Seòmar agus comataidhean

The health service is under such stress at the moment. We are aware of the waiting time for an MRI scan, for example. A long Covid sufferer might join that waiting list, and they might then join the waiting list for an ECG and for something else. The reality is that getting an early diagnosis of long Covid will be extraordinarily difficult under the circumstances that the NHS currently finds itself in. I am just putting that out there.

Good morning. I thank the witnesses for giving us their time.

I was going to look at current long Covid services and ask about your experience of accessing specialist care but, from the responses that we have had today, I conclude that we still have some way to go.

I want to put a couple of things on the table. First, are we collecting and utilising data? Secondly, we need to understand from the people who have gone through this journey what specialist care and assessments would look like. What do we need to build?

What I am hearing is the suggestion that, “If we don’t look, there won’t be a problem.”

I want to tie up the issues that were raised in response to questions from my colleague John Mason with what Stuart McIver said about assessments and the ability to diagnose long Covid. You described how, after going private, a long Covid diagnosis was reached by a process of elimination, using ECGs, MRIs and blood tests. The issue is that that is an intensive process for NHS staff to carry out. As my colleague John Mason said, that would be a huge amount of resource to allocate and potentially take away from other areas of the NHS. How do we deal with that?

That is the point that I was trying to tease out.

Good morning. I thank the witnesses for their evidence. I will follow on from my colleague’s line of questioning. We understand the front-line cost of dealing with Covid—we know what the investment in that was—but I am interested in the spending required for the fallout from Covid.

We know that the cost of Covid was higher because of our poor health report card. A lot of people who suffered from Covid and tragically lost their lives were dealing with other issues, such as obesity, type 2 diabetes and heart conditions. However, in dealing with Covid, we had to drop our focus on such conditions. Should OECD countries prioritise conditions such as long Covid and non-Covid-related diseases and other issues that were affected by Covid restrictions, such as cancers, elective surgery, mental health issues, obesity and physical fitness? Will we need to reinvest in addressing those conditions as we deal with the fallout from Covid?

My final question concerns one of the questions that we asked the OECD on data collection and deployment, which is one of the important issues with regard to potential future pandemics—not just Covid-related data but data relating to the other conditions that we discussed earlier, with regard to their direction of travel.

We heard that, generally speaking, across the OECD countries, there is a lack of such data and that, having gathered data, we cannot disaggregate it to help to shape the way in which we tackle the health issues that are associated with Covid. I have talked many times about the fact that we do not have an IT structure that allows that to happen—few countries do. Do you agree that we should invest in that area, as a baseline?

Welcome, cabinet secretary. We know the cost of having dealt with Covid previously. You indicated to other members that, looking ahead, there is a budget that assumes further Covid spending. However, on dealing with the fallout of Covid, there is a cost associated with other conditions that were affected by the Covid restrictions. I refer to cancer, elective surgery, mental health, obesity and physical fitness, for example. We know that to be true, which is why I was interested in your last answer to John Mason. Will the Covid recovery budget reflect our ability to deal with that fallout from Covid? It will inevitably turn up somewhere in the ledger.

We wait with interest to see whether raising taxes actually puts more money into the budget.

I will go back to my original question, on the funding of treatment for non-Covid-related conditions during the Covid recovery. We know from data that those most affected by Covid and those who had the worst outcomes had other health conditions such as obesity, type 2 diabetes or heart conditions.

We are looking ahead and discussing the preventative agenda, as we prepare for future pandemics. From talking to the OECD, we know that it is not only us doing that: all Governments are dealing with what is in front of them at the moment and it can be difficult to look further ahead. Given what we know about the impact that Covid had on people with other conditions, would it not be prudent to start looking at how we can tackle Scotland’s poor record on health? The cabinet secretary knows that I am very interested in that subject. Would it not be prudent to start looking at how we can tackle that poor health record as we look ahead to future pandemics?

We agree on the outcomes that we want. Outcomes are important, but we currently have a poor report card for health compared to many countries in Europe. I was really exercised about this topic before Covid.

I agree that a lot of positive health outcomes will be tackled outwith the health service. Correct me if I am wrong—I am sure that you will—but I think that 44 per cent of our budget is now spent on health and there has been a reduction of 27 per cent in the local government budget. However, many of the interventions that are required to deal with the impacts of Covid will be dealt with by local government. How do you square that circle, cabinet secretary?