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I thank the witnesses for coming today. Submissions in response to our call for input to our inquiry cited a disproportionate focus on secondary care in the most recent winter plan and claimed that it undermined the Government’s intention to support a whole-system approach. Indeed, health expenditure across the UK is similar to that of other Organisation for Economic Co-operation and Development countries in total, but differs in that most of the spend is allocated to hospital care as opposed to preventative care or community-based settings. It could be argued that the disproportionate expenditure on secondary care is a year-round structural imbalance that exacerbates vulnerabilities, particularly in the acute hospitals.

Do the witnesses agree with the views expressed in written evidence that primary care was not prioritised in the winter plan in the way that it should have been? Perhaps you could pick up on the point that John-Paul Loughrey made about GPs in deep-end practices?

Another thought occurred to me based on my experience of visiting India, which is that they have extremely intensive road safety signage—in some cases, it is quite witty, such as: “You might get ahead but don’t lose your head.” We found the signs quite amusing, and they certainly caught your attention—that is the important thing. You could not go 100m without seeing some sort of sign that would indicate the road safety risks. It might be worth looking at other jurisdictions where they have much more intensive signage to do with issues around road safety than we do. Perhaps it might be worth considering a short-term measure to intensify the road safety signage on the A9.

I agree with colleagues’ recommendations so far. I add that, in practice, the feasibility of the roll-out would depend largely on local authorities leading the logistics. It might be useful to get an understanding from COSLA about how ready the school estate is to adapt to such a change, should it be introduced, what sort of capital changes might be required and what existing contracts might need to be changed. It would also be useful to get an understanding of the opportunity for things such as developing community food networks, using the school as the anchor for a community food network and building resilience around the good food nation concept, which was recently passed into statute by this Parliament.

Rather than simply seeing the issue as a potential liability, I think that it presents us with huge opportunities. Trying to socialise those ideas with COSLA and local authorities would be helpful at this stage, if the committee thinks that there is potential in them.

I have some familiarity with the petition and, obviously, the community of Milton. I agree with all the suggested actions and the sentiments that have been expressed today. There are youth organisations in Glasgow that have demonstrated a positive track record of benefiting their communities. For example, St Paul’s Youth Forum in Blackhill, which has achieved significant improvements relating to youth violent behaviour in that community. We might be able to learn from and scale that model in communities where there is a persistent issue with gratuitous youth violence.

The lack of enforcement and lack of engagement with the issue by the police is a deep concern, because it only emboldens the action that the convener has described, which is completely demoralising for a community that already feels alienated.

I have a supplementary point. I know that you visited Milton to discuss the issue first hand. Perhaps there is an issue with how schools engage with the problem. It might be useful to engage with the schools that have catchment areas in the relevant communities, to get an understanding of whether they have detected the problem and have measures in place to address it or whether they, similarly to the police, feel powerless to deal with it.

There might be a similar thing with teachers experiencing similar issues, which might be useful to understand.

The procurement side of the issue is of particular interest, given the recent failure to achieve success in the latest phase of the procedure. It seems that breaking it down into phases is an inefficient method of delivering the programme, and I wonder whether a continuous mobilisation for road construction approach is necessary. If it is about improving the route by dualling rather than constructing a new road, that would comply with our goals around climate change and so on.

It is about road safety on an existing route, but how the Government delivers the programme is critical. There are other examples around the world. I had the opportunity to visit India recently, and I was on the world’s highest metalled road, in the Himalayas. It was delivered by a state corporation called the Border Roads Organisation, which mobilises a national mission to deliver strategic road networks in India. That is just an example of how the Indian Government is delivering that mission as a continuous programme. It does not stop to procure each phase, which introduces huge stop-start inefficiencies. It knows what its national road network will look like and builds it over a continuous period.

I wonder whether we need to look at the fundamental sanity of the current approach. Railways have achieved significant efficiencies by having continuous rolling electrification. The teams do not stop between phases; they just run across the network, putting up the pylons and running the cables. A similar approach for the strategic road network and the trunk road network could be an interesting proposition.

I agree with the proposed actions, and I have some familiarity with the petitioner’s case from press coverage—I think that it has had quite a high profile in recent months.

I will make one additional point. The university in question—the University of Glasgow—is not affiliated to NUS Scotland, so it would be appropriate to also ask that university’s student representative council to make a submission, simply because the institution is not under the ambit of the NUS.

There are some major structural issues here. Most notably, in Glasgow, there is no common housing register across all the registered social landlords in the city, so having visibility of adapted housing is challenging and often involves making numerous duplicate applications to various housing associations. That has been a massive public policy failing since the stock transfer in Glasgow, and it has never been addressed in 20-odd years. That is one aggravating factor.

I would also highlight recent engagement that I have had with hospices in Scotland. There was a pretty harrowing exhibition at the University of Glasgow recently, which was called “Dying at the Margins” and which I think is due to come to the Parliament later this year. It presented case studies of people who could have lived out their final days at home but who, because of accessibility issues and lack of willingness of housing associations, councils and housing providers to make adaptations to housing, ended up in hospitals or hospices—often inappropriate settings where they did not want to spend their final days. That was pretty shocking. Often a pretty mercenary calculation was made that, if someone was going to be alive for only another few months, there was no point in paying the money to make adaptations.

There is an aspect of how palliative care is managed in the home, and the hospital at home concept, that merits consideration. The issue causes huge costs to the NHS as a result of delayed discharge. People who are terminally ill are in acute hospital wards, which are a highly medicalised environment and probably not appropriate for them. There are all sorts of aspects that introduce great costs that are not being dealt with. There is a bit of system failure in relation to ensuring that adaptations are efficiently and cheerfully carried out where needed.

A number of hospices were involved in the production of that exhibition. It might be useful to solicit their views on what policy changes need to happen. That might open up a pathway to other stakeholders that are engaged in the policy area. Marie Curie would be an obvious first stop for those discussions, because it was certainly an anchor organisation in the production of that exhibition and it has highlighted to me this critical issue in the community.