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I do take that seriously, and I recognise why Mr Whittle raises that question. He has a far more illustrious athletics background than I do. My athletics career was cut short although, even still, I do not think that I would have been as fast over 400m as Mr Whittle was.

Seriously, I very much recognise the point that he is making. I want to make sure that the opportunities that were afforded to us to access sporting and leisure services are afforded to my children. I have set out to colleagues across the committee my recognition of the impact of investment that is beyond what we would deem to be health and social care spending and is preventative. That can be in our sporting and leisure facilities and in our cultural estate. I recognise the point that the member is making.

I will come back to Mr Whittle on the active healthy lives funding and the sport funding, so that he gets greater clarity on our intention and how we are providing support to sporting organisations and those who provide the phenomenal opportunities that exist across the country. That is something that he and I witnessed at the most recent sports awards, where we saw incredible dedication, from community and grass-roots level, right up to elite level in Scotland. We should be incredibly proud of that and continue to support it.

I will provide more information for Mr Whittle on that.

I understand Mr Sweeney’s question. It is a difficult situation. Whether it is in the health and social care budget or any other aspect of revenue and resource spending across Government, providing comparators can often be difficult, when in-year revisions take place because of Barnett consequentials or other in-year changes.

Obviously, we are looking for greater certainty on what our budget will be, which would be helped if United Kingdom Government spending reviews gave a greater trajectory towards what our financial allocations will look like. We also want to ensure that we have a stable budget that is balanced over the year. Due to the impact of austerity and spiralling UK inflation, we have had to make in-year budget revisions over the past couple of years, which we want to avoid doing this year. We want to give certainty to the system about what is coming forward.

With regard to providing clarity and detail, we are more than happy to provide written confirmation after this evidence session on the points that Mr Sweeney raises about the comparisons between one budget and the next or, indeed, between autumn budget revision and budget positions.

Gillian Mackay points to what I think is the greatest risk that we have in the coming year, not just in health and social care services but across the public sector, and that is the impact that the rise in national insurance contributions will have.

We do not yet have clarity or certainty about what that impact will look like. We know that, across the entirety of the public sector, including people who are contracted to deliver public services, such as GPs, social care providers, dentists and people in the community and voluntary sectors, the cost to Scotland will be approximately £750 million. We have had an indication from the UK Government that it will cover somewhere between £290 million and £350 million, which means that we will have an immediate substantial deficit of £400 million or more.

The funding that has been suggested thus far by the UK Government is only for those who are directly contracted in our public services; it does not cover people such as GPs and social care providers and people in the community and voluntary sectors, universities and so on. We face a substantial risk. We know from social care providers, including some GPs that I have spoken to, that the rise represents an existential risk for some of them.

The UK Government has rightly sought to raise revenue, but I do not believe that it understood the implication of choosing to raise that revenue from employer national insurance contributions. That is evidenced by the fact that we still do not have clarity in terms of what it describes as the mitigations relating to the damage that the move will cause. It could have chosen other ways of raising the revenue that is required to start to unpick austerity. It made the wrong choice, and that will have potentially catastrophic implications for not just health and social care services but public services in Scotland and across the UK. That is why I hope that committee colleagues will unite with the Scottish Government in saying that the issue must be quickly resolved at source by the UK Government, so that we can provide certainty to those employers—our GPs, social care providers and so on—that are seeking to make employment decisions right now but have no certainty about what their national insurance position is going to be.

Some of those providers will be disproportionately impacted because of the nature of the route that has been chosen by the UK Government, such as those with a higher number of staff who are paid at a lower salary rate.

One of the other issues that I believe is going to be problematic is that those who are contracted to provide more than 50 per cent of their business within the public sector will not be eligible for some of the relief that the UK Government has proposed. That, again, serves to illustrate to me that the move has not been properly thought through and that the UK Government has chosen the wrong area from which to raise revenue.

Again, I underline that the UK Government should raise revenue to invest in public services to start to undo the damage that austerity has done. The revenue that has been provided to the Scottish Government through the budget is very welcome—it starts to make progress. It does not answer all the questions from the Scottish Government or, indeed, other Governments. I genuinely believe that the UK Government went down the wrong route on raising revenue and that there will be clear and stark unintended consequences that it will have to resolve—and quickly.

Yes, I absolutely recognise that, but my point is that, when someone does not need an appointment, it is difficult to understand whether they would have needed an appointment in the first place.

Our preventative activity is about reducing the overall level of interaction with secondary care services, in particular. We want to reduce the level of acute admissions and to stop the escalation of people’s ill health. All that is wrapped into what we are seeking to do in the budget, especially with the £200 million that we have set aside for reducing waiting times, addressing the efficiency of flow in the system and reducing delayed discharge. That involves providing capacity to our social care providers and our primary care providers.

The issue is not only about general practice. We have a huge opportunity with ophthalmology in the community and from encouraging greater utilisation of our pharmacy first programme. A range of interventions are available. However, I again point to the fact that not all prevention will be achieved through health service intervention. Mr Whittle and other members have spoken about the importance of our sporting and leisure facilities, as well as that of cultural and other public service interventions.

Part of the discussion that we will be having with IJBs is about the deployment of the £100 million for improving the delayed discharges picture and ensuring that IJBs have the resource and certainty available to them to allow investment in care packages and care home support.

Mr FitzPatrick asked what my expectation would be. The reduction in the levels of reserves that Alan Gray has just narrated meets the fact that there is pressure across the public sector. I do not think that anyone would expect there to be high levels of reserves sitting there when there is fiscal pressure across public services. Those things need to be balanced. I acknowledge Audit Scotland’s report in that respect, and the Auditor General’s concern about ensuring that there is financial sustainability going forward.

We must continue to work with our partners in local government and health boards to ensure that there is funding sustainability for our IJBs so that they can continue to meet service demand and be sustainable over time. We need to ensure that that is a smooth process. Alan Gray talked about ensuring that the allocated reserves are there to allow investment over time and allow some of those multiyear projects to be delivered.

Sandesh Gulhane is right that there is an oral health inequality, but it has reduced substantially. I hope that Alan Gray has access to the figures. Child oral health inequality has reduced substantially. We have seen a reduction in the number of children who arrive at dental services with cavities, so the childsmile programme has clearly made an impact and reduced inequalities.

The reason why we have invested in general dental services and reform of the funding for NHS dentistry is to ensure that our dentists find carrying out NHS work more attractive. That is also why, in the budget, we are investing in increasing the number of dental training places so that we can increase the number of dentists coming into the system. We are increasing the number of Scotland-domiciled dental places by 10 because we recognise that it is an incredibly competitive environment for potential students to go into and we want to ensure that we maximise the number of dentists who come into the health service.

I am happy to provide greater detail on the reduction of childhood dental health inequality in the follow-up correspondence. The information gives a good summary of the progress that has been made and the impact that childsmile has made. I think that Mr Gulhane will welcome that.

Thank you very much, convener, and good morning, colleagues. I really appreciate the opportunity to answer your questions today.

I want to begin by wishing Christina McKelvie all the very best in her treatment. We look forward to her return as Minister for Drugs and Alcohol Policy.

We launched the national mission to reduce drug-related deaths in 2021. Since then, the Scottish Government and our partners have worked tirelessly to bring innovative, structural change to that complex emergency, and we remain fully committed to reducing drug deaths and harms. Backed by £2 million of investment from the Scottish Government, a safer drug consumption facility, the first in the United Kingdom, will open soon in Glasgow. That landmark evidence-based service, which was co-designed with local people using substances, will help protect those who are most vulnerable from overdose and reduce harm.

It is, however, just one of the programmes of work that we have been taking forward. I would like to use this opportunity to outline the wider action that we are taking to reduce harm and to improve the lives of people and communities that are impacted by drugs and alcohol.

On 31 October, Audit Scotland published a report on drug and alcohol services, which acknowledged that we have “improved national leadership” and have made significant progress in tackling Scotland’s long-standing issues with drugs and alcohol, notably through significant investment and innovative action in our national mission. That action includes widening access to life-saving Naloxone, expanding treatment capacity and increasing access to residential rehabilitation.

However, despite all the progress, there is more to be done. The report specifically draws attention to work on local accountability, so we are stepping up our work with local leaders to strengthen accountability against national and local outcomes. It also highlighted the need for a “whole-systems approach” and “more preventative” action, and I assure colleagues of the Government’s commitment in that area.

Our response to the Scottish Drug Deaths Taskforce’s recommendations has delivered progress, for example, the publication this September of the mental health and substance use protocol and our work to implement the “Drugs and Alcohol Workforce Action Plan 2023-2026”, which was published in December 2023. Our whole-systems approach to prevention aligns with our wider vision for health and social care—that of a Scotland where people, including those with drug and alcohol dependencies, live longer, healthier and fulfilling lives.

There is, however, clearly still more to be done. The first years of the national mission were about laying the foundations; we are now committed to building on those foundations while responding to new threats and challenges, such as the emergence of novel, stronger synthetic drugs, which pose increased risks to our communities.

Scotland’s drug and alcohol deaths remain too high—I am absolutely clear on that point. Each death is a tragedy—a life lost too soon—and it will be felt dearest by the families concerned. However, we are driven by a steadfast belief in the necessity and possibility of change, and we remain fully committed to delivering on our commitments.

I look forward to the opportunity to provide fuller updates during the meeting.

Ms Haughey touches on an important issue. We all have agency in respect of tackling stigma, with regard to the language and terminology that we use and the recognition that drug or alcohol dependency is a health issue. Government can show clear leadership in that regard, and we are trying to do so.

Nonetheless, there is a role for, and a responsibility on, those who report the news to be cognisant of not only the people who have a drug or alcohol dependency, but their family members. They should ensure that the language that is used to describe those issues does not create greater barriers, or maintain barriers, that prevent people from feeling that they are able to access treatment. That is the stigma issue.

We need to move on from the stereotypes and some of the language that is and has traditionally been used in this area. That is clear in the language that we in Government use, and in how we approach the issue, and I believe that we are making progress on that as a Parliament, too. However, you are right that all of us, including our colleagues in the media, have a role to play in that regard.

It is important to proceed as I have just set out. There are recommendations in the report on which we are already making progress. I accept those areas of challenge, including around local leadership, that need to be addressed.

I welcome the report in general; it recognises—as I said in my opening statement—the national leadership that has been provided and the progress that is being made, and the progress that has been made through the interventions from the Scottish Drug Deaths taskforce.

We will respond more formally in due course, but I do not think that the committees will see much challenge from us to the report, if I can put it that way. We will take seriously the recommendations that are in there.