Chamber
Meeting of the Parliament 09 March 2011
09 Mar 2011 · S3 · Meeting of the Parliament
Item of business
“Report on preventative spending”
I place on record my thanks to Andrew Welsh for his contribution to the Parliament and its workings. I also thank the Finance Committee for its report.
Having listened to this afternoon’s debate, I think that we should reflect on some measures that we have taken. We should not beat ourselves up too much about issues to do with preventative interventions. Malcolm Chisholm mentioned the David Kerr report—the national framework for service change in the NHS. The smoking ban was supported by many members of the Parliament. The vaccination programme for the human papilloma virus—HPV—to prevent cervical cancer was advocated by many members, too. I can also mention antenatal care interventions, fruit in schools, school meals projects, the sexual health strategy, the breastfeeding legislation that was championed by Elaine Smith and the Scottish bowel screening programme. We have taken many measures that have gone beyond the political cycle, and we have reached levels of debate and discussion to which we should continue to aspire. However, we should not be complacent.
There are barriers, and I believe that we politicians are one of the significant barriers in the way of progress in this regard—with a lack of ambition, perhaps, or a lack of courage, and with our innate ability to cut to the political chase and try to score points. Those are sadnesses, and I do not exclude any political party or individual from that. We should frequently look at ourselves in the mirror to try and visualise whether we are enacting the principles that have been set out in the Finance Committee’s report—and also set out by others in the past.
We should not forget, either, the empires that are built by officials in the public sector across the country and the protectionism that leads to an inability to instigate change or reform in the way that we should be doing.
We should not forget the professional vested interest that exists in relation to some of the substantial changes and challenges that we face on issues such as preventative interventions, as was covered in the committee’s report.
I think that it was Andrew Welsh who spoke about the moral perspective. I hope that we can continue throughout the election period and beyond with the debate and discussion on the morality of our decision making and our ability to reach the higher ground and a higher plane of decision making.
We are always deficient as far as information is concerned, but we have good resources when it comes to knowing where ill health occurs, where there is a lack of educational opportunity and where we need to make interventions. I recall from when I was Minister for Health and Community Care that the chief medical officer could almost tell me, by postcode, how many heart attacks would take place in certain parts of Glasgow. That drove the statins programme, through which we sought to address that challenge in a preventative manner.
The example of North Karelia has been mentioned. A different approach was taken there, but if one charts the reduction in the rate of heart attacks over the years there, one sees that Scotland figures pretty well in comparison. We took a medicine-based approach, using statins and other interventions. Although I would advocate that the approach that was taken in North Karelia was a better one, we have also taken some preventative measures that are of value to our communities here in Scotland.
Going back to the principles around our commonality of interest, I think that it is indeed about spending to save—money is important, and prevention is better than cure. Actually, it is also better for people. It is better for families, for children and for communities if we carry out preventative interventions in the manner that is described in the committee’s report. Ross Finnie reminded us of economics lectures about the opportunity costs of taking actions or not taking them.
Various members have raised the bar in the debate. Margaret Smith spoke about the need for consensus. A range of Tory speakers made contributions about calibration and how we use information. Elaine Smith spoke about the breastfeeding legislation. I am glad that she was excited about a Finance Committee report. I, too, have a degree of excitement about the report, which has brought a lot to the Parliament’s discussions.
Joe FitzPatrick mentioned the idea that we need to shift the balance of resources even harder. That has been a personal ambition of mine, and an ambition of my party, for a number of years, and we need to put all our shoulders behind that effort. He spoke in noble terms about what we need to do in that regard, and I want all of us not to forget those noble sentiments as we go through the battle of elections and whatever comes out the other end. We have a collective responsibility in the Parliament to try to address the worthwhile issues that have been raised in the report.
Johann Lamont talked about the challenge of the shift to preventative spending and Linda Fabiani rightly talked about the good work of Scotland’s Futures Forum, which we should not forget. Malcolm Chisholm, who made the pretty bold statement that he knew everything about what we spend, reminded us that we might know the price of everything but the value of nothing. We need to bear that in mind as we go about our efforts and consider the causes and effects of our interventions.
Statistics can act in strange ways. A civil servant once told me excitedly that the health inequality gap had closed, because middle-class women were drinking more. The gap between the working class and the middle class had closed, but for all the wrong reasons.
We have a good report on our hands. One of the witnesses in the inquiry—I do not know who—said that a leap of faith is required. I hope that the Parliament will be up to making that leap of faith in future. That is my appeal to the Parliament.
16:21
Having listened to this afternoon’s debate, I think that we should reflect on some measures that we have taken. We should not beat ourselves up too much about issues to do with preventative interventions. Malcolm Chisholm mentioned the David Kerr report—the national framework for service change in the NHS. The smoking ban was supported by many members of the Parliament. The vaccination programme for the human papilloma virus—HPV—to prevent cervical cancer was advocated by many members, too. I can also mention antenatal care interventions, fruit in schools, school meals projects, the sexual health strategy, the breastfeeding legislation that was championed by Elaine Smith and the Scottish bowel screening programme. We have taken many measures that have gone beyond the political cycle, and we have reached levels of debate and discussion to which we should continue to aspire. However, we should not be complacent.
There are barriers, and I believe that we politicians are one of the significant barriers in the way of progress in this regard—with a lack of ambition, perhaps, or a lack of courage, and with our innate ability to cut to the political chase and try to score points. Those are sadnesses, and I do not exclude any political party or individual from that. We should frequently look at ourselves in the mirror to try and visualise whether we are enacting the principles that have been set out in the Finance Committee’s report—and also set out by others in the past.
We should not forget, either, the empires that are built by officials in the public sector across the country and the protectionism that leads to an inability to instigate change or reform in the way that we should be doing.
We should not forget the professional vested interest that exists in relation to some of the substantial changes and challenges that we face on issues such as preventative interventions, as was covered in the committee’s report.
I think that it was Andrew Welsh who spoke about the moral perspective. I hope that we can continue throughout the election period and beyond with the debate and discussion on the morality of our decision making and our ability to reach the higher ground and a higher plane of decision making.
We are always deficient as far as information is concerned, but we have good resources when it comes to knowing where ill health occurs, where there is a lack of educational opportunity and where we need to make interventions. I recall from when I was Minister for Health and Community Care that the chief medical officer could almost tell me, by postcode, how many heart attacks would take place in certain parts of Glasgow. That drove the statins programme, through which we sought to address that challenge in a preventative manner.
The example of North Karelia has been mentioned. A different approach was taken there, but if one charts the reduction in the rate of heart attacks over the years there, one sees that Scotland figures pretty well in comparison. We took a medicine-based approach, using statins and other interventions. Although I would advocate that the approach that was taken in North Karelia was a better one, we have also taken some preventative measures that are of value to our communities here in Scotland.
Going back to the principles around our commonality of interest, I think that it is indeed about spending to save—money is important, and prevention is better than cure. Actually, it is also better for people. It is better for families, for children and for communities if we carry out preventative interventions in the manner that is described in the committee’s report. Ross Finnie reminded us of economics lectures about the opportunity costs of taking actions or not taking them.
Various members have raised the bar in the debate. Margaret Smith spoke about the need for consensus. A range of Tory speakers made contributions about calibration and how we use information. Elaine Smith spoke about the breastfeeding legislation. I am glad that she was excited about a Finance Committee report. I, too, have a degree of excitement about the report, which has brought a lot to the Parliament’s discussions.
Joe FitzPatrick mentioned the idea that we need to shift the balance of resources even harder. That has been a personal ambition of mine, and an ambition of my party, for a number of years, and we need to put all our shoulders behind that effort. He spoke in noble terms about what we need to do in that regard, and I want all of us not to forget those noble sentiments as we go through the battle of elections and whatever comes out the other end. We have a collective responsibility in the Parliament to try to address the worthwhile issues that have been raised in the report.
Johann Lamont talked about the challenge of the shift to preventative spending and Linda Fabiani rightly talked about the good work of Scotland’s Futures Forum, which we should not forget. Malcolm Chisholm, who made the pretty bold statement that he knew everything about what we spend, reminded us that we might know the price of everything but the value of nothing. We need to bear that in mind as we go about our efforts and consider the causes and effects of our interventions.
Statistics can act in strange ways. A civil servant once told me excitedly that the health inequality gap had closed, because middle-class women were drinking more. The gap between the working class and the middle class had closed, but for all the wrong reasons.
We have a good report on our hands. One of the witnesses in the inquiry—I do not know who—said that a leap of faith is required. I hope that the Parliament will be up to making that leap of faith in future. That is my appeal to the Parliament.
16:21
In the same item of business
The Deputy Presiding Officer (Alasdair Morgan)
SNP
The next item of business is a debate on motion S3M-7994, in the name of Andrew Welsh, on the Finance Committee’s “Report on preventative spending”. I call A...
Andrew Welsh (Angus) (SNP)
SNP
This will be one of the last speeches that I will make as an MSP, and it is my final scheduled contribution as convener of the Parliament’s Finance Committee...
Elaine Smith (Coatbridge and Chryston) (Lab)
Lab
I know that the debate is supposed to be consensual, but will Andrew Welsh comment on the abolition of the health in pregnancy grant?
Andrew Welsh
SNP
Such questions are better posed elsewhere. I am relaying to Parliament a positive report, rather than the usual negativity that is produced in debates. I say...
The Cabinet Secretary for Finance and Sustainable Growth (John Swinney)
SNP
Mr Welsh said that this was his last scheduled appearance in a parliamentary debate as convener of the Finance Committee. As finance secretary, I am always a...
Jeremy Purvis (Tweeddale, Ettrick and Lauderdale) (LD)
LD
I heartily endorse the cabinet secretary’s comments, but does he recognise that the committee found it difficult to establish what baseline information on ou...
John Swinney
SNP
Mr Purvis goes on to fascinating and complex ground in all of these areas. With Scotland performs, we have tried to identify a set of indicators that will pr...
David Whitton (Strathkelvin and Bearsden) (Lab)
Lab
I am pleased to speak for Labour in support of the Finance Committee’s report. I associate myself with the remarks of the cabinet secretary on our convener, ...
Derek Brownlee (South of Scotland) (Con)
Con
I thank the committee clerks, and the witnesses who gave evidence to the inquiry. I also thank Andrew Welsh for his time as convener of the Finance Committee...
Jeremy Purvis (Tweeddale, Ettrick and Lauderdale) (LD)
LD
This is an important debate, which is why I am particularly sorry that I will have to leave before the end of it, as I have a meeting regarding my constituen...
Linda Fabiani (Central Scotland) (SNP)
SNP
As a member of the Finance Committee, I, too, was very pleased to take evidence in the inquiry into preventative spend and to help to compile the report.Ther...
Malcolm Chisholm (Edinburgh North and Leith) (Lab)
Lab
I start by paying tribute to Andrew Welsh for chairing the Finance Committee in a model, non-partisan way for the past four years, and for the contribution t...
Joe FitzPatrick (Dundee West) (SNP)
SNP
I associate myself with the words of tribute for our convener, Andrew Welsh. As Malcolm Chisholm said, Andrew has always convened the finance committee in an...
Johann Lamont (Glasgow Pollok) (Lab)
Lab
I trust that I will not change the tone of the debate too much.I am grateful to have the opportunity to contribute to the debate. As the first person to spea...
Margaret Smith (Edinburgh West) (LD)
LD
As a non-member of the Finance Committee, I thank Andrew Welsh for his contribution to the Parliament, and the committee for its very useful report.The commi...
Jamie Hepburn (Central Scotland) (SNP)
SNP
I congratulate the committee on its work on this report. I am not on the committee and have not been intimately involved in the process, but even a rudimenta...
Linda Fabiani
SNP
Not that many.
Jamie Hepburn
SNP
It seems plenty to me. I also gently point out that Mr Welsh had represented Angus for five years before I was born, although I am not sure whether he will t...
Elaine Smith (Coatbridge and Chryston) (Lab)
Lab
I do not often get excited by the work of the Finance Committee, important though it is. However, its report on preventative spending is excellent, and I com...
Ross Finnie (West of Scotland) (LD)
LD
The debate has been interesting and, by and large, consensual. Like several members who have spoken, but not the majority, I do not serve on the Finance Comm...
Derek Brownlee
Con
Ross Finnie raised an important point about the outcome basis. Although there has been a shift in rhetoric in Parliament about moving towards an outcome basi...
Andy Kerr (East Kilbride) (Lab)
Lab
I place on record my thanks to Andrew Welsh for his contribution to the Parliament and its workings. I also thank the Finance Committee for its report.Having...
John Swinney
SNP
It is not often that I can follow Mr Kerr in a debate and agree heartily with many of the sentiments that he has expressed. I particularly agree with his sta...
Tom McCabe (Hamilton South) (Lab)
Lab
As others have done, I acknowledge Andrew Welsh’s service. I will not repeat all the plaudits. I simply say to him that he should be proud of his public serv...