Chamber and committees

Given that we are not having a three-day conference, convener, I will leave the point there, but I hope to be able to come back in later.

Good morning, gentlemen. I will continue with questions on preventative spend. I have a particular interest in the impact of physical activity on health, including mental health. However, we also heard from the previous panel about the impacts on mental health of housing, transport and poverty, so we have a multiportfolio issue here. I whole-heartedly agree with your priority on preventative spend, but how do you justify that spend by measuring outcomes? As you know, we are all going to ask that question. How do you follow the money?

Unsurprisingly, I will continue the conversation on preventative spend and how we deal with that issue. In Scotland, we have a comparatively high level of economically inactive people, and a high proportion of that is health related. I have quoted extensively the—now dated—Mental Health Foundation’s “Food for thought: Mental health and nutrition briefing”, which looks at the impact of food on mental health, and SAMH’s connection with physical activity. We recognise—I am quite sure that everybody here recognises—that, if we could tackle the issue of economically inactive people by preventing that from happening in the first place, that would mean more money coming into the system. However, that money would not come to the health budget.

On preventative spend, I believe 100 per cent that what we eat and how we move about has a huge impact on our mental health. How does that weave its way into the budget in a way that is effective and that we can measure? That is an easy question to start with.

Of course.

Thank you, convener. I will also try to be commendably concise.

I begin by commending the petitioners and everyone else who has contributed as the petition has progressed. I am a South Scotland MSP, and, like Mr Burnett, my mailbag and surgeries are full of people who are concerned about the level of development that is happening in their communities. Ultimately, the petition is about how we balance the national imperative to reduce our vulnerability to volatile and finite fossil fuel resources against ensuring that communities who will have to live in the shadow of that infrastructure are not overwhelmed by it.

It is clear to me that we do not have that balance right. As the petitioners have highlighted in their submissions, all too often communities feel that they are fighting an uphill battle to be heard during the planning process. The complex and bureaucratic planning process for such infrastructure is not something that any group of individuals can take on easily. The costs are high, both in time and money, and the return on all that investment can end up being little more than an automated acknowledgement of receipt email from a Government department.

Some developers go above and beyond to engage with communities and alter their plans to try to accommodate local concerns, but that is often the exception rather than the rule. In many cases, people challenge development not because of a blanket opposition to it, but because they want to understand how it will affect them and to be confident that their concerns are understood. The current approach to planning is simply not equipped to offer any of that certainty, and there is no question in my mind about the fact that the planning process could and should be improved. The best day to improve it, of course, was yesterday.

I gently urge the committee to consider holding a debate in the chamber on the petition, which would allow members of all parties who are dealing with these issues to stand up for their constituents.

We are asking what the bottom line is. It is very easy for us to talk about shifting from spending on acute care to spending on preventative measures, which I am a big advocate of, right up until there is an acute problem right in front of us. You gave the analogy of the spend on 60 very ill babies as opposed the spend on thousands of babies. The bottom line is this: how does PBMA help us shift incrementally towards preventative spend? The trajectory of the acute spend in front of you inevitably leads to less preventative spend, and so to more people needing acute care. It is an ever-decreasing circle. How do we utilise what we are talking about to try to reshape the way in which we think?

Good morning. You have opened a door here. One of the things I want to delve into, having looked at some of the responses to the call for views, is the desirability of moving away from acute spend and towards preventative spend. I was struck by a quote from Dr Will Ball, who said:

“There is a strong case for rebalancing spending towards earlier, preventative, and community-based support to reduce reliance on acute services and improve outcomes.”

I have bored members lots of times with this before, but that reminds me of the Mental Health Foundation’s publication, “Food for thought: Mental health and nutrition briefing” and how improving diet can improve mental health, and Scottish Action for Mental Health’s quite hard push for the idea that being physically active improves mental health. It is very difficult to measure those things, but there is a certain level of intuition that says, “That has to be right.” This really is at the margins, but how do we bring that thinking into the PBMA framework? We have to measure such things, because everything has to be measured these days, apparently, so how do we bring in that intuition? Intuitively, what Paul Sweeney was saying about housing and so on sounded correct. How do we bring that into the PBMA framework?

I have a long-standing interest in the topic and I have been listening to what has been said about public procurement. I have been talking for years about the fact that there are big hospitals in Glasgow and Edinburgh that do not have kitchens and do not have the ability to cook any food that is procured locally. We currently drive packaged food up the M6 from Wales, and most of it ends up being thrown out.

When we speak in glowing terms about the wide-ranging good food nation plan from the Scottish Government, we do so in that environment. How do we square the circle if a hospital has no ability to cook food? We are buying it from Wales already packaged, bringing it up here, reheating it and then throwing it out. Can anyone explain how we square that circle?

The education environment is a key battleground in this area. We are trying to tackle poor physical and mental health and behaviour, as well as hunger and malnutrition. However, it is not beyond the ability of man and woman to come up with a solution to those.

I am interested to hear your opinion on how the plan could and should address those issues. If kids are coming to school hungry, should we not be considering breakfast provision? Should we not be looking at how we drive pupils’ behaviour when it comes to eating breakfast? I would link an activity to that—the driver could be to get pupils to come to school to partake in an activity and then to point out to them that breakfast has been provided. That approach would take away the stigma that is associated with a free school meal.

We are talking about food, but I find it difficult to separate that from the need to be physically active, given that a lot of health indicators in later life will be around muscle mass and VO₂ max and the like. Basically, I am asking whether the good food nation plan is taking maximum advantage of opportunities in the education environment.