Chamber and committees

The issue comes back to our general ethos as a health committee, which is that we think that every portfolio should have a health aspect to it, because quite a number of the drivers of health inequalities do not fall within the health portfolio. An example of that is transport. Quite a lot of the people to whom we spoke on Friday and Monday talked about the cost of transport and the cost of food, which they said were having an impact on their health and their ability to access services.

David, would you like to come in on Gillian Mackay’s question?

Since no health committee meeting would be the same without this line of questioning, we move to questions from Paul O’Kane on the impact of Covid-19.

In informal sessions, we certainly heard very strongly: “Don’t just consult us—involve us in the decision making”. Your point about almost road testing things with focus groups of people that the decisions will affect is absolutely important.

I will pick up on a few things with David Walsh before I open the discussion up to my colleagues.

David Walsh talked about mitigation measures and the issues that are faced when things outwith your control—in particular, austerity measures—have an impact. Obviously, austerity measures were put in place by those who thought they were a good idea, or to save money. However, what is the long-term cost of austerity measures when we look at what you said about the impact on people’s health? Where does the Scottish Government sit in relation to mitigation with a fixed budget?

That rounds off our session. I thank the four of you for the time that you have spent with us. It has been very interesting and a very good start to what we hope will be an important and interesting inquiry, at the end of which—we should always remember this—we will make some recommendations.

At our next meeting, which will be on 31 May, we will continue to take evidence as part of our health inequalities inquiry. We will focus on the impact of the pandemic on health inequalities and the work to tackle those.

That concludes the public part of our meeting.

I said that I would leave human rights to the very end, because it has run through a lot of what we have been talking about. The human right to live your life well is fundamental.

It is difficult to talk about conversations from our informal evidence sessions when three out of four of the witnesses who are here today were not party to those, so I will not use specifics. However, I was struck by people we spoke to who are seeking asylum and people who are advocating for family members and friends who are in prison, and we also heard about Gypsy Travellers and people with no recourse to public funds. The thread going through a lot of our conversations was that people do not feel that they are getting access to their basic human rights.

What would a human rights approach to tackling the structural inequalities look like? What specific interventions could be made to make human rights the thread that runs through the delivery of absolutely all our services, regardless of whether people have recourse to public funds and whoever they are in society in Scotland? What would that look like? It is a huge question, so you can see why I left it till the end.

I was particularly struck by what people told me about our prison population not getting access to healthcare, including medication, even if they have clinical health conditions when they go into or come out of prison. That will stay with me for a long time—frankly, it blew my mind. Other people from marginalised communities also feel that they do not have access to healthcare. Could there be interventions to ensure that they get that access?

Item 2 is the first formal evidence session of our inquiry into health inequalities. This session will focus on progress in addressing and tackling health inequalities in Scotland since 2015, when our predecessor committee published a report on that topic.

I thank everyone who took part in our informal evidence sessions last Friday and yesterday. The evidence that we heard at those sessions will feed into a formal evidence session, which will take place on 14 June, but do not be surprised if it comes up throughout all our evidence sessions, because it was very powerful testimony from people with lived experience. I thank Claire Stevens for organising the attendance of a lot of the people whom we spoke to, because their voices really need to be heard. Regardless of the formal session on 14 June, I imagine that people will make reference—albeit with names redacted—to some of the things that we heard, particularly from the people who feel that they lack access to healthcare.

I welcome to the committee David Finch, who is assistant director of the healthy lives directorate of the Health Foundation. David is attending online; I believe that he has had a little difficulty with the connection, so I hope that that connection is being made as I speak.

I also welcome Gerry McCartney, who is professor of wellbeing economy at the University of Glasgow, and is attending in person; Claire Stevens, who is the chief executive of Voluntary Health Scotland, who helped us to organise our informal sessions and is attending in person; and David Walsh, who is public health programme manager at the Glasgow Centre for Population Health, and joins us online.

I was going to ask all the witnesses about the progress that has been made since 2015 and I do want that to be in the back of your minds. I know that you all have an opening statement to make, but I will say up front that health inequalities is a massive subject and it would be remiss of the committee if all we did was talk about the problems. I want our inquiry to look at how and where we can find solutions, actions and recommendations in areas of devolved competence.

With that in mind, I will start with the opening statements. David Finch is not online yet, so we will go first to Gerry McCartney.

Claire, would you like to comment?

David Finch would like to come in.

Does anyone else want to come in on that issue?

Given the point about deindustrialisation, I imagine that parts of England and Wales have been similarly affected, but that may not show up in national data in the same way as it does in Scotland.