Seòmar agus comataidhean

That ignores the £200 million in the budget that is allocated to waiting times improvement and improvement in capacity in relation to delayed discharge. Those budget lines—the £200 million—are not just about meeting immediate need and delivering capacity; they are also about working with boards to have a sustainable service delivery model that means that they provide health service and social care capacity on a sustainable basis. That is about reform and improvement, as well as meeting the immediate demand that we all know exists for us to address waiting times and delayed discharge.

The point that Mr Gulhane makes ignores some of the investment that is being made elsewhere in the budget.

In spite of our investing a significant amount on a record increase to bring health and social care spending to record levels, there are challenges remaining, and there will be boards that continue to face financial challenges. The financial delivery unit will keep working with them, and we expect those that are on the escalation framework to continue to progress towards becoming more financially sustainable.

I have a number of points to raise. Providing greater certainty over funding allows for longer-term planning; I made that point in response to questions from Mr Whittle and Mr Sweeney. Bringing down the level of demand, particularly on secondary care services, and shifting the balance of care into the community, will be of critical importance to achieving greater financial sustainability in health and social care services.

Improving the health of our population is also critically important. I made the point on “The Sunday Show” with Martin Geissler that one of the most important things that individuals can do to take responsibility is to take advantage of the vaccination programme, if they are eligible for it. It is good for people in terms of preserving their health, but it is also good for the health service because it reduces the demand that arises from, in this case, respiratory conditions such as flu, respiratory syncytial virus and Covid, which tend to spike at this time of year.

We continue to invest in breaking down barriers to people looking after their own health and wellbeing better. That comes through the likes of the community link worker network, as well as the investments that we are making in sport, physical activity and wellbeing, and the impact that the culture budget spend will have on our health and wellbeing, particularly our mental health. As a former culture minister, I know that that expansion is good in its own right, but it also has the opposite impact to what happened during Covid, when not being able to go out and experience culture and leisure services had a clear and demonstrably detrimental impact on people’s mental health. Expanding provision and increasing access in those areas can have a virtuous and positive impact. A number of areas that are outside the health budget help to improve our health and wellbeing.

Finally, we are making investments to reduce child poverty on a wider Scottish budget and cross-portfolio basis. Poverty is one of the greatest drivers of ill health and health inequality. By addressing child poverty, we can also increase the health of our population and reduce demand on our health services. I can therefore point Mr Torrance to a number of areas that help to make our health service more sustainable.

Yes. All potential capital projects that have been on the stocks will be part of that consideration, as well as anything new that has come through. Clarity on all that will be provided at that time.

We are adopting innovation that is coming through the academic sphere, the private sector and our staff. There is incredible innovation, particularly on clinical pathways and clinical governance, to do things in a more efficient way. Our staff are doing fantastic work there, including through the skill projects and the Scottish infection prevention and control education pathway.

AI provides a particular opportunity, as does the digital side. We have already seen the beneficial outcomes of that from a radiography perspective in the cancer space. We need to make sure that we get that right, and that we do it in a safe and ethical way, but I go back to my earlier point about embracing innovation that can free up clinical time, so that our clinicians can deliver more human-to-human caring, which is so important.

The chief scientific officer for health, Dame Anna Dominiczak, is working incredibly hard in the Triple Helix Group, which brings together industry, the health service, Government and academia to make sure that our health service and our economy get the maximum benefit of the innovation that is coming through.

I point the committee to Dame Anna’s work as something that addresses some of Emma Harper’s queries. There is a huge opportunity before us, and I am determined to ensure that our health service is better able to embrace and support the innovation that is coming through and those who are investing in innovative technologies so that they can be adopted more quickly in the health service. That involves a cultural shift, as well as a practical and structural shift, in the way that the health service operates. I am, however, determined to do that, because I cannot see us having successful reform and improvement without adopting greater innovation. It has to be central to the plan.

The short answer is yes, and the long answer is that we have gone beyond that. The funding that we have raised from our more progressive income tax policy means that, this year, we have £1.7 billion more resource to allocate to public services. That means that we are able to invest across Scottish public services to a greater extent than if we had followed UK spending plans.

Again, I am more than happy to provide additional information, but the policy remains that all consequentials for health are passed on in full.

I will attempt to be pithy, convener.

Alan Gray is right that, where hospital occupancy is sitting as high as it is at some acute sites, our clinicians’ ability to meet the patients’ needs and the efficiency of the flow of the hospital are reduced.

Hospital at home is another incredible example of how we can meet patient needs and expectations. Patients are treated literally in their own homes and are kept at home for longer. Our investment in the budget will take us on a pathway to reach 2,000 hospital-at-home beds by the end of 2026, which would make hospital at home the largest hospital in Scotland. That is right for patients and for the health service, and that is why it has been an important innovation in the NHS over the past years.

I do not remember saying that winter pressure is not as bad in reality. I am not sure where Mr Gulhane’s reference comes from.

There is pressure at all times of the year, and our health boards need to be able to have a surge capacity response to meet the demands on them. For example, at the peak of the last wave of Covid-19 in the summer, 600 beds in Scotland were taken up with Covid patients, which is equivalent to the capacity of Wishaw general hospital. We have pressures in winter, but that example illustrates that pressures and surges can happen throughout the year. That is why it is important that we give our boards the flexibility to be able to respond to those in ways that are right in their areas.

On what Mr Gulhane referenced in relation to NHS Tayside, the budget is about creating greater capacity in the health service to meet scheduled care demand and planned care and to reduce waiting times. We are working right now at increasing that capacity and ensuring that we can have a better run rate so that more patients are treated. We will eat into and erode the longest waits so that patients can get the treatment that they need.

Sorry, but will you repeat that? I missed what you said.

We are considering the recommendations carefully. There is a lot in the report that demonstrates the progress that we have made already. Some of the recommendations, such as strengthening local leadership and providing greater transparency, are areas in which we are already developing work. We welcome the report, and we are still considering our direct response to each individual recommendation, as the report was published only on 31 October.

We take seriously all the commentary that comes from Audit Scotland in general and in this area in particular. We will consider all the recommendations carefully and respond in due course.