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Official Report: search what was said in Parliament

The Official Report is a written record of public meetings of the Parliament and committees.  

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Dates of parliamentary sessions
  1. Session 1: 12 May 1999 to 31 March 2003
  2. Session 2: 7 May 2003 to 2 April 2007
  3. Session 3: 9 May 2007 to 22 March 2011
  4. Session 4: 11 May 2011 to 23 March 2016
  5. Session 5: 12 May 2016 to 5 May 2021
  6. Current session: 12 May 2021 to 2 August 2025
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Displaying 775 contributions

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Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

Right across the board, in everything that we do, we look at things through an inequality lens. With any policy that we introduce, we make sure that we look at things in that way and that we specifically target those people who suffer the greatest health inequalities.

We are doing a number of simple things. For example, we had a manifesto pledge to ensure that children all over Scotland had access to a bike, and we now have 10 pilots going on in different parts of Scotland. The barriers to bike ownership are different in different communities. We are putting in place pilots that make bikes accessible to people in every part of our community. The challenge is not just with being able to afford a bike; it is also necessary to have somewhere to store a bike. Someone who lives in a city-centre flat might not have anywhere to put their bike. There is also the challenge of a lack of bike infrastructure. Most people would think twice about letting their children out on busy city roads. Cycle lanes need to be provided so that they can cycle safely. The ability to repair bikes is also required in communities. The challenges are multiple, but the pilots will help us to solve the problems.

We thought about having a specific pilot for people who need accessible bikes, but we decided that it was more important to ensure that accessible bikes are available everywhere. A thread that runs through our work is ensuring that there is provision for those people for whom bike ownership is really challenging, perhaps because they have a disability and cannot use a standard bike. I think that the pilots will give us a great deal of information that will help us to transform the landscape over the course of the parliamentary session.

Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

You are absolutely right. One of the challenges is that such considerations have to be taken account of at the design stage. We must think about how we will encourage the use of active transport when we plan the infrastructure. As I said, there are more barriers than the barrier to bike ownership.

You arrived late, so I think that you missed the part of the discussion about using our NHS facilities as anchor institutions. That is partly about procurement and spending money in local communities, but it is also partly about ensuring that healthcare settings are as healthy as they can be and that people who work there can use active transport to access them, instead of having to take their cars. It is really important that we ensure that that is the case.

Time and time again, when I speak to people who are interested in sport and physical activity, I explain that one of the significant challenges of my role is that I am regularly preaching to the converted. I speak to people who already recognise the importance of sport and physical activity; what I need to do is speak to people who do not recognise that. I need to speak to the people in councils and the NHS who make decisions on the spending of public money, as well as the people who make decisions about planning infrastructure. I need to speak to people across the board who are involved in making such decisions so that we ensure that we have a cohesive approach, that we think about 20-minute neighbourhoods and that we consider the need for our NHS staff to be healthy in going to and from work.

Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

We will see a number of significant differences, but the first thing to do with that question is to reflect on what the past 18 months has given us. It has been an exceptionally challenging time and it is hard for us all to think of any positives. However, some positives might have come from the campaign over the past 18 months. A light was shone on pre-existing health inequalities, and I feel strongly that Scotland is unwilling to tolerate those any longer. As a Government and as parliamentarians, we have a mandate, and we will be able to build consensus and take bold steps in tackling some of those inequalities.

If we think about how difficult it was when this new virus hit us and we had no infrastructure in place, and we talk about how much testing and vaccination we have done now, it is almost hard to remember that, at the beginning of the pandemic, what we did time and again was the impossible. As a Government, we have a taste for that. We achieved the impossible because we worked together and turned to face a common enemy. That is powerful. We have found ways of working together and collaborating that will stand us in good stead.

We have seen significant behavioural changes, although not right across the board. There are still inequalities in the behavioural changes that have impacted people in the past 18 months, but we have seen people making such changes as socialising through exercise, for example, or working from home and making sure that they take time to go for a walk at lunch time. We need to hang on to those behavioural changes. Members will certainly see work going on to try to encourage people to be physically active during their working day. We already have the daily mile, which is fully integrated into schools. Many schools are signed up to that, and we want to be a daily mile nation. We want everybody to have the opportunity to exercise every day.

My sense is that there has been an increase in health literacy. People know where to go for high-quality information. NHS Inform was already quite a trusted source of information, and it has now become the first point of contact with the health service for many people. That will stand us in good stead. People are looking at local data for the pandemic and infection rates, and are making risk assessments. There have been significant behavioural changes over the past 18 months that will stand us in good stead as we move forward.

On prevention, we will have to take bold steps on big issues such as non-communicable diseases and, on diet and obesity, we will have to take bold steps to tackle the obesogenic environment. That means that all of us will have to come together collectively to take steps to make it easy for the population to do the right thing. We will see consultations and work on all those things—on alcohol, tobacco and diet—over the next few months.

As I said, a public health bill is coming. That may not be in the first year, but members will see work in advance of that bill over the next year.

Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

No, that is fine.

Drug and alcohol services are often combined on the ground, so much of the work that is led by my colleague Angela Constance in respect of investing in drug and alcohol services will benefit people with alcohol dependence, as well.

You are absolutely right to highlight alcohol as a priority. We saw a rise in alcohol deaths over the course of the pandemic last year. That bucked the trend over a number of years. We have done a lot of work on that front, and we were starting to reap the benefits of that. Last year, we saw a 17 per cent increase in such deaths, which was devastating and tragic for those affected. We saw an increase in such deaths throughout the United Kingdom; in fact, the increase in Scotland was slightly smaller. There was a 20 per cent increase in the rest of the UK and a 17 per cent increase in Scotland. That is probably testament to some of the policies that we have in place.

In the work around alcohol prevention and treatment, we are driving forward our alcohol framework, which has 20 actions to reduce alcohol-related harm and which enables the World Health Organization’s focus on tackling the affordability, availability and attractiveness of alcohol. The key aspect of that work is minimum unit pricing. Like everyone here, I imagine, I think that that is a wonderful, well-targeted and effective policy. We committed to reviewing it within two years of its introduction but, unfortunately, the pandemic prevented us from holding that review. We have begun to gather information in order to review the minimum unit pricing of alcohol.

We are undertaking a range of work to improve alcohol treatment services throughout Scotland, including on a public health surveillance system and implementation of the UK-wide clinical guidelines for alcohol treatment.

Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

I assure you that alcohol is equally a priority. Angela Constance and I work closely together, and we are determined not to introduce further silos in that work, which is profoundly unhelpful for the people who are accessing help. The money is intended to improve alcohol and drug partnerships and shore up the services on the ground, which will benefit people with alcohol problems.

Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

We are working across portfolios. The Tory-Lib Dem coalition came in in 2010 and brought in welfare reform, and there is powerful and well-documented evidence that that worsened inequality across the UK. Some of those welfare reforms affected disabled people most severely, and some of the most vulnerable people in society suffered. In the past 14 years, while the Scottish National Party has been in Government here, the UK Government has systematically dismantled the welfare system and has made health inequalities significantly worse.

Despite that, the Scottish Government has done a great deal. Those who look at the UK as a whole would say that the Scottish Government prioritises health inequalities and poverty. Work to ensure adequate housing protects people in Scotland from health inequalities.

An awful lot of money is spent on, for example, mitigating the bedroom tax in Scotland. That tax, which was introduced by the Tory-Liberal Democrat coalition, punishes disabled people in particular, and people in Scotland do not have to pay it. If we are looking at what has happened over the past 14 years, we really have to look at the welfare system, too.

09:30  

As for finding opportunities for mitigation, I again highlight the bedroom tax as a perfect example. If the Scottish Government has to spend money on issues that are reserved, that means less money for devolved matters, and there is a limit to how much of that sort of thing we can do. Every year, we spend millions on mitigating the bedroom tax, and that is particularly beneficial for disabled people in Scotland. As I have said, though, there are limits to how much we can do and how much we can spend. I am very proud that the Scottish Government has introduced the Scottish child payment and that, during this parliamentary session, we will increase that payment and extend it to all children. However, there are budgetary limits to what the Scottish Parliament and Government can do in the face of the systematic damage to the welfare system that is coming from our other Government.

Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

Child poverty has lifelong impacts, so tackling it is absolutely the place to start and to focus on for prevention.

Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

You are absolutely right—it is an unwelcome reality that, across our society, communities experience health, quality of life and even life expectancy differently. That is not acceptable, and improving health and reducing health inequalities across Scotland are a clear ambition for the Government.

The pandemic has both exacerbated health inequalities and heightened awareness of the people we need to protect. The first thing that we all need to be clear about is that the solution to health inequalities will not lie entirely in my portfolio. Health inequalities relate to inequalities in wealth and power. The solutions to health inequalities lie in, for example, tackling poverty, which is a high priority and a mission for the Government.

We absolutely have to tackle the socioeconomic inequalities. I will bring in Michael Kellet to tell you a bit more about how we recognise that our health and social care institutions can be anchor organisations in tackling socioeconomic inequality, by offering good employment opportunities and leading the way in good work practices. We have a fair amount of work going on in that regard.

On preventative policies, Christie’s work was incredible, and it is always important that we reflect on whether we have made the impact that he hoped we would. I do not think that we have, but we have done some pretty impressive work. If you think about the issue of alcohol, you will see that much of the effort that we put into tackling the problem relationship that we in Scotland have with alcohol is preventative. Much of that work is bearing fruit, but the issues are difficult to tackle and it will take longer for us to feel the benefits of that.

In the past year, there was an increase in the number of alcohol-related deaths all over the UK. No death from alcohol is acceptable and it is devastating that there was an increase last year. However, the slightly lower increase in Scotland shows that preventative policies are bearing fruit here. Although we had an increase, it was not as high as elsewhere in the UK. That can largely be attributed to our preventative policies, such as minimum unit pricing of alcohol, which is a policy that every one of us should be proud of.

Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

Dr Marion Bain, who is a deputy chief medical officer and was involved in developing the women’s health plan, can give you a little more information about PCOS.

It has been suggested to me that a number of conditions should have been included in the plan. I recognise that it is not all-encompassing. The plan and its priorities were developed with input from women, and we agreed with women who have lived experience the areas that we should target first.

The plan is momentous and I love the fact that Scotland is leading the way with it. I am determined for the plan to deliver tangible change for women, but it is just a start. There is more to come to tackle the health inequalities that women experience as a whole.

Health, Social Care and Sport Committee

Session 6 Priorities

Meeting date: 9 November 2021

Maree Todd

Health services throughout the world are often criticised for being reactive rather than preventative. There is a lot more that we can do to ensure that people live long, healthy lives and that we prevent illness before it happens. We can support people to stop smoking, prevent people from drinking too much alcohol and make the food environment easier to navigate so that is easier to eat healthily than it is to eat unhealthily. We can do all those things, but they do not necessarily sit on the health professionals’ shoulders.

There are also actual health issues involved, too. For example, picking up and treating hypertension is an important preventative strategy. Much of that work lies in primary care.

I will bring in Michael Kellet. I mentioned the work that we are doing with the Convention of Scottish Local Authorities, the NHS and universities—a lot of public services—on using anchor institutions to change the health of the communities that they serve. That is exciting work. It is an exciting approach because it takes the burden off the healthcare professionals who are at the coalface but uses our NHS to improve the nation’s health. It is quite a clever way of doing it.