Chamber and committees

We agree on the outcomes that we want. Outcomes are important, but we currently have a poor report card for health compared to many countries in Europe. I was really exercised about this topic before Covid.

I agree that a lot of positive health outcomes will be tackled outwith the health service. Correct me if I am wrong—I am sure that you will—but I think that 44 per cent of our budget is now spent on health and there has been a reduction of 27 per cent in the local government budget. However, many of the interventions that are required to deal with the impacts of Covid will be dealt with by local government. How do you square that circle, cabinet secretary?

In relation to planning for the next pandemic, are you saying that we are being reactive and that Governments are looking at what is in front of them right now, rather than at what is coming down the line, so the whole preventative agenda has been parked? Do we need to try to lift our heads and look further down the track?

My last question on that subject is about the collection of data. Are we collecting the right data to be able to detail the impact of Covid not only on the population but on non-Covid-related conditions? Are we able to disaggregate the data to be able to plan ahead?

I said that the percentages of the budget had moved.

Good morning. I thank the witnesses for their evidence. I will follow on from my colleague’s line of questioning. We understand the front-line cost of dealing with Covid—we know what the investment in that was—but I am interested in the spending required for the fallout from Covid.

We know that the cost of Covid was higher because of our poor health report card. A lot of people who suffered from Covid and tragically lost their lives were dealing with other issues, such as obesity, type 2 diabetes and heart conditions. However, in dealing with Covid, we had to drop our focus on such conditions. Should OECD countries prioritise conditions such as long Covid and non-Covid-related diseases and other issues that were affected by Covid restrictions, such as cancers, elective surgery, mental health issues, obesity and physical fitness? Will we need to reinvest in addressing those conditions as we deal with the fallout from Covid?

Good morning, minister—it is nice to see you, and thanks for coming in. It is always good when one of our colleagues tells the minister what we are going to ask. [Interruption.] The good news is that I am not going to ask about data now—although my beliefs on data, especially healthcare data, are well known: we are very good at collecting data but not particularly good at deploying it, especially across sectors. We need to get better at that and we could get better at that.

I want to follow up the extremely important issue that Murdo Fraser raised, which we could probably spend the whole time talking about. During Covid, access to healthcare was restricted, which had a significant impact on elective surgery for chronic pain and on access to mental health services. It is reasonable to extrapolate from that that the economic inactivity rate would move in an upward direction. At a certain level, if a person’s pain is not treated, it becomes chronic pain, so more people must have moved in that direction.

I am always interested in the cross-portfolio impact of decisions. I go back to the reprioritisation of £65 million in primary care funding and £38 million in mental health funding. The minister said that, for every £1 that is spent, you get £5 back. Surely that indicates a false economy—taking money from one side of the ledger affects the other side of the ledger. Given the return on such investment, would it be prudent for the Government to revisit the position?

It is interesting that the minister mentioned that mental health issues cost our businesses £2 billion; I have read that the cost is more like £4 billion-plus to the economy. How do we strike a balance?

I will use the fact that the minister brought up data. We collect good data; if we do not deploy it in a way that gives you the answers that you need, we need to invest more in it—we could get into that big time. Should we focus first on how we deploy the data to give us better and more accurate responses?

We could discuss that issue all day, minister, but I had better finish off my questions. We know that Scotland is the unhealthiest nation in Europe, so I am slightly concerned that you think that things will get worse. We know that economic inactivity follows ill health, and there is no doubt that Covid has significantly exacerbated that. Surely, if we focus on health—and education, for that matter—we will positively impact the employment and activity rates in Scotland. That is why I said that it is time that we look to undertake more cross-portfolio working rather than working in silos, which is what are doing just now.

One thing that I want to touch on, which is one of the most important things that we have spoken about today, is the impact that employers can have on the health and wellbeing of staff.

Given that we have a real problem with mental health, would it not be prudent for the Government to start pushing an initiative that encourages occupational health and the promotion of health and wellbeing within businesses? It could take a significant burden off statutory services if we could get employers to recognise that correlation between the £5 they get back and the £1 that is spent on mental health. Could the Government focus and bear down on that?

I know that it is unusual to be brought back in. On Mr Ewing’s point, I have highlighted the lack of record keeping across all local authorities, which seems to hamper things. The key here is that you only have to have probability; you do not have to have proof. I also underline the phrase “in loco parentis”—it is key to your deliberations. Thank you for allowing me back in.