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I will let Professor Linda Bauld answer that.

I certainly do. Of course, I do; I am the public health minister.

That is a challenge in healthcare environments across the board. It is really important that we think about the cultural impact of such legislation. It gives clarity and certainty to people in Scotland. They will know that hospitals do not allow smoking within their perimeters. I think that that alone will reduce the level of conflict in implementing the ban.

There was a lot of concern in advance of the smoking ban about how the ban would be implemented. Before the ban, there was often friction around how no-smoking areas were implemented. The smoking ban brought clarity to the situation. People know that they are not allowed to smoke and that there will be consequences if they do so. It is not simply a matter of appealing to their good nature; there is the potential for issuing a fine should they not comply with the legislation. That brings clarity and reduces conflict.

I would not disagree with anything there. I will not get into the detail of your first comment about the fact that the Government in the UK could change. Scotland has consistently voted left wing—either Labour or the Scottish National Party—for many decades, and we do not always get the Government that we vote for: we get the Government that our neighbours choose. To be frank, that is a fundamental challenge for the health of people in Scotland.

Undoubtedly, I think that, if we look at the issues in totality, Carol Mochan said much that would chime with some of the policies that the Scottish Government is developing. An example is the development of anchor institutions—I will let Michael Kellet say a little more about that. That development is recognition that we have a powerful opportunity through spending on our NHS that could be used to benefit communities. We could use that spending power to ensure, for example, that individuals who are less likely to be in the workforce have opportunities to be employed and trained, and are supported to fulfil their potential. We could use it by bringing in local procurement policies, which would mean that all the things that we have to buy to run the NHS could benefit local communities.

We could use some of the assets that the NHS has for community empowerment projects, by handing over buildings and land to support communities to do what they want. That is a hugely exciting opportunity, and if we get it right, it absolutely will have an impact.

Carol Mochan mentioned the generality of the space that we live in. Again, there is a lot of work on that going on across the board. We talk about 20-minute neighbourhoods. There are different opinions the length and breadth of Scotland about how doable that approach is in some areas, but it is a great concept to have everything you need within walking distance of your house, is it not?

Again, I highlight that it is important to consider the twin challenges that we face—tackling poverty and achieving our ambition for net zero—when we are thinking about what our environment looks like. To be honest, I would like us to think a bit more about them in considering how we deliver our public services.

As public health minister, I am a little tormented, to be honest, by the fact that we keep centralising public services so that people have to travel some distance—often, in my part of the world, by car—to access healthcare and local authority services. We need to think a bit more about how we can deliver such services closer to home. That would be better for people’s health; it would make it easier for them, and would not put in their way barriers that prevent them from accessing vital public services. That would also make a difference in respect of our net zero ambition—think how many journeys are made by people travelling for NHS appointments.

Carol Mochan mentioned early learning and childcare. It was a huge privilege for me to be involved in delivering that policy in the previous session of Parliament. I cannot tell you how significant that social infrastructure investment is; it will benefit children and their families the length and breadth of Scotland.

We found that investment in high-quality early learning and childcare has a direct impact on the individual child. It can literally close the attainment gap before it appears. We know that children from the poorest backgrounds are, when they present at school at the age of five, about 18 months behind their peers in language, literacy and numeracy. High-quality early learning and childcare can reverse that. We need the priority to be on eligible two-year-olds—about 25 per cent of children in Scotland are eligible for accessing provision early—in order to close that attainment gap.

However, the benefit does not stop there—the provision benefits not only the individual child, but their family. I have heard time and again about families who are really struggling. Many of us around the table who are parents will remember tag-team parenting, where one parent comes into the house and the other parent leaves to go to work. A lot of families are living like that, and are living under immense pressure, just to earn enough money to cover their household bills. The provision of high-quality early learning and childcare by the state gives them room to manoeuvre and to have family time, which is really important for them and for their children.

The final point, which is mind blowing—I used to get very excited when I thought about it—concerns the impact of high-quality early learning and childcare. As we see in studies from the US, the impact on the child is not only as they reach their school years and go through their education—it is lifelong. For children who have experienced high-quality early learning and childcare, there is a measurable impact on their parenting ability when they have their own children.

As a Government, how much do we love having policies that can effectively tackle some of the long-standing intergenerational challenges that Scotland faces? We in the Scottish Government are absolutely committed to tackling those challenges. That is why, despite all the economic benefits that come from ELC in Scotland, our ELC provision is absolutely focused on the beneficial impact on the child, and we are ensuring that that provision is high quality.

Michael Kellet might come in here.

I am certainly willing to take on board your view on that. We will be looking at issues around vaping. We have had a consultation on the regulation of vaping, and we will look at some of those issues later in the year. I am willing to take on board your view on that, but, as I understand it—perhaps Jules Goodlet-Rowley can come in on this—primary legislation would be required, because the original act, which allowed me to bring the SSI before the committee, did not include vaping. We would be required to look at primary legislation on vaping, and that would be an altogether larger task. However, I am certainly willing to keep that on the radar and include such provision should the opportunity arise in future.

We try hard to make all our legislation evidence based. The evidence on second-hand harm from vaping is not particularly solid or clear yet, and I think that it would be hard to introduce primary legislation on that front right now. However, I ask Jules Goodlet-Rowley whether she has anything further to add on that. She is more familiar with the 2016 act than I am.

In a perfect world, we would have foreseen that technology when we wrote the original legislation.

You are absolutely right to talk about how smoke drifts into hospital buildings from outside. For 20 years, I worked as a hospital pharmacist. I have asthma and am one of those people in the workforce who would wheeze as I accessed areas of my workplace where smoke was. Our air conditioning literally pulled smoke in from the smoking area and pumped it into the ward. That is not unusual.

We need to think about the exposure to second-hand smoke that such things cause for staff, patients accessing care and everyone who visits the hospital. That is why the measure is really important. When it comes to raising its profile, today is a busy news day, but I suspect that it will make the news when it is introduced, and be covered by our national news outlets. I also expect the signage at hospitals to be clear.

The two-week run-in—which was not our intention—gives a little time for awareness to be raised about the change on smoking around hospitals, before people face fines for breaking the rules. That is probably helpful. I would hope, therefore, that there will be absolute clarity to everyone that people cannot smoke near hospitals.

Thank you for the question. I will focus on what the Scottish Government can do, but we cannot ignore the fact that, as I have highlighted to the committee before, it feels as though I am working with one hand tied behind my back. What the Scottish Government gives with one hand, the UK Government takes away with the other.

The unwelcome reality is that health inequalities are widening, including the gap in health life expectancy. That is completely unacceptable, and we know that we need to do more, particularly on the implementation gap. We recognise that addressing the wider determinants of health such as poverty and inequality requires cross-Government working and partner-led action. The answers to health inequality do not lie simply in my public health portfolio.

Where potential levers for tackling poverty are reserved, we will continue to put pressure on the UK Government to rethink its social and welfare policies, for example, which absolutely help poverty to persist. We are introducing extra social security programmes that are well beyond anything that the UK Government offers.

We know that we have a lot still to do to tackle the determinants of health where we have control of the levers, and we are making progress in a lot of key policy areas. For example, with the child poverty delivery plan, we are putting money into the pockets of families now, helping to tackle the cost of living crisis and setting a course for sustainable reductions in child poverty by 2030. I have already mentioned the game-changing Scottish child payment, which is £20 and will increase to £25 when it is extended to cover under-16s by the end of this year. Our five family benefits, including the Scottish child payment, will be worth up to a maximum of £10,000 by the time a first child turns six and £9,700 for subsequent children.

We have extended our fuel insecurity fund by making available a further £10 million to third sector organisations to support people who face fuel insecurity. That means that we have allocated more than £1 billion since 2009 on tackling fuel poverty and improving energy efficiency. That particular policy area highlights the challenges for the Scottish Government in fully tackling those issues. My constituency of Caithness, Sutherland and Ross is the furthest north mainland constituency in Scotland, and we pay the highest prices in Scotland for our electricity. Indeed, we pay more for our electricity than people down here in the central belt do, despite the fact that we are net producers of green energy. We are also, in large part, off the gas grid, so electricity is a really important source of energy for us.

However, the matter is fully reserved to the UK Government, which has chosen, through its policies, to continue that injustice. In my constituency role, I wrote to the Chancellor of the Exchequer about six weeks ago, but I have not even had the courtesy of a response yet. The UK Government has no interest in fixing these appalling injustices and, as a result, many of my constituents where I live in Scotland are living in extreme fuel poverty, entirely because of a UK Government policy choice.

I think that it is 5 September and that two weeks later—on about 20 September—the SSI will mean that environmental health officers can use fixed penalty notices.

Thank you for inviting me to give evidence to the inquiry today. I am aware that, last month, my officials and Public Health Scotland took part in a private session with the committee at which they outlined the range of work that we are undertaking to support a reduction in health inequalities. I was pleased to hear that members found the session useful.

We have made many positive changes. However, I want to be up front about the challenges that we face on the issue. Scotland’s long-standing health inequalities are fundamentally about income, wealth and poverty. The recent report from the University of Glasgow and the Glasgow Centre for Population Health attributes stalling life expectancy trends in Scotland directly to United Kingdom-led austerity measures. The report makes a number of key recommendations, including protecting the real incomes of the poorest groups, especially with the currently escalating inflation rates. The evidence strongly suggests that implementing such measures would reverse death rates and reduce the widening health inequalities that we see.

We are doing all that we can to mitigate the impact of such policies. The introduction of the Scottish child payment of £20 per week is just one of the measures that we are taking to mitigate the adverse impact of UK Government-led reforms and to put money back into the pockets of the people who have been hardest hit. We have more than 200 community link workers across Scotland playing a vital role in supporting people with issues such as debt, social isolation and housing, and our welfare advice and health partnerships are now well embedded in 150 general practice surgeries in Scotland’s most deprived areas. However, we simply do not have all the levers at our disposal to tip the balance and change the trajectory on life expectancy.

I have stressed in previous debates and evidence sessions that the Parliament needs to be a public health Parliament in which all parties come together to consider how we work jointly to tackle issues. Our work on child poverty provides us with an opportunity to live up to that expectation. It is a national mission and our commitment to wide-ranging action is demonstrated by the work that is taking place across portfolios to consider outcomes for children and young people. It includes a collective focus on what we are doing in childcare, what we are doing to support people into work and what we are doing to support those who are furthest away from the labour market. None of it is easy and we are learning as we go, but that is precisely the approach that we need to address health inequalities across all the social determinants of health.

As part of the strategic reform of health, our emerging care and wellbeing portfolio is creating a sustainable health and social care system that will promote new and innovative ways of working. That includes our place and wellbeing programme, which is bringing together all sectors to drive change jointly and locally to reduce health inequalities.

An example of that is our work on positioning national health service and social care providers as anchor institutions in our communities, working with others such as housing associations, local government and universities to nurture the conditions for health and wellbeing. NHS and social care providers are significant sectors across Scotland, and they are well placed to provide opportunities in local communities by increasing access to employment in health and care and making available NHS land and buildings to support communities’ health and wellbeing.

Our role is to enable local change, not dictate what form it takes. The voice of people with lived experience will be crucial in guiding and shaping local action on health inequalities. To reiterate, we all have a collective responsibility to address health inequalities—it is not the sole responsibility of health and social care. I am committed to playing my role in that endeavour.

There is a real appetite for change among us all. That consensus and that support are both welcome and necessary, and I am pleased that we are having an open and honest discussion on the subject.