Seòmar agus comataidhean

:Some decisions taken by central Government obviously have an impact on local government through the wage bill. The Scottish Government has set a 9 per cent pay policy, which appears to have almost all been spent now, in the first couple of years of the policy. What is COSLA therefore expecting in relation to wage growth within the local government sector, next year and in future years?

:If there is no further money coming forward and the unions do not agree to a real-terms cut in wages, what is the net result for other services?

:Okay—

:Contained in the spending review for the next three years is a significant shift in the focus of health expenditure away from hospitals and towards community-based healthcare. The overall budget rises by 2.4 per cent in real terms, whereas the increase for national and territorial health boards is 0.4 per cent. That means that other areas such as community-based healthcare and primary care see much more significant increases of roughly 12 per cent. The Institute for Fiscal Studies says that, for health boards to be able to continue to deliver, they will have to make 3 per cent annualised efficiency savings. The IFS describes that as potentially “heroic” when compared with the recent capacity to deliver efficiency savings.

Some health boards—for example, NHS Dumfries and Galloway—are at stage 3 of the support and intervention framework as a result of their financial pressures. If health boards do not deliver those 3 per cent efficiency savings, what will be the risk to the sustainability of Scotland’s hospitals and those health boards? Would the Scottish Government have to step in? Would that move resource away from primary care, community care or elsewhere? Is there a risk that some of our health boards could, in effect, go to the wall between now and the end of the decade?

When we have put the concerns of COSLA and other organisations to the Cabinet Secretary for Finance and Local Government in relation to the spending review, we have got the impression that the spending review gives a somehow notional figure, and that we should not set much store by it. What confidence does that give you with a three-year budget cycle? If the minister responsible for it is effectively saying, “Don’t worry about these figures; something more will turn up,” does that give you any concerns as to how local authorities will plan for the medium to long term?

:How easy would it be to pivot away from the commitments on community-based healthcare and primary care in order to move that resource back? The Government would potentially have to examine portfolios such as local government and justice if it found that there was inflexibility between those two areas of healthcare in Scotland.

Looking at these amendments, I would say, as I said in the chamber last week, that we are very unhappy with the budget in its totality. It is hard to argue against these measures, cabinet secretary, but the risk that you are now running in many respects—for example, in relation to social care—is that, although you have found additional money at this stage in the budget process, it is rather like the burglar who robbed you blind two years ago returning to offer you some of your goods back and expecting you to be grateful.

The ultimate issue in relation to the budget—I am thinking of rates relief, for example—is that this is, in many respects, too little, too late. If we look at this year’s local government settlement, although we welcome additional funding for social care, which will deal with some of the crises that we are seeing in health and social care partnerships and integration joint boards, we think that it will be insufficient to deal with the challenge that councils face in delivering social care. As we have just been discussing in relation to preventative spend, many of the problems that we are seeing throughout, say, the health service, which also faces issues in this budget, are being made worse by the crisis in social care. We question whether the prioritisation in the budget is sufficient.

Overall, I repeat what I said last week in the chamber. We do not object to these individual measures, but the budget in its totality still does not pursue the right priorities for Scotland, and it contains misplaced priorities.

This question is for Paul Cairney. Recently, the Scottish Government has made great play of co-creation in policy making and working closely with those with lived experience. In your submission, you say:

“Avoid power hoarding at the ‘centre’. Co-produce policy with citizens.”

That was meant to happen with the national care service, the establishment of which was meant to be a collaborative effort involving all stakeholders, including those with lived experience. However, basically, that crashed against a wall.

I am mindful of the old Henry Ford adage that, if you asked your customers what they wanted, they would say, “Faster horses.” Could the result of such co-production be policy inertia, because it involves outsourcing difficult decision making to citizens? Ultimately, people want their Government to come up with solutions, not to keep asking them question after question in order to avoid taking tough decisions on—in the case of the example that I mentioned—social care.

I will follow up on the point about data and outcomes. Often, the way in which the Scottish Government puts it to the committee in relation to, for example, the Scottish child payment, is to ask, “Who could argue with seeking to eradicate child poverty?”. Huge amounts of money are being spent on concessionary travel, for example, but, as you have rightly identified, that does not mean that somebody in Dumfriesshire has any greater access to a bus, despite the fact they would have the freedom to travel without paying if they had a bus service. What needs to be done to pivot away from chasing the headlines with national developments and towards pointing out to the public and the Parliament that there is always an opportunity cost—often, a significant one—in pursuing free bus travel but disinvesting in rural bus services. Another example would be extolling the virtues of the Scottish child payment without pointing out that that £500 million could be spent on reducing child poverty in other ways, such as through employment or better housing for families. What needs to be done to re-engineer that conversation, not only internally but externally, with the public?

Recently, it was put to the committee that not everything can be a priority. The Government makes great virtue of the fact that it is prioritising eradicating and reducing child poverty at the same time that it is potentially making real-terms cuts to councils. Is the Government being honest enough with the country and saying that, if it has a major policy priority, it has to deprioritise something else when it has a fixed budget?