Committee
Health, Social Care and Sport Committee 10 February 2026 [Draft]
10 Feb 2026 · S6 · Health, Social Care and Sport Committee
Item of business
Draft Climate Change Plan
Professor Sir Gregor Smith (Scottish Government)
Watch on SPTV
First, thank you for the opportunity to come and give evidence on this subject. As you know, I have outlined the situation in several of my annual reports. I see it as one of the biggest population health challenges that we currently face, not just in Scotland but around the globe. Ensuring that we take an approach that addresses some of the human effects of the planetary health crisis is critical. It is particularly important that we do that in an integrated way, so that we do not miss the opportunity also to tackle the other population health challenges that I have outlined previously. Having a balanced approach across those four population health challenges is really important.I am delighted that I have been able to be involved with other clinicians across the country in beginning to shape our approach in NHS Scotland to tackling the issue of emissions across our estate. Although much of that work involves the infrastructure of the estate, there has also been an incredibly important workstream on reducing the healthcare and care impacts of emissions.This is my starting point: the type of care that is the most harmful to the environment is care that is not necessary. Taking a much more balanced approach to prevention in the first place and treating that as our priority is the very first step that we have to take. Taking a national approach to improving prevention will not only help us with the impacts on planetary health, as it will clearly have an impact on human health as well.Secondly, we need to identify the healthcare that is provided that does not significantly improve the health of our population or of those patients who receive it. The Organisation for Economic Co-operation and Development suggests that, in most healthcare systems, about 20 per cent of the resources that are utilised in providing care do not actually improve health. Using a value-based approach to health and care to ensure that the kind of care that is provided is materially improving people’s health is the second element that I would outline.On the healthcare that is provided, the next step is to develop practices and make choices to minimise our impact through emissions—whether in relation to volatile gases or the propellants in inhalers that you mentioned, or by considering greener healthcare pathways and alternatives to what we might think of as traditional healthcare to improve health and help people with their healthcare. I am delighted that, through the realistic medicine programme of work, through value-based health and care and through my work with colleagues across the country, clinicians have been fully involved in identifying new ways of working that can help to improve our emissions profile in Scotland.
In the same item of business
09:20
The Convener
SNP
The second item on our agenda is a further evidence-taking session on the Scottish Government’s draft climate change plan, “Scotland’s Climate Change Plan: 2...
Emma Harper (South Scotland) (SNP)
SNP
Good morning to you all, and thanks for being here today.After I have asked my questions, I will probably come back further down the line to discuss green th...
Professor Sir Gregor Smith (Scottish Government)
First, thank you for the opportunity to come and give evidence on this subject. As you know, I have outlined the situation in several of my annual reports. I...
Emma Harper
SNP
You mentioned prevention—obviously, it is not only the health portfolio that looks at prevention. Last week, I asked the Cabinet Secretary for Health and Soc...
Professor Smith
It absolutely has to be a cross-portfolio thing. Everyone on the committee will be familiar with the Marmot review’s model of health. At the base of that mod...
Emma Harper
SNP
Does the climate change plan reflect how we can tackle health inequalities? A lot of the approaches to challenges in the population health framework—I am thi...
Professor Smith
In my view, it does. I apologise for going back over this territory again—this is the key part that I want to reiterate. I will quickly run through the four ...
Brian Whittle (South Scotland) (Con)
Con
Good morning, Professor Smith. I was interested to hear you talk about the preventative agenda, which is something that is close to my heart. It has been muc...
Professor Smith
I could talk all day about prevention. It has to be at the core of our response if we are to create a more resilient society for the future and make sure tha...
Brian Whittle
Con
You and I have had quite a few conversations on the issue. My point is that we have always known—well, we have known for a long time—what would be impactful ...
Professor Smith
Thank you for that important question. Having the support of this committee in ensuring that prevention is at the forefront of everything that we do is reall...
Brian Whittle
Con
Thank you.
Sandesh Gulhane (Glasgow) (Con)
Con
I declare an interest as a practising NHS general practitioner.Good morning, Sir Gregor. Before I ask the questions that I was going to ask, I want to go bac...
Professor Smith
I do not think that I said anything in my evidence this morning about giving health boards more power. That has not been any part of the conversations that I...
Sandesh Gulhane
Con
If health boards are being given the ability to do more in communities to fulfil the agenda that you are talking about, they will presumably be given more mo...
Professor Smith
I again disagree with your assertion. We are talking about health boards using the resources that they have in a more focused and perhaps—some would say—prec...
Sandesh Gulhane
Con
Taking that point alongside the inverse care law, let us consider a facility in Drumchapel that serves a community that needs as much intervention and help a...
Professor Smith
One of the most important aspects of the prevention agenda just now is to identify, through the precise use of data, the exact needs of the different communi...
Sandesh Gulhane
Con
I have some questions about the estate—my next question is about that.First, on the point that you made, we have seen GP funding going up in Bearsden, becaus...
Phillip McLean (Scottish Government)
I am happy to answer that question. Our low-confidence estimate is £700 million of capital. We do not have a great deal of confidence in the methodology that...
Sandesh Gulhane
Con
How much does it cost to change an NHS light bulb?
Phillip McLean
I am afraid that I cannot provide you with that level of detail. However, moving from fluorescent tubes to LED lighting in a hospital environment is not stra...
Sandesh Gulhane
Con
Sorry, you were in the middle of speaking about other things.
Phillip McLean
Yes, I was talking about the capital cost. The estimate also does not take into account how much of the cost will need to be paid for by the public sector. P...
Sandesh Gulhane
Con
My final question is about the fact that we have an estimated £1.5 billion maintenance backlog. Does that need to be addressed urgently, and do buildings nee...
Phillip McLean
To give overall context, patient safety is our number 1 priority. This financial year, the Scottish Government is providing £114 million of additional invest...
Sandesh Gulhane
Con
Previously, there were cuts, were there not?
Phillip McLean
No, there have not previously been cuts to maintenance and equipment replacement.
Sandesh Gulhane
Con
Cuts to the capital budget.