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I will pick up on some of the modelling that has been done in the productivity paper that you prepared, Professor Ulph.

The number of people in the NHS workforce in Scotland would make it the fourth largest city in Scotland. I think that the head count sits at 181,000 people, so it is the biggest employer in Scotland by a considerable distance. That clearly has an effect on national performance in terms of productivity. Do you have any thoughts on whether we can improve our analysis of the productivity of the NHS workforce in informing national policy?

Sorry—it looked as though you wanted to comment.

Can you elaborate on the evidence base for longer-term objective setting and setting those budgets accordingly? An interesting example might be health and social care partnerships cutting a programme without any reference back to the centre and the impact that that might have on national performance. Do we need to do more to improve those metrics and key performance indicators?

I thank the witnesses for their contributions so far. We have discussed pay pressures in the NHS and general financial pressures. The Scottish Government agreed a pay increase for 2023-24 of 6.5 per cent for most NHS staff and 12.4 per cent for junior doctors. Nonetheless, payroll pressures continue to persist as a structural challenge for the NHS.

Mr Whyte, you said that wages account for a lot of spend. We need to balance that with recruiting new staff and retaining staff who might otherwise bleed overseas or to external agencies, for example. How do we strike that balance? Do you have any insight into how well boards or national pay bargaining structures are performing in that regard? Structurally, are we potentially adrift from where we need to be?

I have a follow-up question about the potential consequences of capital investment. Do you see an issue with capital investment and productivity enhancement vis-à-vis labour intensity in the system?

We have had a lot of correspondence from members of the public as a result of our call for feedback on the state of the national health and social care system and mental health in Scotland, particularly on waiting times for child and adolescent mental health services. Waiting times data for the most recent quarter shows that 73.8 per cent of children and young people were seen by CAMHS within 18 weeks. That figure is lower than that for the previous quarter, and it falls short of the Scottish Government’s target of 90 per cent of people being seen within 18 weeks. I understand that the delivery plan for the mental health strategy will look at when boards can reach the waiting times standard, but will that plan be accompanied by funding so that health boards can build the required capacity to meet that target effectively?

Okay. That is disappointing.

Could you tell us a bit more about the mechanisms that you are looking to deploy to ensure greater consistency and reduce variation? What specific operational changes do you propose to make?

I recognise that you cannot commit to specific funding at this stage, given that it is not necessarily in your gift alone as the cabinet secretary, but there is the broader objective of allocating at least 10 per cent of expenditure to mental health, as set out in your party’s manifesto and the Bute house agreement. Is the end of the current parliamentary session still the target? Will there be a commitment to that 10 per cent target, or will there be a proposed cut in real terms to the mental health budget?

I thank the cabinet secretary for that response. The Royal College of Nursing strongly fed back the point that nurses in training felt that they were not able to continue with their studies because of the financial costs. Having an employee status at the outset under an apprenticeship-led model would offer a way of remedying that.

Another major issue that has been fed back is the abolition of non-residential care charges. That was raised very strongly by stakeholders. Non-residential care charges are still in place, with the cost in Glasgow almost doubling. There was no mention of care charges in the programme for government, despite the strain of the cost of living crisis and its impact on some very vulnerable people. Is ending non-residential care charges still a priority for the Scottish Government, or is that not on the radar at the moment?

The recruitment crisis in social care is another major issue that has been fed back strongly to the committee. The programme for government included a commitment to a pay rise to £12 per hour for social care staff. If the Government had acted when calls for the rise to £12 per hour were made three years ago, that increased level would now be worth almost £14 per hour, after inflation. Does the cabinet secretary think that that is sufficient to address the scale of the recruitment and retention issues in social care, bearing in mind the opportunity cost of not acting?