Chamber and committees

The Scottish Government is committed to improving life expectancy and tackling health inequalities across Scotland. The recently published Population Health Framework, a joint publication by the Scottish Government and COSLA, highlights that the circumstances and environments in which people are born, grow up, live, work and age – known as the building blocks of health – are the most influential factors shaping health outcomes.

The Framework’s supporting evidence paper notes that Scotland has experienced a decline in healthy life expectancy – the number of years people can expect to live in good health – alongside a stalling of improvements in mortality rates after decades of steady progress. These trends are associated with several major factors: the UK Government’s austerity policies during the 2010s, Brexit, the COVID-19 pandemic, and the ongoing cost-of-living crisis. Together, these influences have weakened the building blocks of health, widened existing inequalities, and exacerbated Scotland’s longstanding disparities in income, wealth, and power.

In response, the Population Health Framework sets out a whole-system cross-government and cross-sector approach centred on prevention. This approach builds on existing Scottish Government actions, including initiatives on diet and healthy weight, and efforts to tackle child poverty. Through this approach, the Scottish Government aims to raise overall life expectancy while closing the gap between the most deprived 20% of communities and the national average by 2035.

Our position is unchanged on waiting times – by March 2026 no one will wait more than 12 months for a new outpatient appointment or inpatient/daycase treatment.

We are investing more than £110 million this year to cut waits, and we expect to see the full impact of our targeted funding in the coming months. This targeted funding is expected to deliver more than 213,000 additional procedures and appointments this year.

Our plan is clearly working with a record number of hip and knee operations last year and the highest level of operations performed in July since February 2020.

Whilst Scottish Government sets the strategic policy direction for the NHS in Scotland, operational matters including staffing are the responsibility NHS Boards. NHS Boards take account of national, regional, and local priorities, and we expect NHS boards to plan and provide safe, effective, and high-quality care, in line with their statutory service provision and workforce planning responsibilities.

To help address recognised workforce pressures, Scottish Government continues to invest heavily in radiology training. Scottish Government is currently funding around 190 specialty training places in clinical radiology, including 78 extra places which have been added since 2014. This enables doctors to train and enter the workforce following completion of training - which takes a minimum of 5 years. Clinical radiology specialty training programmes have been filled at 100% in Scotland from 2014 to 2024, with 230 resident doctors successfully completing training in this period.

To further support a coordinated response to pressures in cancer services, Scottish Government commissioned the National Oncology Coordination Group. This group considers real-time assessments and develops proactive risk mitigation proposals aligned with the strategic aims for cancer. This collaborative approach across NHS Boards in Scotland is ensuring that services can deliver for people with cancer.

The Scottish Government has a strong track record in the investment in and delivery of affordable homes. Since 2007 we have supported the delivery of more than 139,000 affordable homes, with 99,000 of these being made available for social rent. This has resulted in the delivery of affordable homes in Scotland being 47% more per head of population than in England, and 73% more than in Wales. However, prevailing economic conditions across the United Kingdom in recent years, driven by EU-exit, Covid-19 and wider global pressures, has made delivery in recent years more challenging. For example, construction inflation reached 24% in the summer of 2022.

Despite these headwinds we remain absolutely committed to our longstanding affordable home ambitions. We are investing £808 million in 2025-26 alone, and remain focused on delivering at least 70% of homes for social rent towards our 110,000 affordable homes target. This investment includes a doubling of our acquisition fund from £40 million to £80 million in 2025-26 helping to deliver homes more quickly, the majority of which will be for social rent. Of the 28,537 affordable homes delivered to end March 2025 against our target, 77% are for social rent.

We have announced plans to invest up to £4.9 billion over the next four years in a multi-annual, multi-billion pound affordable housebuilding project and continue to work with partners to maximise delivery in Scotland.

We recognise the challenges facing Scotland’s health and social care system. That is why we have already taken significant steps to set out clear, short and longer term actions to improve access to treatment, shift the balance of care, harness digital innovation, and strengthen prevention.

We recently published the, Foreword - NHS Scotland operational improvement plan - gov.scot the Scotland's Population Health Framework - gov.scot and the Health and Social Care Service Renewal Framework - gov.scot in which we outline our shared vision for reforming and renewing health and social care services to ensure they are more sustainable, preventative, and equitable.

We remain committed to engaging with leaders across health and social care, including clinical leaders, to design and deliver the change needed in our NHS.

With regard to charging for services, the Scottish Government’s policy could not be clearer: our National Health Service must be maintained on its founding principles – publicly owned, publicly operated, and free at the point of need. As we have previously said, the provision of health services must always be based on the individual needs of a patient.

The Penrose Inquiry’s report, published on 25 March 2015, contained a single recommendation, which was that the Scottish Government take all reasonable steps to offer a hepatitis C virus (HCV) test to everyone in Scotland who had a blood transfusion before September 1991 and who has not been tested for HCV. The Scottish Government accepted this recommendation and in response a Short-Life Working Group (SLWG), involving key stakeholders such as the Scottish National Blood Transfusion Service, was established by Health Protection Scotland. The SLWG progress report was published on 2 September 2016, setting out the range of work undertaken by the SLWG.

The Scottish Government accepted the recommendation of the SLWG that there should be an awareness raising campaign to encourage people who had (or are likely to have had) a blood transfusion prior to 1991, and who have not already been tested for hepatitis C, to come forward for testing. A targeted awareness raising campaign to encourage such individuals to be tested was launched in October 2016 and an evaluation of the campaign, as recommended by the SLWG, was completed by Health Protection Scotland in 2018. The SLWG also recommended that a Chief Medical Officer letter should be sent to all clinicians in Scotland to remind them of certain risk factors and clinical indicators for HCV infection and making them aware of the recent advances in therapy and thus the benefits of HCV testing. The Chief Medical Officer accordingly wrote to all clinicians in Scotland on 20 September 2016, following up a previous letter issued just after the publication of the Penrose report on 27 March 2015. The Penrose Inquiry’s recommendation has therefore been fully implemented.

Scottish Government committed to a Four Day Working Week pilot in the public sector to explore the wellbeing and productivity benefits that a shorter working week could bring. No additional funding was allocated to either Accountancy in Bankruptcy or South of Scotland Enterprise to deliver the pilot in their organisations.

The pilot was delivered in partnership with The Autonomy Institute who published their evaluation report on 27 August. The report can be accessed here - Four day working week pilot - Public sector pay - gov.scot.

The National Child Sexual Abuse and Exploitation (CSAE) Strategic Group held an extraordinary meeting on 15 July to consider the Casey Audit. The minutes of the Group’s meetings are published on the Scottish Government website: https://www.gov.scot/groups/national-child-sexual-abuse-and-exploitation-strategic-group/.

It was noted that Police Scotland is undertaking a number of activities in relation to the Casey Audit including an initial assessment of the current child sexual abuse investigative landscape across Scotland, an analytical review looking at previous group based offending investigations and are carrying out a mapping of CSAE policy, process, practice and investigations. An update on this work will be provided at the Group’s next meeting in October at which there will be further discussion of the Audit findings, alongside other key inquiries and practice reviews including the Independent Inquiry into Child Abuse (IICSA) to inform next steps in its ambition to enhance our shared response to child sexual abuse and exploitation in Scotland.

Scotland’s National Child Protection Data Group also discussed the Audit’s data findings and recommendations in July and officials are taking forward work to explore opportunities to improve data and intelligence on this issue.

Scottish Government officials continue to engage with the UK Government’s response to the Casey Audit to understand implications for Scotland and opportunities to work together and share learning.

How the recommendations are taken forward will be determined following consultation with stakeholders, including NHS Boards and OSCR. Consultation will ensure no unintended consequences as well as appropriate consideration of capacity, as significant work will be involved for both for the Scottish Government and for Health Boards. The timing of that consultation has yet to be determined.

In the meantime, funds remain available to be directed in accordance with the charities’ purpose, and taking account any restricted funds.

It is also important to note that neither OSCR's inquiry nor the Independent Review indicated that there are widespread issues in the decisions being made about the use of NHS Endowments’ charitable funds.

The Scottish Government does not hold this data.