Chamber and committees

On that point, you have said that this is the direction of travel that you would like to go in, and the Cabinet Secretary for Health and Social Care has said exactly the same, but the truth of the matter is that we are an unhealthy nation. In the health secretary’s own words, we are getting sicker, and that is compounding the problems at A and E. What action is the Government going to take to tackle that sort of health inequality? After all, we have talked about this issue a lot, and the Christie commission report has been around for a long time, too.

Good morning, cabinet secretary. I am sure that we will continue to learn about the impacts of Covid, and we already know that its effects are disproportionate on the older population and those who have conditions such as obesity and diabetes, as well as those who live in poverty. We have on-going learning in relation to that.

I have had this conversation with you and with the Cabinet Secretary for Health and Social Care before. It is about the potential, out of the back of Covid and the learnings from Covid, to look at the way that we deliver services and how we tackle health inequalities. That is a good target to have on many levels, not least for those experiencing inequalities, but there is also a positive cost to tackling health inequalities. I wonder whether the Government is considering exactly that? We have had positive conversations about that. What is the Government doing on the back of Covid to look at the way in which we deliver health and other services in order to tackle health inequalities?

Finally, I want to ask about another of my pet likes: the application and deployment of technology, and the ways in which technology helped us with tackling Covid. Where are we with that? I am on record as saying that we are way behind the curve in our ability to deploy healthcare tech, but is the Government considering the deployment of technology as part of pandemic preparedness?

It came from Belfast harbour. As part of my investigation into the issue, I travelled to Belfast to meet businesses across there and meet Belfast harbour. I looked at how the south-west infrastructure is impacting on Belfast and the goods over there. At that time, Belfast harbour said that the figure was 6 per cent. I cannot accurately tell the committee where it is now, but that percentage will certainly not be declining. I would think that it would be increasing.

I am grateful for the opportunity to speak again on these long-running petitions, which were was lodged while I was on the Public Petitions Committee during the previous session of Parliament. The saga has been running for longer than that—it goes all the way back to 2010 and before. In 2010, when the then First Minister Alex Salmond opened the Cairnryan ports, he committed to improving the connectivity of the A77 and A75.

There is a huge volume of traffic, especially big 44-tonne lorries, because 44 per cent of all goods going in and out of Northern Ireland go through that port. A lot of those goods are just-in-time products, such as food. The port is hugely important to the prosperity of south-west of Scotland and the whole of Scotland. The A77 connects Cairnryan to the central belt and the A75 connects Scotland to the south and allows goods from Ireland to move on to the south.

That route is under threat because there is another route, between Dublin and Holyhead, where there has been an investment in connectivity. Vehicles coming off at Holyhead go straight on to a dual carriageway, and it is now possible to go by motorway from Belfast down to Dublin. The actual time that it takes for goods to travel between Dublin and Holyhead and between Belfast and Cairnryan is becoming closer. There is evidence that about 6 or 7 per cent of goods are now moving to the Dublin to Holyhead route. The Cairnryan route is therefore under threat.

I have, in fact, undertaken the route from Glasgow to Cairnryan in a 44-tonne lorry. I would advise that you do that sometime, convener. It is very interesting when you are going through places such as Girvan and very narrow streets, and you can see out of the cab people having their dinner about three yards away from you. Anybody who has travelled that route knows that it is a dangerous route. It is a route where, if something happens on the A77—which happens frequently—the diversion takes you on to a B road, which is extremely dangerous for 44-tonne lorries.

It is an on-going saga. It is taking too long. We need investment in the south-west. Only 0.04 per cent of the transport budget in the past decade has been spent in the south-west. I used to say that it was the forgotten part of Scotland; now, the feeling is that it is the ignored part of Scotland. We need this to move along much more quickly than is the case.

That is correct.

Rob Gowans, it is fair to say that, during Covid, the third sector was put under extreme pressure in its work on things such as addiction services and other essential services that augment council and NHS services. Where are we now on recovery? Is the third sector being funded properly?

Mairi Spowage, you said that one of the solutions lies in ensuring that there are positive destinations for our children. You also talked about the green economy and green economy jobs. That plays directly into the first two questions, which were about joining up portfolios under the banner of the wellbeing economy. Does the current review of the budget lend itself to helping to increase those green economy jobs in Scotland?

Good morning. Having listened to the conversations that have taken place this morning, I am trying to find a way to frame what I want to say. I know that “build back better” is a buzz phrase, but I think that, post-Covid, we should do that by taking the opportunity to create a wellbeing economy; we should always strive to have a wellbeing economy.

However, the perpetual issue, which has been exacerbated by Covid and the cost of living crisis—or “cost crisis”, as it has been described today—is that the health and social care budget accounts for 44 per cent of the Scottish Government’s total budget; we have the unhealthiest nation in Europe. Yesterday in the chamber, I had a conversation with the Cabinet Secretary for Health and Social Care about the fact that people who are turning up at services are sicker than they were before the pandemic. That problem will be exacerbated, so there will be much more of a pull on resources for NHS services. That money has to come from somewhere.

Sarah Watters highlighted the fact that there is increasing pressure on council and third sector budgets, and that—perversely—putting more pressure on those budgets puts more pressure on the health of the nation. The Government has brought forward the spending review. Does that give us the ability to tackle the perpetual problem that we face in the here and now, rather than in the long term?

That is an easy question to answer. I will go to Sarah Watters first.

I go back to what the convener started with: the pressures on the NHS workforce. We were given statistics on vacancy rates, but those are averages across the country. One benefit of being a list MSP is that I work across a number of NHS boards, and it is obvious that the statistics vary greatly across boards. In South Lanarkshire, it is extremely difficult to get an appointment with or even to speak to a GP, yet, in South Ayrshire, it is easier to do that; however, the neonatal units in South Ayrshire are under extraordinary pressure, whereas those elsewhere are perhaps not.

Linking to that, I was looking at numbers of excess deaths over the period of the pandemic. Deaths due to cancer, dementia, circulatory issues and respiratory issues were significantly fewer than expected during the Covid period. We can read into that what we will. Obviously, we need to understand that, in measuring Covid, it was important to be consistent, so that we could identify trends.

Looking at the budget, which is coming increasingly under strain, how do we take all those factors into account in the management of an NHS that will change? Perhaps Mary Morgan would start with that easy question.