending public money on stuff that was not going to happen. Alternatively, people could say that that is a reasonable assessment of the level of risk that society faces and that the Government is right to prepare on that basis. I would like to see us plan for the type of approach that makes sure that we are prepared, but also that we have the capacity to increase our footprint, should it be necessary.

I am more optimistic about taking forward the work of the Christie commission than Mr Whittle is, because I think that a lot of good stuff has been done over the years. I am not going to sit here and say that everything has been done or that as much has been done as I would like to have been the case, but I think that a lot of proactive, early intervention work has been undertaken. However, we need to do more of it, and the Covid recovery strategy and the focus on specific tangible measures for doing that is the focal point of that activity.

The crucial point—and I have aired this with the committee before—is that we have to remain absolutely focused on the central purpose of that activity, which is to reduce inequality in our society. Inequality was in existence before Covid and got worse during it, and we now have to use Covid recovery to address the situation.

Education maintenance is an entitlement, so, should an individual apply for it, they must get it regardless of the size of the budget. We do our level best to estimate the likely demand for education maintenance allowance. Historically, the budget line has been underspent, and one of our obligations in our approach to the management of public finances is to follow the guidance that budgets should be taut and realistic. In the circumstances that we are in just now, when I am having to take resources from one area of the Government’s budget to allocate to another—to pay public sector pay claims, for example—and I have to find money to do that across different areas of Government, I have to ensure that there is budget clarity for accountable officers to make it clear that they have the necessary finance to spend. Therefore, if I have £3 million in an education maintenance allowance budget line that I do not think I will require, I can take that away and put it somewhere else, such as to address public sector pay claims, and that will allow me to support accountable officers to fulfil their obligations.

Obviously, we have made a judgment that is based on the best evidence that we have available to us. Should the total cost for education maintenance allowances be greater, I will have to address that financial pressure during the course of the financial year. All the budgets are monitored daily, and the information is provided to me to enable me to make judgments about where it is appropriate for us to reallocate expenditure to meet financial pressures.

However, I stress that the education maintenance allowance is an entitlement, so, if demand outstrips the £22 million that will be retained in the budget, I will have to find the resources to accommodate that. Based on previous years’ experience, that is an appropriate judgment to make.

We are, but we are trying to do so in a way that protects the fundamental values that we believe in and the fundamental elements of our programme for government. Emma Roddick will be familiar with the programme for government that was set out at the beginning of September. It develops the thinking that emerged from the Government’s manifesto for the 2021 election, which was based on, essentially, ensuring that we secure a fairer and a greener future for individuals in our society. Those priorities and those values were reinforced by the Bute house agreement with the Scottish Green Party, which flows into the programme for government.

We are setting the direction, which is about ensuring that we create a fairer society, that we make the transition to net zero and that, in doing so, we create new and sustainable employment opportunities in Scotland. Those are the underpinning values, and the decisions that I am taking are designed to protect that programme as much as possible. Clearly, however, the decisions that I have had to take put significant financial strain on the Scottish Government.

Yes, because it is a demand-led budget, so whoever is entitled to it will get it. It is simply about making sure, given the degree of pressure that I am having to deal with within this financial year, that I do not allocate money into budget lines in which it is unlikely to be required when it is required in other budget lines.