Chamber and committees

Person-centred, safe and high-quality care for mothers and babies throughout pregnancy, birth and following birth can have a marked effect on the health and life chances of women and babies, and on the healthy development of children throughout their lives. This can help to mitigate the impact of inequalities and deprivation and their long term health and other consequences for families.

We continue to prioritise improvements to maternity and neonatal care through the implementation of The Best Start programme, in partnership with senior leaders and clinicians. For women who experience multiple disadvantage, as well as those with additional complex needs, we know that continuity of carer from a primary midwife is likely to be particularly important. That is why we have included women and families from lower Scottish Index of Multiple Deprivation (SIMD) quintiles, as well as those from minority ethnic communities, as priority groups for the introduction of continuity of carer.

The Scottish Government has commissioned Healthcare Improvement Scotland (HIS) to lead a national review to understand any contributing factors to the increase in neonatal mortality during 2021-22. This review will assess and determine whether there are any themes, underlying causes or safety factors that have contributed to the increased neonatal mortality rate from both a clinical and system perspective.

The Scottish Government carried out a consultation on the Future of Gaelic and Scots as part of the work to develop the proposed Scottish Languages Bill. As part of the consultation, the Gaelic and Scots Division undertook a variety of public engagement events to ensure views of local communities were reflected. This included attendance at conference run by the authors of the research, The Gaelic Crisis in the Vernacular Community. The responses to the consultation are now being analysed and will help shape any future legislation.

The 2023-24 budget confirms our ongoing commitment to invest in social care and increasing the sustainability of the sector ahead of implementation of the National Care Service.

The 2023-24 Stage 1 budget presented, at level 4, a total investment of £1.2 billion in Social Care support and National Care Service (NCS) delivery. This total represents a social care spending increase of over £800 million compared to 2021-22, demonstrating that we are well ahead of our trajectory to increase spending by 25% (£840 million) over the life of the Parliament.

The £1.1 billion expenditure line supports a number of areas including an additional £100 million for adult social care pay up to £10.90 per hour, £344 million of existing funding to support pay, £124 million for care at home investment, £60 million for the Carers Act and funding to support inflationary uplifts for Free Personal Nursing Care Rates. We note the Report on the Financial Memorandum published on 1 December by the Finance and Public Administration Committee and are currently revising the NCS Financial Memorandum. This will provide more detail on expected spend in 2023-24 and beyond.

The impact of material switching is outlined in Section 7 of the Final Business and Regulatory Impact Assessment (BRIA) which was published on 22 December 2021. You can access the document here: https://www.gov.scot/publications/deposit-return-scheme-scotland-final-business-regulatory-impact-assessment/ .

The next evaluation is planned for the end of the current funding cycle (to March 31 2026) and will include all funding that has been allocated from within the Climate Justice Fund. The evaluation will cover whether or not the funding has achieved it’s strategic objectives, and whether the Fund as a whole is continuing to demonstrate best practice in delivering climate justice against the three pillars of justice that were adopted following the previous evaluation.

An Accelerated National Innovation Pathway has been established to standardise and facilitate the adoption of health and care innovations. The Scottish Health Technology Group also supports standardisation by providing robust governance and advice. Digital technologies are required to meet clinical safety standards such as Software as a Medical Device (SaMD) and compliance with MHRA regulations.

Scotland’s first Data Strategy for health and social care will articulate further national principles and deliverables around the ethical use of data. The strategy is due for publication this year

Despite the UK Government stepping back from COVID funding from 2022-23, there remain COVID related pressures and costs across the system. The 2022-23 health budget provides for test and protect, PPE and the ongoing vaccination programme, including costs relating to delivery of Covid-19 vaccinations and the extended seasonal flu vaccination as well as staff, venues and storage. The £147.471 million represents the net of these costs once partially offset by income related to dental and miscellaneous services which is also included in this budget line.

Throughout the 1140 hours expansion the Scottish Government has sought to improve conditions across the private, third and childminding workforce delivering funded Early Learning and Childcare (ELC). This includes our investment to support local authorities to set sustainable rates at a level that enables payment of the real Living Wage to those workers delivering funded ELC. Payment of the real Living Wage is a key measure in tackling in work poverty, and Scotland is the only part of the UK to apply this to the ELC sector.

Overview of Local Authority Funding and Support for Early Learning and Childcare Providers: 2022-23 , highlights that average rates paid to providers in the private and third sector to deliver funded ELC to 3-5 year olds have increased by 57% between 2017 and 2022, from £3.68 per hour in 2017-18 to £5.77 per hour in 2022-23.

The investment for the payment of sustainable rates has supported real progress in pay. For example, in 2016, before the ELC expansion to 1140 hours, the Financial Review of Early Learning and Childcare in Scotland estimated that approximately 80% of practitioners delivering funded ELC in private and third sector providers were paid less than the real Living Wage.

The Financial Sustainability Health Check , published in August 2021, reported that 88% of private and third sector providers delivering funded ELC intended to pay the real Living Wage to all of their staff from August 2021.

However, public funding and Scottish Government policy can only effect a certain amount of change in pay. The childcare market is a mixed economy - the August 2021 Financial Sustainability Health Check reported that funding for the delivery of funded ELC accounted for, on average, around 33%-45% of overall income for private childcare services – and employers in the private and third sectors are responsible for making their own decisions about pay and conditions.

We are working with partners and sector representatives, including through our Real Living Wage and Fair Work Implementation Group, to understand any barriers to paying the real Living Wage and to ensuring all childcare staff perform their essential work under terms and conditions which meet Fair Work criteria.

All health and care systems are tested during development, implementation and rollout, and this is a critical part of the process for all technologies in use. All health boards have test environments or suitable processes in place to do this which is supported by national test infrastructure, environments and resources from NHS NES and NHS NSS. If I can refer the member to response in S6W-14170 on 7 February 2023. It is not possible to give an exact figure on how many new health and care technologies have been tested due to the wide range of activity and the multiple organisations involved in testing since 2007.

All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers

The Climate Justice Fund aims to support communities facing the impacts of climate change under a justice-based approach. The decision to allocate £2m of it to address loss and damage was based on the scale of the need, the lack of funding from others, and the influence the additional funding would have on other governments and organisations to commit funding to address loss and damage.

The £2 million for loss and damage aims to increase ambition and accelerate global action and to influence the global agenda on the issues of loss and damage and climate justice. It has funded the programs outline in the response to question
‎ S6W-13351 on 10 January 2023 .

An additional £5 million on loss and damage was subsequently allocated on the basis that the initial £2m was effectively supporting communities (based on feedback from global stakeholders and evidence from ongoing quarterly monitoring of the programmes) and that a specific allocation on non-economic loss and damage would both support vulnerable communities and bring focus to an area that was under-researched and under-funded. The need for more to be done to both understand and address non-economic losses and damages, in particular as experience by women, was one of the key insights from the Scottish Government hosted October 2022 loss and damage conference as well as from ongoing consultations with our partners.

The £7 million on loss and damage does not meet the scale of the global need. But it does allow the funding of pilot projects that support communities and the building of an evidence base of what works that will strengthen both Scottish Government’s and global partners’ future work. It has also played a role in unlocking funding commitments from other governments and organisations. While Scotland was the first country to commit funding to loss and damage, the global commitments to fund loss and damage have grown to over $300m.

All answers to written Parliamentary Questions are available on the Parliament's website, the search facility for which can be found at https://www.parliament.scot/chamber-and-committees/written-questions-and-answers