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Yes—we all do. All those who are at leadership and decision-making levels have responsibility and accountability for delivering health and social care services. Sandesh Gulhane is right that, ultimately, I am the health and social care secretary and the buck stops with me. That is why I am determined to show the leadership that I can to deliver against the priority areas with the budget—reducing waiting times, increasing access to primary care services and reducing delayed discharge. If we achieve against all those areas, we will improve the system for our patients and create a more sustainable service, which is what we all want.

I will make several points to Ms Mochan. First, reducing alcohol-related harm, as well as drug-related harm, is a clear priority for the Government, and it is one that we continue to invest in.

Secondly, on the resource that is going in, there is a cash increase to our alcohol and drug partnerships. I have already pointed to the additional £19 million of baseline funding, which is to give greater certainty to our alcohol and drug partnerships and will enable them to employ people in the projects that they are delivering for a longer period, rather than on a short-term basis. As a result, they will be able to deliver more sustainable services.

Thirdly, I point to our work on wider interventions. We have already increased the minimum alcohol unit price, which has had a demonstrable impact on reducing alcohol harm through fewer hospitalisations and deaths. We are also working with Public Health Scotland on alcohol advertising and on whether greater impact could be made, using an evidence-based approach, by using further restrictions. I expect Public Health Scotland to report back on that in the coming months. If further intervention is required from the Government, we will take those opportunities. There are a number of areas that we are investing in.

Lastly, the investment that we are making in our alcohol and drug partnerships includes £60 million a year for the drugs mission and reducing drug-related deaths, which takes us to £250 million across the lifetime of this Parliament. That supports the capacity for our alcohol and drug partnerships to ensure that they can meet the demands from people with alcohol dependency and from those with both an alcohol dependency and a drug dependency. I believe that that is making a demonstrable difference, and that we will continue to make progress. That is, in part, thanks to the investment that has been made; it is also due to the incredible work that has been delivered by the staff in the partnerships and those in the community and voluntary sector who are supplementing that.

We can certainly look at that. I do not know whether Alan Gray has more information on it than I do.

Like Mr FitzPatrick, I am particularly pleased with where the IJBs in Tayside are on that. That has come about after a number of years of work in which the whole system has been geared towards responding to need. The whole system has bought into the way that the service is run and into ensuring that there is a good flow.

Mr FitzPatrick is right that there is not the same consistency in other parts of the country. I do not know whether I have done this in the committee, but I have certainly pointed out in the chamber the service difference in NHS Ayrshire and Arran, for instance. There is significant variation between the best performing IJB in Ayrshire and Arran and those that are struggling a bit more. My officials continue to work with the areas in which we need to see improvement.

This is not all about social care or local government; it is also about recognising that, from a healthcare perspective, we must get clinical pathways working well and efficiently. We should have in place discharge-without-delay processes so that we understand predicted dates of discharge and have discharges before noon and weekend discharges. All those things should be happening in the health service.

Where the best services are being delivered, there are clear and strong relationships between acute services and the community. I point to the phenomenal work that has been done in NHS Ayrshire and Arran on the frailty assessment units in the acute sites at Crosshouse hospital and University hospital Ayr. That has made a demonstrable difference for people with frailty who arrive in accident and emergency departments. There are better lines of communication between our unscheduled care services and those in the community, so there are better connections and people are able to be discharged before being admitted into the wider hospital. The best way of reducing delayed discharge is by avoiding admissions in the first place. The work that we are doing through the investments in this financial year is about ensuring that we have those strong and sustainable frailty assessment units across Scotland.

The clear lesson from NHS Tayside is that good, strong integration between health and social care services and community services is paramount. My team and the Convention of Scottish Local Authorities are working very closely to achieve just that.

I do not think that it is an either/or. We have to address hospital capacity. Hospital occupancy rates across Scotland are far too high and there are people in hospital who have been there for too long. The lengths of stays in hospital are too long, and one of the drivers of that is delayed discharge. There are people who stay in hospital for far too long, and we need to get them out into the community.

Artificial intelligence is an option if the technology is available for us in that regard. However, as I said to Mr FitzPatrick, proper collaboration between our acute sites, the community and our health and social care partnerships is critical in ensuring that we recognise and address the needs of individual patients. I saw evidence of some of that work in East Lothian when I sat in on a morning huddle in which we looked at what work was being done to get each patient in an acute setting back into the community.

As I said, some of the pressure in our hospitals, with the performance of our accident and emergency departments sitting at too low a level, is driven by hospital occupancy rates being too high, the lengths of people’s stays in hospital being too long and, as Mr Whittle set out, people not moving back into the community—into their own homes or other facilities—quickly enough. The £100 million that we have set out is about addressing those issues and allowing primary care to hold more patients in the community for longer.

We need to invest in all those areas, because we need to take a whole-system approach in order for things to work. We need to look at all possible avenues and opportunities, including the use of technology and direct resources.

I will be accountable for the progress that the budget is able to make. I am confident that we will be able to reduce waiting times. The investment that we will make, which I hope colleagues round the table will recognise is needed and which I therefore hope that they will vote for, will deliver £100 million of greater capacity in scheduled care. That will allow a capacity increase, which I hope will be sustained, to address our waiting times.

We estimate that that funding will provide 150,000 patients with treatment, whether that is surgery or diagnostic scopes and scans. That will enable us to reduce waiting times by March 2026, which is a critical commitment in the budget and one for which I will be held to account. We are working with our boards—particularly those that have regional or national centres such as the Golden Jubilee hospital and our national treatment centres—to ensure that they are able to maximise their capacity and run rates so that we can get through those patients.

I recognise that, if anybody waits too long for treatment and care, their wider health and mental health can deteriorate. Some of those patients then pick up other issues and conditions, which we want to avoid. That goes back to the point about prevention. We can deliver various levels of prevention and, by reducing waiting times, we can reduce the impact that some of those conditions can have on a person’s wider health.

Reducing waiting times is a fundamental priority and I have set it out in the budget. The £30 million that was invested this year has made a demonstrable difference and started to reduce some of the longest waits across Scotland. It has provided a starting point of capacity that we need to build on, and that is happening as we build towards the £100 million coming into place in April.

That is a fair challenge. I am answering questions about where we are now. We will invest in the health service to reduce the longest waits. We have embarked on that, with the starting point being £30 million this year, and £100 million will come into the budget next year. That is to ensure that we reduce the longest waits, because I recognise that we are not where we want to be. I accept the fact that we have not made the progress that we want to make.

That being said, I have confidence in the plan that is before us to build on the £30 million that came through last year and the £100 million that is coming from April. We are investing capital and resource to make sure that we increase capacity and are directing capacity towards the national treatment centres and regional hubs to ensure that we maximise the efficiency and productivity of the system. I am confident that we will meet the commitment that we set out in the budget.

Of course, that funding can arrive only if colleagues round the table vote for it and a budget is passed. Because the Scottish Government does not command a majority in Parliament, if we want waiting times to improve, we need to vote for it. That will be an important consideration for all of us in the coming months.

Good morning, convener and colleagues. I am very pleased to be here to talk about the health and social care aspects of our proposed Scottish budget.

The budget sees record funding for health and social care, with more than £21 billion for the portfolio. The budget will help to deliver progress for Scotland’s health and social care services, as well as lay the foundations for longer-term reform and improvement.

It is a budget for delivery that directly addresses the issues that people are most concerned about and that will support our services, ensuring that they are effective, efficient and sustainable. The budget will empower our reform programme to make those crucial services fit for Scotland’s future.

The significant budget allocation includes an increase in our capital spending power of £139 million from 2024-25, as well as a commitment of almost £200 million to reduce waiting list numbers and delayed discharge. We will continue to focus on the reform and improvement of the performance of our services by deploying existing resources more efficiently and effectively, and we will continue to take decisive action to support delivery against the reform vision, which I outlined to the Scottish Parliament in June.

The budget will support measures to improve population health and early intervention preventative measures that will be delivered through effective primary and community care services. As such, we will prioritise and increase access to and capacity in primary care, including by supporting services in general practice, and we will enable the use of measures to sustainably treat more patients in community settings. That includes support for the expansion of hospital at home; immediate investment in general medical services to support critical services; general practice stabilisation and other primary care enhancements; additional support for general practice; a critical dental workforce and training package; and a community eye care programme that will transfer patients from waiting lists.

Central to the operation of our health service are the health boards, which will receive more than £16.2 billion in total from the proposed budget. That sum includes funding to honour commitments to fair pay settlements for our health workforce.

As outlined in the budget document, our commitment to renew and reform our national health service means that we will seek to start work in 2025-26 on delivering a series of new acute care facilities.

The formula is under review, and we continue to review it. It is a very complicated financial system, and unpicking it could have unintended consequences, so we need to ensure that, if we change it in any way, we deliver improvement rather than detriment.

I do not have a timescale for when we expect to publish any commentary on the NRAC formula or reach a decision on whether we change it. The important principle in the budget is that the budgets for all boards are within 0.6 per cent of the NRAC formula, so there is no detriment to any territorial board across the country. All of them have parity in being able to deliver services, and we will keep the NRAC formula under review.

I will bring in Alan Gray in a second to provide more detail on that. First, I note that I did not use the words that Mr Sweeney used to describe the situation on mental health services. I said that there is a challenge, and I want it to be clear that I recognise that there is a challenge. For some people who are waiting too long to access services, Mr Sweeney’s description would be apt, but that picture is not faced by everybody in the system, nor is it faced by every mental health practitioner—although, again, I understand that those practitioners who are under pressure will recognise the description that Mr Sweeney used.

I will bring in Alan Gray now to determine issues around the budgetary situation.