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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 4 April 2025
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Displaying 1046 contributions

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Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

I have set out the £2.2 billion allocation in the health and social care portfolios. The wider Scottish budget will take social care provision to almost £6 billion—across the wider spend that is contributing to provision—but the direct funding that comes from my health portfolio will be £2.2 billion.

Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

We are looking at a wider cross-government infrastructure investment plan, to be delivered after the UK Government’s spending review in the spring. Once we—as we hope we will—get multi-annual funding and greater certainty around the capital position, that will allow us to have greater certainty around our capital plans.

I and others across Government wanted to make sure that we are able to take forward capital projects and to lift the pause on health capital spending. That has been illustrated through the investment in the Belford hospital, the eye pavilion and Monklands hospital. Monklands is in my constituency, so I am recused, from a Government decision-making perspective. Those are important areas of investment that we need to take forward. The capital investment that comes through the budget allows those projects to progress, but the big decision-making points will come after the UK spending review and publication of the infrastructure investment plan thereafter.

Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

In the interest of time, I will provide the answer to the RAAC question to the committee in writing. We are aware of the situation in the health service and we support boards in relation to the immediate mitigations and the remedial works that are required.

I take the issue of net zero very seriously. It can be both a capital and a resource revenue investment opportunity. Again, I would be happy to provide in writing some information on the areas that we are looking at. I am exploring that issue right now, particularly on the revenue side, and I would be happy to provide more detail in writing to the committee, when that can be published.

Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

I do take that seriously, and I recognise why Mr Whittle raises that question. He has a far more illustrious athletics background than I do. My athletics career was cut short although, even still, I do not think that I would have been as fast over 400m as Mr Whittle was.

Seriously, I very much recognise the point that he is making. I want to make sure that the opportunities that were afforded to us to access sporting and leisure services are afforded to my children. I have set out to colleagues across the committee my recognition of the impact of investment that is beyond what we would deem to be health and social care spending and is preventative. That can be in our sporting and leisure facilities and in our cultural estate. I recognise the point that the member is making.

I will come back to Mr Whittle on the active healthy lives funding and the sport funding, so that he gets greater clarity on our intention and how we are providing support to sporting organisations and those who provide the phenomenal opportunities that exist across the country. That is something that he and I witnessed at the most recent sports awards, where we saw incredible dedication, from community and grass-roots level, right up to elite level in Scotland. We should be incredibly proud of that and continue to support it.

I will provide more information for Mr Whittle on that.

Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

I understand Mr Sweeney’s question. It is a difficult situation. Whether it is in the health and social care budget or any other aspect of revenue and resource spending across Government, providing comparators can often be difficult, when in-year revisions take place because of Barnett consequentials or other in-year changes.

Obviously, we are looking for greater certainty on what our budget will be, which would be helped if United Kingdom Government spending reviews gave a greater trajectory towards what our financial allocations will look like. We also want to ensure that we have a stable budget that is balanced over the year. Due to the impact of austerity and spiralling UK inflation, we have had to make in-year budget revisions over the past couple of years, which we want to avoid doing this year. We want to give certainty to the system about what is coming forward.

With regard to providing clarity and detail, we are more than happy to provide written confirmation after this evidence session on the points that Mr Sweeney raises about the comparisons between one budget and the next or, indeed, between autumn budget revision and budget positions.

Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

Gillian Mackay points to what I think is the greatest risk that we have in the coming year, not just in health and social care services but across the public sector, and that is the impact that the rise in national insurance contributions will have.

We do not yet have clarity or certainty about what that impact will look like. We know that, across the entirety of the public sector, including people who are contracted to deliver public services, such as GPs, social care providers, dentists and people in the community and voluntary sectors, the cost to Scotland will be approximately £750 million. We have had an indication from the UK Government that it will cover somewhere between £290 million and £350 million, which means that we will have an immediate substantial deficit of £400 million or more.

The funding that has been suggested thus far by the UK Government is only for those who are directly contracted in our public services; it does not cover people such as GPs and social care providers and people in the community and voluntary sectors, universities and so on. We face a substantial risk. We know from social care providers, including some GPs that I have spoken to, that the rise represents an existential risk for some of them.

The UK Government has rightly sought to raise revenue, but I do not believe that it understood the implication of choosing to raise that revenue from employer national insurance contributions. That is evidenced by the fact that we still do not have clarity in terms of what it describes as the mitigations relating to the damage that the move will cause. It could have chosen other ways of raising the revenue that is required to start to unpick austerity. It made the wrong choice, and that will have potentially catastrophic implications for not just health and social care services but public services in Scotland and across the UK. That is why I hope that committee colleagues will unite with the Scottish Government in saying that the issue must be quickly resolved at source by the UK Government, so that we can provide certainty to those employers—our GPs, social care providers and so on—that are seeking to make employment decisions right now but have no certainty about what their national insurance position is going to be.

Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

Some of those providers will be disproportionately impacted because of the nature of the route that has been chosen by the UK Government, such as those with a higher number of staff who are paid at a lower salary rate.

One of the other issues that I believe is going to be problematic is that those who are contracted to provide more than 50 per cent of their business within the public sector will not be eligible for some of the relief that the UK Government has proposed. That, again, serves to illustrate to me that the move has not been properly thought through and that the UK Government has chosen the wrong area from which to raise revenue.

Again, I underline that the UK Government should raise revenue to invest in public services to start to undo the damage that austerity has done. The revenue that has been provided to the Scottish Government through the budget is very welcome—it starts to make progress. It does not answer all the questions from the Scottish Government or, indeed, other Governments. I genuinely believe that the UK Government went down the wrong route on raising revenue and that there will be clear and stark unintended consequences that it will have to resolve—and quickly.

10:15  

Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

Yes, I absolutely recognise that, but my point is that, when someone does not need an appointment, it is difficult to understand whether they would have needed an appointment in the first place.

Our preventative activity is about reducing the overall level of interaction with secondary care services, in particular. We want to reduce the level of acute admissions and to stop the escalation of people’s ill health. All that is wrapped into what we are seeking to do in the budget, especially with the £200 million that we have set aside for reducing waiting times, addressing the efficiency of flow in the system and reducing delayed discharge. That involves providing capacity to our social care providers and our primary care providers.

The issue is not only about general practice. We have a huge opportunity with ophthalmology in the community and from encouraging greater utilisation of our pharmacy first programme. A range of interventions are available. However, I again point to the fact that not all prevention will be achieved through health service intervention. Mr Whittle and other members have spoken about the importance of our sporting and leisure facilities, as well as that of cultural and other public service interventions.

Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

Part of the discussion that we will be having with IJBs is about the deployment of the £100 million for improving the delayed discharges picture and ensuring that IJBs have the resource and certainty available to them to allow investment in care packages and care home support.

Mr FitzPatrick asked what my expectation would be. The reduction in the levels of reserves that Alan Gray has just narrated meets the fact that there is pressure across the public sector. I do not think that anyone would expect there to be high levels of reserves sitting there when there is fiscal pressure across public services. Those things need to be balanced. I acknowledge Audit Scotland’s report in that respect, and the Auditor General’s concern about ensuring that there is financial sustainability going forward.

We must continue to work with our partners in local government and health boards to ensure that there is funding sustainability for our IJBs so that they can continue to meet service demand and be sustainable over time. We need to ensure that that is a smooth process. Alan Gray talked about ensuring that the allocated reserves are there to allow investment over time and allow some of those multiyear projects to be delivered.

Health, Social Care and Sport Committee

Budget 2025-26

Meeting date: 17 December 2024

Neil Gray

Sandesh Gulhane is right that there is an oral health inequality, but it has reduced substantially. I hope that Alan Gray has access to the figures. Child oral health inequality has reduced substantially. We have seen a reduction in the number of children who arrive at dental services with cavities, so the childsmile programme has clearly made an impact and reduced inequalities.

The reason why we have invested in general dental services and reform of the funding for NHS dentistry is to ensure that our dentists find carrying out NHS work more attractive. That is also why, in the budget, we are investing in increasing the number of dental training places so that we can increase the number of dentists coming into the system. We are increasing the number of Scotland-domiciled dental places by 10 because we recognise that it is an incredibly competitive environment for potential students to go into and we want to ensure that we maximise the number of dentists who come into the health service.

I am happy to provide greater detail on the reduction of childhood dental health inequality in the follow-up correspondence. The information gives a good summary of the progress that has been made and the impact that childsmile has made. I think that Mr Gulhane will welcome that.