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Good morning, convener, and thank you for the invitation to discuss the Scottish budget and what it means for Scotland’s health and social care services. The budget includes funding of more than £19.5 billion for the continued recovery of the national health service—our health and social care system. The budget provides an uplift that exceeds front-line Barnett consequentials. It means that resource funding for health and social care has more than doubled since 2006-07.

Despite that investment, the system is under extreme pressure as a result of the on-going impacts of Covid, Barnett, Brexit and inflation, and United Kingdom Government spending decisions have also resulted in hard choices, as greater efficiencies and savings will need to be made. However, investing in Scotland’s NHS is non-negotiable for this Government. The budget settlement gives our NHS a real-terms uplift in the face of UK Government austerity. Crucially, it includes more than £14.2 billion for our NHS boards, with an additional investment of more than half a billion pounds.

The budget supports investment in excess of £10 billion for the NHS pay bill, rewarding our dedicated and skilled NHS staff for their work in recent years. There is more than £2 billion for social care and integration, which means that, two years ahead of our original target, we are delivering on our programme for government commitment to increase social care spending by 25 per cent over this parliamentary session. It provides an additional £230 million to support delivery of the pay uplift to a minimum of £12 per hour for adult social care workers in the third and private sectors from April 2024, representing a 10.1 per cent increase for all eligible workers.

We continue to invest in quality community health services to support our prevention and early intervention priorities. That includes investment of more than £2.1 billion for primary care and supporting spending in excess of £1.3 billion for mental health.

We will continue to work with partners to address the challenges that the settlement brings and to take forward the reform that is essential for the delivery of a sustainable health and social care system as well as high-quality services. I am happy to respond to any questions that members have.

I have heard that argument a few times, but I do not quite follow it. There are other professional regulatory bodies that cover supplementary groups; for example, in pharmacy, the regulator covers groups other than just pharmacists. I do not follow the argument that, in some way, the GMC taking on the role of regulating PAs and AAs will cause public confusion around the role of the GMC. If you have a complaint to make about a PA, an AA or a doctor, and their responsible regulator is the GMC, you take the complaint to the GMC. I do not follow the argument that, for some peculiar reason, it will become confusing if the GMC regulates two other groups besides doctors, given that other regulatory bodies do that and it does not appear to cause any difficulty for the public when pursuing a complaint or an issue with the relevant regulatory body.

The total budget for social care in 2024-25 is just over £1 billion and, in 2022-23, it was £879.6 million. That is a £200 million-plus increase, which is a reflection of the additional investment that we are putting in to increase pay in social care.

I do not think that I have a figure on what we inherited. I would have to come back to you with that, because that goes back to the 2006-07 budget.

NHS Grampian is taking the project forward. Through NHS Scotland assure, we will provide the health board with as much support and assistance as we can to ensure that it gets these things right and addresses any changes that have to be made. However, I am afraid that there is no additional headroom in the capital budget, given the cut to that budget by the UK Government. That has a direct impact not only on capital projects relating to health, but on capital projects right across the Scottish Government, so any additional costs will have to be met within the overall project budgets.

I am not sure whether we have enough flexibility. That brings me back to the point that Carol Mochan made about the challenge that we face in giving organisations budgets to take programmes forward over the year that then have to be adapted and changed in year when we get information about something coming on to the market. I will have to think about what more we can do to allow some flexibility in that respect.

With regard to vaping, the sector has grown to quite a marked degree—indeed, it has grown exponentially—over the past number of years. It is associated not only with health issues but with environmental consequences, and there is a need for stricter regulation around it. In fact, we are taking forward the joint consultation with the other nations to look at what further restrictions should be put in place. There is no doubt in my mind about the need for proactive action on the part of Government in the preventative space.

I will take away your point about in-year flexibility, but I am conscious of some of the challenges that we face with regard to the way in which we fund organisations if we are looking for them to adapt in the course of a financial year.

I do not know whether it will make that easier, but it will give us the ability to be much clearer about the outcomes that we are looking to achieve with that investment and the public expenditure that goes into social care, and it will give us the ability to seek to achieve much more consistency.

It has benefits for staff, such as allowing for collective bargaining, which I know is an important issue for trade unions. The creation of a national care service will be critical to supporting us to achieve a more attractive place for folk to work, greater consistency in how services are delivered, and better alignment with the needs of our NHS. It will also help us to get greater consistency in how funding is used and ensure that it is being used to achieve better outcomes for individuals who need to make use of those services, in a way that we do not have at the present moment.

There were no significant works and there was no major disruption to services. In the few areas where work was needed, it was done as part of normal routine maintenance work.

The capital budget for the Baird hospital and ANCHOR centre projects is what was originally agreed. Within the overall project—

Yes, I think so. There is always an ambition to invest much more in preventative healthcare where we can. That is challenging when we are in a very difficult financial environment and given the significant demand that services are facing. Notwithstanding that, however, we should do that where we have the opportunity. We have committed to exploring issues around a public health levy over the next year and I think that, if its introduction is agreed to, it would provide an opportunity for investment in other areas of preventative spend.

We should also recognise that innovation in technology can play an important part in some of the preventative approaches that we pursue. I mentioned the work on diabetes. New digital technology could have a real impact in reducing the side effects that people can experience as a result of diabetes and in helping them to live more healthily. We know that that will have a preventative effect in the future because of the benefits that come from it. We know that the use of AI in radiography can help to identify issues at an earlier stage and allow for earlier intervention, which could further reduce expenditure in the future.

Technology and innovation can play a really important part in ensuring that we do more in the preventative space, and any additional investment that might come through a public health levy in future years to support that would be very welcome.

You are right that mental health services are about 8.8 per cent of our expenditure at present and I hope that we will have those services at 10 per cent by the end of this parliamentary session. That will depend on future budgets and the availability of finance, but it would certainly be our intention to do that. As I said earlier, however, there has been a very significant uplift in mental health expenditure since 2020-21. The level of Scottish Government investment in the area has more than doubled, but 10 per cent is still our ambition. We are at 8.8 per cent and we need to look at whether budgets in future years will allow us to continue the increase to achieve a 10 per cent allocation.