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It is absolutely central, because we cannot have a sustainable and improving health service without a sustained and improving workforce. I am very proud of our incredible workforce. In the past 14 weeks, I have been able to see some of it in action. As health secretary, and previously as a user of the health service, I have seen the fantastic work that our workforce delivers.

On interaction with the workforce around reform, I am keen to hear directly from the workforce, its representatives and the trade unions on setting out how we move forward in a sustainable way and how we make sure that we continue to see improvements. I am keen to hear from the workforce about its ideas for changing how the health service works to make it more responsive to the needs of the people of Scotland and to make sure that it continues to be sustainable.

Having discussed the issue with people over the past few months, I know that that must be about making sure that we prevent ill health. The public health work that we are doing is of critical importance in making sure that we have a healthier population, in stopping the continued escalation in demand that we have on our health service and in making the shift on the flexibility of our employment patterns. We have seen some of that in the implementation of changes under agenda for change over recent weeks. That is where we will need to go, but that has to be informed by discussions with the workforce, which I am committed to having as part of the reform discussions.

The orders do not cover that area, but we are looking to introduce legislation that would cover it, because I share Dr Gulhane’s concern about it.

The orders will widen the scope of regulations that are already in place, but we are looking to expand what is covered through legislation, as my colleague, Jenni Minto, has already outlined to Parliament.

The Scottish cosmetic interventions expert group’s phase 2 recommendations include the introduction of legislation to regulate the administration of non-surgical cosmetic procedures. Following the 2020 consultation on the regulation of those procedures, our initial priority, from a clinical safety perspective, was to consider regulating the administration of dermal fillers. As we are aware, if they are administered incorrectly, they often cause long-term damage that can be reversed or limited only by the urgent administration of specific prescription-only medication.

Because of the number of non-surgical cosmetic procedures that are now available, we are working with our stakeholders to consider the potential scope of further regulation that is needed within the area. The stakeholders include: healthcare professionals who represent the British College of Aesthetic Medicine and the British Association of Cosmetic Nurses; hair and beauty industry representatives; environmental health officers; and HIS. Their input is hugely valued.

It is also worth noting that part of the phase 3 recommendations of the interventions expert group was to consider independent services that are provided by other healthcare professionals who are not currently included in the “independent clinic” definition. Our work today to add pharmacists and pharmacy technicians is an important step forward, but I absolutely share Dr Gulhane’s concern. We are working to expand some of that regulation to take in the areas of concern that he set out.

That goes beyond what is in the orders that are before us today, but I would be happy to have a further conversation with Dr Gulhane about the on-going work that we are doing on expanding regulation of cosmetic procedures, including the detail that Dr Gulhane is looking for, which is part of the consultation and discussions that we are having with stakeholders.

That points to some of what I was referring to in response to Ms Mackay.

The use of innovation in our health service is going to be critical. Some of that is already in place—Ms Harper spoke about Near Me, which is currently in use—but there is more that we could do to ensure that we continue to utilise some of that innovation to a greater extent.

We also need to look at some of the innovations with regard to digital technology and the advances—if they are ethically used—in artificial intelligence. Critically, we need to ensure—as Ms Harper was driving at in her question—that that is done in not only an ethical way, but an equitable way, so that those who are in remote and rural areas can benefit from such innovations if they choose to do so, and take advantage of that way of working.

I am very keen to use innovation—as I have set out, it will be central to our being able to see reform and improvement in our health service in a way that maintains capacity and the opportunity for caring by those—the medical professionals and staff who work across our health service—whom we task with supporting patients coming through the system.

Like Ms White, my thoughts are with the family of the little girl to whom she referred. Those incidents are tragic examples that we wish to avoid, and everything that we do as a Government, and as health boards and services, is to try to prevent such situations from happening.

Ms White is correct about the pressures on the Ambulance Service and about those pressures not being unique to Scotland. Unfortunately, we have seen the type of ambulance stacking that we saw at Aberdeen royal infirmary elsewhere in the UK, too. That is partly due to the significant increase in demand that we have seen. We are seeing a clear increase in demand on our ambulance services. We also need to have those services in the right place to respond to incidents such as those that Ms White spoke about.

We have made a significant investment in our Ambulance Service to support an increase in the number of practitioners and paramedics working within it to respond. We are also working with boards on how they can make sure that the flow at their hospitals is working better.

That goes back to the point that I mentioned about the importance of social care to our health service. It is important that we get our social care services working for the people who need them, but delays in social care also have an impact that goes all the way back through the hospital, right up to the front door, where ambulances are stacked outside because of the pressure in the hospital. That pressure is not necessarily in accident and emergency, although that is sometimes the case; it might be about accessing beds in the hospital.

We are making investments in all areas of the system to relieve that pressure. We can see that that is working, but it needs to move faster in order for us to see continued improvement in the services that we have available to us.

A significant number of people who would be considered to be in the delayed discharge category are adults who have incapacity, which is an incredibly complicated area. I will take up Ruth Maguire’s invitation and encourage people to ensure that they have power of attorney arrangements in place, as well as arrangements that allow for people to get access to the health and social care services that they need. As a Government, we are looking to introduce legislation on adults with incapacity in order to make sure that we are improving the system and the services for it. My colleague Jenni Minto has responsibility for that bill and we are looking at it during this parliamentary term.

I am happy to reiterate what I set out earlier: I share Dr Gulhane’s concern and the work is on-going. The regulations take us a step forward, but it is imperative that we continue our work to widen regulation of that area. I am happy to come back to the committee with more information on the on-going work on that.

Motions agreed to,

That the Health, Social Care and Sport Committee recommends that the National Health Service (Scotland) Act 1978 (Independent Health Care) Modification Order 2024 be approved.

That the Health, Social Care and Sport Committee recommends that the Healthcare Improvement Scotland (Inspections) Amendment Regulations 2024 [draft] be approved.

Good morning, convener and colleagues. Thank you very much for inviting me to be here. I welcome the opportunity to discuss the wellbeing economy, fair work and energy portfolio spending plans as set out in the budget for 2024-25.

You will have heard the Deputy First Minister speak about the challenging context for the recent budget, as well as the many opportunities that lie ahead. The budget underlines our commitment to progressing the First Minister’s three missions of equality, opportunity and community. Our focus on delivering a fair, green and growing economy is underpinned by investment in this portfolio and wider investment across Government of £5 billion that will make an economic difference.

We are committed to green growth. We will scale up renewable energy, with investment of £67 million as part of our commitment to provide up to £500 million to anchor a new offshore wind supply chain in Scotland. Combined with funding via enterprise agencies and the Scottish National Investment Bank, the total support for offshore wind in Scotland for 2024-25 is £87 million. That investment will stimulate and support the private investment that is critical to the growth of the sector. That is one of the greatest areas for us to achieve growth, transform our economy and leverage private capital, as was identified by the First Minister’s investor panel. To help to realise that, we will, this year, set out a green industrial strategy to ensure that we seize the economic opportunities of the transition to net zero.

The budget is focused on funding that will have the biggest economic impact possible. It will increase investment in digital connectivity by more than 50 per cent, and we will expand our Techscaler programme, progress the implementation of the national innovation strategy and begin delivery of the “Pathways: A New Approach for Women in Entrepreneurship” report to diversify and encourage more entrepreneurship, particularly to see more women start and scale their own business. Our Techscaler and digital roll-out programmes are examples of our strong progress in delivering our national strategy for economic transformation ambitions.

I wrote to you last week advising that the national strategy for economic transformation is being refreshed so that it remains fit for purpose in a changing landscape and is focused on delivering as fast as possible in the areas in which we have a competitive advantage. We continue to support business, including by freezing the basic property rate—delivering the lowest such rate in the UK for the sixth year in a row—and providing a package of reliefs worth an estimated £685 million. The small business bonus scheme remains the most generous of its kind in the UK—it takes an estimated 100,000 business properties out of rates altogether—and, across all elements, 95 per cent of businesses in Scotland are estimated to be paying lower rates than those anywhere else in the UK.

Our missions and values are the guiding principles of the budget, and that is clear through the actions that we are taking to promote a fair economy, including recognising the critical role that employability has in achieving the First Minister’s three missions. I believe that, despite the challenging fiscal context that we are faced with, we have developed a package that will help to deliver a fair, green and growing wellbeing economy.

Thank you, and I look forward to the discussion that we have before us.

We have provided relief and have acknowledged the challenge in our island communities. We have provided 100 per cent relief to island community businesses in that sector, in acknowledgement of the fact that there are challenges. If we could have done more, we would have done so. The decision that we have taken is evidenced by the fact that, in England, there is a real-terms cut to the NHS budget. At a time of challenge for our NHS, when we are recovering from the pandemic, the right decision was taken.

That is not to say that we are not looking at all that we can do and at other opportunities that might be available. That was part of the reason for the meeting that Tom Arthur, the Deputy First Minister and I had with industry representatives last week. It was very constructive, and further engagements are planned ahead of the UK budget in order to look at what relief and support might be able to be provided in devolved and reserved areas. I absolutely appreciate, and I articulated to them my understanding of, the challenges that the industry faces. If we had had the finance available to provide alternative support arrangements, we would clearly have considered that, but, at that stage, the fiscal context was such that we were not able to do that.

That is because of the tax decisions that we have taken, which Mr Fraser opposed.