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Yes, they were taken to address all those things. I thank Emma Harper for her reflection on the investment that we are making in predominantly rural and island boards. The national resource allocation committee formula recognises the increased challenges and costs that are associated with delivering services in those areas. Ensuring that the funding allocation for every board in Scotland is within 0.6 per cent of the NRAC formula ensures that there is parity across all boards and that boards that have challenges in delivering services, predominantly in rural and island settings, are able to deliver them. The discussions that I have had with board chairs and chief executives show that there is enthusiasm about what they can do with the increased funding and what they can deliver.

I have clear priorities on expanding primary care and general practice, in particular, and on reducing delayed discharge and waiting times. Those are clear areas of investment in the budget, because I recognise that that is what people need to see from health and social care services in the coming year. We have put our money towards our priorities.

Yes, I am happy to provide that in writing. That budget line is used to ensure that flexibility is available across the year. I cannot remember the exact reason why there has been a reduction, but the overall position for the health boards that we fund is clearly up.

Perhaps Alan Gray can provide more detail.

Yes, that is still where we seek to go. From a cash perspective, we have provided an increase to mental health spending. As Mr Sweeney outlined, there are two areas: the direct spending that is provided by Government and the service provision that is provided by our boards. We are confident that the investment that we are providing via our boards, as well as from Government, will ensure that we meet the needs of the people of Scotland.

Of course, there is a significant area of challenge, particularly after Covid, in people who present with increased and more acute mental health issues. That has been particularly stark in child and adolescent mental health services; however, particularly in those services, there has been a good story to tell for Government and boards, in that there has been a significant reduction in waiting times, and significant investment. Funding has doubled and there has been a near 50 per cent increase in staffing over the period, which has resulted in greater capacity.

Issues still exist in regional areas, and we are working with them to ensure that they meet the wider Scottish standard. The most recently reported figures on child and adolescent mental health services are the best on record and have provided a significant improvement on where we have been, which is a good news story.

We have issues with consultant psychiatric staffing. In those areas, we are working with NHS Education for Scotland in an attempt to provide the required capacity for acute in-patient support as well as support for general practices to provide mental health support from our community mental health practitioners.

There is a range of intervention in the mental health space, because we recognise that it is a growing challenge. That is borne out from the most recent census data, which demonstrates the challenge that people feel with their mental health.

That is a very good question. That is done by negotiation and discussion and by recognising where demand will be. By the way, the £2.2 billion that is coming from my portfolio is an increase of £160 million—I think—that will go into social care. That is taking us beyond the commitment that we made previously to increase social care spending by 25 per cent over the course of this parliamentary session. We have gone beyond that by £350 million. The allocation comes through discussion, predominantly between the finance secretary, who also has responsibility for local government, and me. As I and Alan Gray have set out, there is an increased baselining of local government funding to include social care spending. I am happy to provide greater clarity on that in a follow-up letter.

That is a challenge. We need to ensure that we fairly remunerate our incredible staff and that we incentivise people to choose careers in health and social care even when some of their skills could be deployed in other parts of the public sector or the economy.

I am very proud of the fact that we have provided pay deals—not just this year but in previous years—that mean that, for the majority, our health and social care staff are the best paid in the UK. We have made sure that our consultants are paid competitively compared to consultants in other parts of the UK, and we have matched UK pay review body recommendations for many, including our general practitioners.

Ms Mackay is right that balancing that to ensure that we deliver service sustainability is an important consideration. However, we need staff, including front-line staff, to be able to deliver against the clear objectives that I have set out in relation to the budget. Those objectives are: to reduce delayed discharge, which means increasing social care capacity; to increase the accessibility of primary care and general practice; and to reduce waiting times. We will need to buy greater provision, which means greater investment in staff. There is always a balancing act to be done. That is why we have set out clear support to our boards around the 15-box grid that I referred to in order to achieve recurring financial savings and service improvement to maximise the capacity of clinicians and staff and so that the productivity and efficiency of the system are sound.

The utilisation of innovation to free up clinical time and the advent of the theatre utilisation tool, which is delivering 20 per cent increased efficiency in our theatres, represent more examples of how we can ensure that every penny and every pound that we invest in the health service go further. That helps to ensure that the investments that we are making in our staff, which I am proud to make, can continue and can be sustainably achieved in the future.

I accept that that will continue to be challenging, but it is important that we continue to push for maximum efficiency and productivity in our health service. We need to make sure that every penny and pound that are invested go as far as possible. That is why we have the national conversation, through which we are working with our clinicians—to ensure that reform and improvement are clinically led and managerially enabled—and which is about reducing the areas of low clinical benefit.

It is about making sure that we successfully deploy polypharmacy reviews. We know that the cost to the health service of people who are on multiple prescriptions—10-plus prescriptions—is about £350 million a year. A lot of work is going on to reduce the potential harm that can come from that. Polypharmacy reviews are important in reducing prescribing rates and making sure that we continue to practise realistic medicine in delivering better outcomes for patients. Those are some of the areas that boards can look to and that are in the 15-box grid that we provide to them.

It is also about more positive innovations, rather than feeling that service detriment can come from such decisions. It is about embracing innovation—a point that I know Mr Whittle is particularly interested in—and making sure that we free up greater clinical capacity to deliver the parts of care that can be delivered only by humans and the care, compassion and loving approach that our clinicians deliver. There is a range of areas that our boards can look to.

I recognise that delivering recurring savings will continue to be challenging, because we have asked boards to do that in recent years, too. However, as Mr Whittle said, it is vitally important for the public to be able see the £21 billion budget being delivered as efficiently and effectively as possible and delivering the greatest bang for its buck.

In the 35 seconds that I have available, I will agree that we need to shift to a more preventative model. We have provided a real-terms increase to local government, with more than £1 billion extra in the budget.

I recognise that, as is the case with the health budget increase, there will still be pressures across local government—of course there will be. We have had a decade and a half of austerity that has eroded the potential for investment in our public services. However, the 2025-26 budget directs funding to public service investment for exactly the reasons that Mr Whittle has set out. I very much recognise the extent to which health is affected by many other portfolio spending areas. Mr Whittle gave the example of the role that local government plays in providing leisure facilities and sporting facilities. I hope that the budget will help to support those facilities and that the impacts that he has suggested will occur are not an inevitability, because of the investment that we are making.

Measuring prevention is, by its nature, difficult, because it is difficult to know what you have stopped happening.

However, I recognise Mr Whittle’s point. We can look to a number of areas. For example, we are working with the British Medical Association on how we can get more data through from general practice. Primary care is where the bulk of the preventative activity in health spending occurs. Because the provision of primary care is contracted, it is difficult to have a clear picture of where improvements are happening. That said, according to the most recent figures that are available, the number of GP appointments has gone up substantially. In October, there were 8.3 million interactions across the entire multidisciplinary team in general practice, which represents an increase of almost 900,000 on the previous month. The number of such interactions has gone up by a substantial amount year on year.

We know that the level of engagement has increased and that we need to increase capacity. We need to work with the BMA on how we can record what those interactions are doing so that we can have a greater understanding of what they are preventing. That is what Mr Whittle is asking for, and I know that the BMA is up for that and that it wants to continue to provide the answer to those questions.

A huge amount of work is being done by the chief medical officer, along with clinicians, on cardiovascular disease prevention. That is an area that we are seeking to prioritise this year, for all the reasons that Mr Whittle has set out.

A number of conversations are on-going with local government and health boards around social care provision and national care service reform. We have obviously paused stage 2 of the National Care Service (Scotland) Bill to allow for consideration among political parties, as well as discussion with local government. We are looking at what is possible in the budget, with the £100 million that is there, to improve the picture in delayed discharge. I expect a substantial amount of that funding to go into social care provision and to arrive at IJBs in one way or another, whether that is through health boards directly or through local government.

We recognise that we need reform and that we need to improve financial transparency and accountability, and to take account of the service user and carer voices in the process. All those matters are part of our discussions and considerations with local government and other political parties about the next stage of the National Care Service (Scotland) Bill and how we will deploy the £100 million that is there to improve the delayed discharge picture.

With regard to social care, we have set out in this budget the very clear transfer that is taking place between my portfolio and that of local government to increase the baseline level for social care provision. That is a pretty good story to tell. We have increased social care spending by 25 per cent, as was committed to two years ago. In fact, we have gone beyond that. We are spending an additional £350 million beyond the 25 per cent increase, which takes the health and social care budget commitment on social care to £2.2 billion. That is important, given the impact that delayed discharge has on the whole system and the need for us to have a whole-system approach to ensure that we have a smooth process for patients who seek to navigate it, which we will probably come on to talk about.

Again, if more detail is required by the committee on such known transfers, either in the budget or the budget documents, I am more than happy to provide that in writing, so that you get clarity.