Seòmar agus comataidhean

You and I could go back and forth on that, minister, because I think that the feeling on the ground in local government is that Scottish Government decision making, and the choices that have been made, have also had a huge impact. I am thinking in particular of the underfunding of Scottish Government-led initiatives, some of which we have discussed this morning. Nevertheless, I am very conscious of the time allowed to the committee this morning. As I have said, we could have a further discussion on funding, but I think that we have both made our points and they are now on the record.

I know that Gillian Mackay has a supplementary on this theme, so I am willing to give her the last word.

That concludes our questions. Thank you, minister, for your contributions.

We will move on to discuss our final theme this morning: the pandemic and the cost of living crisis. What is the Scottish Government doing to ensure that those who are already vulnerable and who have been affected by health inequalities are not further disadvantaged during Covid recovery and the cost of living crisis?

The fifth item on our agenda is consideration of two negative instruments, which were laid on Thursday 16 June and came into force on the same day. The Delegated Powers and Law Reform Committee considered the instruments at its meeting this morning. It decided to draw them to the attention of the Parliament on reporting ground (j) for failure to comply with laying requirements in section 28(2) of the Interpretation and Legislative Reform (Scotland) Act 2010. However, the DPLRC is content with the explanation provided by the Scottish Government for failure to comply with the laying requirements.

The first instrument is the National Health Service (Charges to Overseas Visitors) (Scotland) Amendment (No 2) Regulations 2022. It ensures that certain NHS services for any overseas visitor who requires diagnosis or treatment for monkeypox are provided without charge to that overseas visitor.

No motions to annul have been received in relation to the instrument.

As no member has any ?comments,?I propose that the committee does not make any?recommendations in relation to the?instrument.?Do members agree with that?

Members indicated agreement.

On that last point, it is correct to say that there are lots of aspirational policies that seek to alleviate such issues. In relation to devolution to local authorities, it seems to me that many of the six priorities that Professor Marmot outlined are what local councils do around, for example, education, employability and building communities. I wonder whether on-going and repeated cuts to local authority budgets have an impact. Professor Marmot, how did Coventry or Manchester deal with what was obviously a reducing picture? Is it your sense that those things will be hard to achieve unless local government is funded appropriately?

I thank the witnesses for their insights, which have been helpful.

I want to ask about progress. With regard to Professor Marmot’s work and, indeed, a lot of the things that the other witnesses have referred to, it strikes me that a lot of what we have heard is not new—it is not rocket science; it is about looking at what works in communities and investing in it. A lot of that work is done by local authority services or by the third sector. Across the piece, there has been a reduction in funding for those sorts of services. Obviously, we can argue about the politics of the source of that issue, but I simply want to get a sense of whether, despite that backdrop, progress has been made in Scotland in implementing many of these strategies. I will start with Professor Marmot.

Good morning. I thank the witnesses for their presentations, which were informative. All the evidence that we have heard, including in the informal sessions, has been useful and insightful.

I am keen to talk about culture in our public services and in service delivery. In the evidence from the group from the Hub in Dumfries and Galloway, someone talked about

“judgmental and uncompassionate public services”,

and they described those as “punitive rather than supportive”.

Obviously, we can see direct links to the issues that Dr Sharon Wright talked about in the social security system more widely. Is that also people’s experience of other public services that exist, whether in the NHS or in local authority housing provision? It is stark when people say that the network of support that we all want to be there to help people is perhaps doing the opposite, and when they feel that it is judgmental.

How do we begin to shift that culture? We have had undertakings on what the Scottish Government is trying to do through Social Security Scotland and undertakings in the local government sphere, but what more can we do to have a culture shift away from that sort of experience?

Given that those comments came from the Hub, I ask Karen Lewis to start.

I will comment briefly on mental health. Both your answers alluded to the multiple and diverse challenges that exist for people. I am keen to understand whether the witnesses feel that front-line workers who support people have enough training on understanding mental health issues, particularly on trying to identify and triage someone who might have mental health issues. That brings us back to the no wrong door approach, trying to take a holistic view of a person and trying to meet them where they are when they interact with services. We have done some of that, but I am not sure that we have done enough. I am keen to get a sense of whether people think that we need to do more and how we might do it across the piece.

In the past two years, Covid-19 has dominated every part of our lives, particularly our actions on health inequalities. I am keen to get a sense of the witnesses’ views on the Covid-19 recovery plan. What should be prioritised in the plan to tackle health inequalities? I appreciate that that is a big question.

I am keen to understand more about the policy interventions that we can make in a devolved context. The committee has heard quite a lot of evidence and had quite a lot of discussion about what happens at the reserved and devolved levels, but I am keen to get a sense of what policy makers can do in the devolved context to make a difference. I ask Ed Pybus to start, because I know that his organisation, CPAG, has been close to the work around the Scottish child payment. Ed, I am keen to get your sense of how we can go further.