Chamber and committees

Again, we will work closely with the boards on how we can support them. We want them to get to a substantially sustainable level. Like any Government, we would always consider writing off the debts of health boards and similar bodies, but that comes at a cost somewhere else in the health budget, and it is incredibly difficult to find that money when we are in a situation in which every penny is allocated.

We want NHS Ayrshire and Arran to be able to stand on its own two feet financially and to have in place the financial mechanisms and controls that can get it de-escalated from level 3 of the framework. That is certainly what Audit Scotland would expect.

Richard McCallum might want to add more to that.

It is a number of years since we took that decision.

You ask a good question. As you can see, we will invest a significant amount of money—[Inaudible.]—in the Baird family hospital and ANCHOR centre project. That is important. You will also see in the capital funding figures that there is significant funding for Parkhead of more than £30 million in-year. That is our biggest investment in a health and social care centre, which is the model that we want to take forward where it works, albeit that it is not appropriate everywhere.

We know that, in health and social care centres, we can get the appropriate support in one place for the public that they serve. That can be exceptionally helpful, particularly when it comes to reducing demand at the front doors of our acute sites. You talked about that issue earlier. I add that, through our manifesto, we have committed to spend £10 billion on health infrastructure over the next 10 years. That is a really ambitious target, so we will have to ensure that we profile the spend appropriately over the decade.

You asked about the capital investment strategy, and you are right to suggest that it will be key to some of the important funding decisions. We intended to publish the strategy after the Infrastructure Commission for Scotland published its report on 20 January 2020, but we have, of course, been focused on the response to the pandemic. We therefore do not have a date nailed down, but I promise Ms Webber that the strategy will be published as soon as it can be. She is right that it is an important document that will give people at least some comfort and reassurance that those important capital projects are being taken forward.

We have not yet made any final decisions on how that money will be earmarked, so we have not given full detail of that. We have to look at what the health board wants to fund and whether it could be financed through capital or resource. You mentioned theatre tables as a specific example. Capital projects are, of course, important investments to make. We need to give health boards the ability to renew their equipment where possible. However, the real focus of our capital infrastructure programme will be on significant refurbishment and significant replacement and build of assets.

Richard McCallum may wish to comment on the specifics around theatre tables being—

There is a slew of regularly published statistics—on which I know Ms Webber will keep a close eye, as we do—that will demonstrate whether we are making progress on that policy area, on which we all want progress to be made. Monitoring and evaluation will be at the heart of what we do. The Scottish Government works closely with our alcohol and drug partnerships to monitor the delivery of the national mission, which is what it is. Any organisation that receives funding for drug services will always provide regular reports on outcomes.

We will also work with public bodies that are vital in relation to that work, such as Public Health Scotland and Healthcare Improvement Scotland, to understand the bigger picture on delivery. Local interventions and the work at a local level will be really important, and officials monitor that, but we must keep an eye on the bigger picture. We will use that data to inform future funding decisions.

We will, quite rightly, be held to account on how we spend the money and on the difference that it is making. I expect that Ms Webber and all parliamentarians will ask questions to ensure that the Government uses the money in the most effective way possible, given the nature of the crisis that we are dealing with.

That is a very fair question. Some of it goes back to what I said to Sue Webber. Given the capital infrastructure projects that we are currently dealing with—the biggest one in my in-tray is the replacement of Monklands hospital—we suspect that most of that money will be backloaded to the latter years of that 10-year spend.

However, that is why the capital investment strategy for health will be published sooner rather than later. I do not have much to add to what I have already said to Ms Webber. I hope that people understand why the strategy was delayed, but I also accept the challenge from elected members that they need some certainty. I guarantee that we are working on the investment strategy and we aim to publish it as soon as possible.

Dr Gulhane is right about that and I absolutely accept that cost can be a barrier. That is why in my previous answer I said that some sports have done well at making their sport more accessible, but other sports and sporting bodies have some work to do.

In the 2022-23 budget, we have increased our funding for sports and funding to support Active Scotland’s key outcomes of encouraging physical activity, developing physical confidence from an early age and so on. We are working very closely with sportscotland to make sure that it supports clubs in communities to offer a range of opportunities—for young people, in particular—to participate through community sport hubs. We are doing as much as we can to work through schools, as well.

Another example is that we are doing what we can to ensure that cycling is more accessible by providing bikes, where we can, to those who cannot afford them, and ensuring that they are available through community hubs, as well.

I will be happy to provide more detail, if I can. I agree with the premise absolutely; there are probably other areas that we need to fund. The cycling facilities fund is one example of what we have done. We also worked well with the Robertson Trust—which members will probably know—the Spirit of 2012 and sportscotland to deliver the changing lives through sport and physical activity fund. That has provided direct resource to sport and community bodies to widen access. It directly funded 17 collaborative partnerships of sport and non-sport organisations to deliver sport and physical activity in communities, with a focus on accessibility. Dr Gulhane’s wider point is one with which I entirely agree.

It is a developing situation. I go back to my initial remarks to the convener: we are perplexed by the level of Covid consequentials and funding that the UK Government has put on the table. It may be that that is its initial estimate and it will add to that as circumstances dictate, but for us it is deeply concerning.

The omicron variant adds financial pressure, without a shadow of a doubt. I have heard Gillian Mackay speak on the issue in the chamber, so I know that she is well aware that, with additional resource, we could potentially go further with measures to compensate businesses, which are already suffering. Even under the guidance, advice and regulations that are currently in place, businesses are getting cancellations by the thousand, which has a serious financial impact. If there is to be another variant, which we cannot discount, it will add even more financial pressure, so that clarity is much needed.

It is really hard. I concur with everything that Stephanie Callaghan has said. As you would imagine, I see every day—from a local MSP’s perspective, let alone from a health secretary’s perspective—the value on the ground of the third sector organisations and partners that Ms Callaghan refers to.

As the Cabinet Secretary for Health and Social Care, I want to make it absolutely clear that we value third sector organisations not only through our words but through our deeds. Our 2022-23 mental health budget will increase by 6 per cent on the 2021-22 figure, and, this year, we have allocated a greater proportion to support community and third sector projects. That includes £15 million for grass-roots community groups via our communities mental health and wellbeing fund, to tackle the impact on adults of social isolation, loneliness and mental health inequalities.

On certainty for the future, I do not doubt that an ask that I get is one that every committee member gets, which is the ask for a multiyear budget. The Cabinet Secretary for Finance and the Economy has laid out some of the groundwork for how she might implement that for future years. That might provide a longer-term, sustainable funding outlook for third sector organisations in the future. We are not at that stage yet, but it is an ambition that the Government has.

I will have a look at the tables that you are talking about and give you an explanation.

The in-year transfers from the health portfolio to local government are grouped together within the budget as “social care investment” and the detailed elements are then set out in the level 4 budget tables, which are available on the Scottish Government website—that accounts for the £1.1 billion total. The £1.6 billion is the overall package of investment in social care and integration, which comes from a combination of funding that has been baselined in health boards and local government and from further in-year transfers from the health portfolio to local government. That is why there is a seeming discrepancy between the figures, but perhaps we could make that a little clearer. That is my reading of it.