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Mairi Spowage, you said that one of the solutions lies in ensuring that there are positive destinations for our children. You also talked about the green economy and green economy jobs. That plays directly into the first two questions, which were about joining up portfolios under the banner of the wellbeing economy. Does the current review of the budget lend itself to helping to increase those green economy jobs in Scotland?

Good morning. Having listened to the conversations that have taken place this morning, I am trying to find a way to frame what I want to say. I know that “build back better” is a buzz phrase, but I think that, post-Covid, we should do that by taking the opportunity to create a wellbeing economy; we should always strive to have a wellbeing economy.

However, the perpetual issue, which has been exacerbated by Covid and the cost of living crisis—or “cost crisis”, as it has been described today—is that the health and social care budget accounts for 44 per cent of the Scottish Government’s total budget; we have the unhealthiest nation in Europe. Yesterday in the chamber, I had a conversation with the Cabinet Secretary for Health and Social Care about the fact that people who are turning up at services are sicker than they were before the pandemic. That problem will be exacerbated, so there will be much more of a pull on resources for NHS services. That money has to come from somewhere.

Sarah Watters highlighted the fact that there is increasing pressure on council and third sector budgets, and that—perversely—putting more pressure on those budgets puts more pressure on the health of the nation. The Government has brought forward the spending review. Does that give us the ability to tackle the perpetual problem that we face in the here and now, rather than in the long term?

That is an easy question to answer. I will go to Sarah Watters first.

Rob Gowans, it is fair to say that, during Covid, the third sector was put under extreme pressure in its work on things such as addiction services and other essential services that augment council and NHS services. Where are we now on recovery? Is the third sector being funded properly?

I go back to what the convener started with: the pressures on the NHS workforce. We were given statistics on vacancy rates, but those are averages across the country. One benefit of being a list MSP is that I work across a number of NHS boards, and it is obvious that the statistics vary greatly across boards. In South Lanarkshire, it is extremely difficult to get an appointment with or even to speak to a GP, yet, in South Ayrshire, it is easier to do that; however, the neonatal units in South Ayrshire are under extraordinary pressure, whereas those elsewhere are perhaps not.

Linking to that, I was looking at numbers of excess deaths over the period of the pandemic. Deaths due to cancer, dementia, circulatory issues and respiratory issues were significantly fewer than expected during the Covid period. We can read into that what we will. Obviously, we need to understand that, in measuring Covid, it was important to be consistent, so that we could identify trends.

Looking at the budget, which is coming increasingly under strain, how do we take all those factors into account in the management of an NHS that will change? Perhaps Mary Morgan would start with that easy question.

Thank you—that is really interesting. I am a big advocate of increasing the adoption of technology in healthcare. It is a major way in which we could make a step forward.

I will push that point a little bit with you, Dr Foster. I was trying to highlight the point that one impact of Covid is on non-Covid-related conditions. Understandably, we had to focus hard on Covid and the public expected that to happen. Ms Morgan talked about what is acceptable to the public. I imagine that there has now started to be a shift back towards elective surgery and cancer care, for example.

On Ms Low’s point about the adoption of technology, how realistic is it in the current situation to talk about giving the health service space to breathe and to consider the long-term strategy for what healthcare will be like in future?

Unless anyone else wants to answer my question, I am happy to leave it there.

Good morning. Dr Phin, you have opened a whole Pandora’s box regarding my specialist subject of prevention—we could probably take up our whole time on that. However, I want to return to your point that vaccination is a key element of Covid recovery. We are currently vaccinating over-50s again. This is anecdotal but, judging from those whom I have been speaking to, there seems to be a higher number of people deciding not to take the next vaccination than was previously the case.

Referring to your point that we require the level of vaccination to stay high to prevent Covid in future, how do we keep the rates high, and how do we keep the public informed? How do we maintain the importance of vaccination?

One area that we need to touch on is the level of funding that the Scottish Government should allocate to future pandemic preparedness and long-term resilience. Obviously, inflation and supply chain issues are currently putting pressure on that. Pre-pandemic, through exercise Silver Swan, we knew that the biggest threat to our public health was likely to be some kind of global pandemic, yet we allowed that work to slide. How do we maintain that preparedness? How robust do we need to be in order to make sure that our preparedness is kept at that level? I put that question to Dr Foster.

I should probably declare an interest: my daughter is a medic in a neonatal unit. I knew how complicated the question was. My point is that priorities shifted drastically during Covid, out of necessity. That has left a major issue that we must deal with at some point. When there is pressure on NHS budgets—as there is—how will all that be considered? Carolyn, do you want to have a go at that?

There is no criticism whatsoever. It is easy to look back to 2020 but, if we had to go through it again, would we alter the approach?