Chamber and committees

When I asked Gerry McCartney about the living wage last week, he said that we needed to remember the difference between the living wage and the minimum wage. Thinking about the Scottish Government’s mitigating of impacts by encouraging employers to implement the living wage, I wonder whether there is an opportunity to continue to ask for employment law or further benefits to be devolved, so that we have better fiscal control and can deliver public funding in the way that the Scottish Government chooses.

I have a quick question about upstream causes of health inequalities, the balance between downstream and upstream interventions and how we address that.

I have a paper from the National Institute for Health and Care Research that uses the river metaphor to talk about public health: downstream interventions focus on things such as behaviour change and treatments for illnesses, and upstream interventions focus on social factors that contribute to health and prevent illness, such as housing, employment and education. What is the balance between upstream and downstream interventions in that regard? I think that Claire Stevens mentioned something in relation to that in her opening comments.

This is a quick supplementary that relates to what Evelyn Tweed and Gillian Mackay were saying. Rishi Sunak could make changes in policy that would address the cost of living crisis, which will probably exacerbate health inequalities. National insurance contributions have gone up, people are in fuel poverty, and people are having to choose between heating and eating. Luckily, summer weather might be coming now. Universal credit has been removed—or, at least, a portion of the uplift was taken away. What is the barrier to the Chancellor of the Exchequer setting a windfall tax or to addressing some of those things? Is it a political issue? What are the constraints?

I will be pretty quick. In our private sessions, one person who gave us information said that inequalities impact assessments are not being made routinely in planning, for instance, and that wider engagement is needed in thinking about how people access services. Do the witnesses have any thoughts on how inequalities impact assessments could be done better in order to tackle health inequalities?

Down the line in our inquiry, we might have more clarity on how health inequalities impact assessments are used. Claire Stevens said that she would support further use of those assessments. I am interested in hearing whether you think that it should be a requirement for public sector organisations to conduct health inequalities impact assessments so that health is considered in every portfolio.

Is the introduction of the living wage one of the policies that is working? As of April 2022, it is £9.50 an hour. Is that giving people enough money to manage their families and homes? Is that part of something that works?

I have a final question about the—

During the pandemic, everybody worked really hard and there was a lot of pressure, emotional stress and fatigue. Is that peer support partly about developing resilience among leadership and about looking at how we will expand the pool and be more inclusive in order to encourage more people into leadership positions?

I have a quick question relating to what Sandesh Gulhane said about the questions in the consultation. Is it not the case that we sometimes ask difficult questions in order to elicit out-of-the-box thinking about changes or new ways of working? The process that we follow sometimes involves asking questions that folk might not like.

Annie Gunner Logan talked about citizen leadership when she gave evidence. That is kind of what you are talking about in relation to identifying people with lived experience—unpaid carers and people who use care services. Is the Scottish Government doing any work to promote or enable citizen leadership?