Chamber and committees

The next item on our agenda is to take evidence on the Scottish Fiscal Commission’s “Fiscal Sustainability Report”, which was published on 8 April 2025, and which has a particular focus on health.

I welcome to the meeting, from the Scottish Fiscal Commission, Professor Graeme Roy, chair; Professor Francis Breedon, commissioner; Dr Caroline Carney, senior analyst; and Claire Murdoch, head of fiscal sustainability and public funding.

Before we move to questions, I invite Professor Roy to make a brief opening statement.

The SFC witnesses are sitting right behind you, so I am glad that you are saying that.

In your evidence earlier, you raised the issue of technology. You talked about reform and how technology can help to reduce costs for the Scottish Government. On page 55 of the Scottish Fiscal Commission’s sustainability document, on health, the SFC assumes that healthcare costs will increase by 1 per cent every year for the next half century, and it talks about the Baumol effect, due to healthcare being labour intensive, and long-term conditions. It also says that 0.13 percentage points of that cumulative increase in annual spend over 50 years—which is clearly a lot—

“captures the effect of technological advancements on healthcare costs.”

The SFC also says:

“Developments in medical devices, techniques, and procedures tend to push up costs, or where costs are reduced, can result in the expansion of treatments.”

Therefore, is it the case that technology does not always deliver the savings that one might look for?

Next week.

You have said that

“the planned Fiscal Sustainability Delivery Plan should be fully transparent about the scale of the risks to the affordability of public services and options for how the Scottish Government can manage them.”

What concerns do you have that the plan will not be transparent?

The Scottish Government has given a commitment to hold an annual fiscal sustainability debate, and I am sure that your report will make a significant contribution to our deliberations. Thank you for your evidence. You certainly came mob-handed.

I will wind up the session with a wee advert for tomorrow morning’s event on the report, which has been organised by the Scottish Parliament information centre. It will start at half past 8 in the Holyrood room. Everyone is welcome. Apparently, it will be chaired by a young, dynamic and outrageously handsome MSP, so it will be worth attending for that alone. Bacon rolls will also be provided, which I know is always a big draw. I realise that some members of the committee—Liz Smith is one—will not be able to come along, as they have other committee meetings tomorrow, but I hope that those of you who can, will do so. There will be an opportunity to ask further questions about what is a really important report.

We will have a two-minute break to allow broadcasting and official report staff to leave.

Thank you for that statement. I do not have any questions, so I will open up the discussion to members of the committee. At the moment, the only member who wants to ask a question is Ross Greer.

Ross Greer makes a good point. For example, 37 per cent of universal credit recipients are in work, which is perhaps not talked about as much as it should be.

Earlier, Professor Breedon and Professor Roy talked about the importance of debt and whether the 98 per cent of GDP level could go up to 150 per cent. We can think about the impact on debt interest, because the UK already pays six times more in debt interest than it spends on the NHS in Scotland in a year. Obviously, if debt goes up, interest payments go up, and it is likely that the level of interest will go up because our rating will decline. That is quite an important point.

I have a final question. Michelle Thomson touched on climate change, but your report states:

“This report does not integrate the effects of climate change or the Scottish Government’s climate change response into our projections because the data is currently unavailable.

Climate change has been deemed the most important health threat of the century.”

It goes on to talk about the impact on society and individuals of

“wetter winters, hotter, drier summers ... temperature extremes ... and frequent flooding”

and about the effects on health and wellbeing.

What discussions have you had with the Scottish Government and, perhaps through the OBR, with the UK Government to try to secure that data? In the presentation that you gave last year, you said that it would cost £186 billion, at last year’s prices, in combined funding from the public and private sectors, to deal with the climate crisis. That figure has stuck in my mind. Where are you with all of that?

When I was watching the news this morning, I found out that I have a mental illness. It was said that hoarding is apparently some kind of mental illness. I have a huge library because I have been collecting books since I was at school, so does that mean that I am a hoarder? One wonders how realistic these definitions are. The definitions might be impactful for individuals, but we have to consider the wider societal impact of how we define some of these things.

Thanks very much.