Chamber
Meeting of the Parliament 09 March 2011
09 Mar 2011 · S3 · Meeting of the Parliament
Item of business
“Report on preventative spending”
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 that he has made to his constituents and in public life more generally for four decades.
This is an important report from the Finance Committee, and a significant development of our work. The Parliament knows a great deal about what we spend—in fact, we on the Finance Committee know everything about what we spend—but we know very little about what we save. We need to become very good very quickly at the science of preventative economics and I hope that the Finance Committee report makes a small contribution to that.
Preventative spending goes much wider than the early years and health and social care, but there are good reasons for concentrating on them in the report. Briefly, in relation to health and social care, we have talked about the issues with a growing elderly population for many years, and we have also talked about shifting the balance of care and, in particular, trying to cut escalating emergency admissions to hospital through preventative and continuous care in the community. Indeed, that was the central theme of the David Kerr report. However, the fact is that, despite great progress in health over the past decade, we have not got anywhere with that agenda.
It is important to flag up both that point and the various issues that are connected with it in the report. It is a big challenge for the next parliamentary session. I believe—if I can be slightly partisan for five seconds—that Labour’s proposal for a national care service will help on that agenda, but the issue is wider. We will need more than that to shift the balance of care and balance of spending.
The most important evidence and recommendations in the report are on the early years. That theme was repeated in a conference in this chamber on Friday morning. I recommend in particular the words and wisdom of Dr Suzanne Zeedyk and Detective Chief Superintendent John Carnochan. Their evidence was given on 26 October and 2 November 2010, and members can also read their speeches in the transcript of last Friday’s conference.
I will start with a brief quotation from John Carnochan to the committee:
“the most important four years of a child’s life are those up to age three.”—[Official Report, Finance Committee, 26 October 2010; c 2555.]
I wish that that was written up on the Canongate wall. We know that it is not just somebody’s opinion. Other members have quoted some of Dr Zeedyk’s evidence, and she explained the neuroscience behind the truth that we all know that
“Children’s brains develop more quickly between birth—really conception—and the age of three than they ever will again.”—[Official Report, Finance Committee, 2 November 2010; c 2614.]
The brains are in place at age three, which is why we need to refocus on the years nought to three—or, we should rather say, conception to three. We were told that the quality of early interactions is particularly crucial.
People say that if we concentrate on the early years agenda we will get results only in the long term. We will get results in the long term—we know that investing in the early years, particularly nought to three, will have implications in improved mental health, reduced crime and so on—but we should also point out that there would be benefits in the short term, too. Suzanne Zeedyk was particularly strong on that point. I do not have time to read out the quotation that I planned to read from column 2614 of the Official Report of the meeting on 2 November, but she made that point. That is important for politicians. It is difficult for us to invest now for benefits in 20 years’ time but, as she points out, we will have benefits within a very short timeframe—within one year—if we invest in the agenda.
Another theme was the tension between universal and targeted services. Derek Brownlee mentioned that with reference to health visiting, but—to mention a third witness—I was struck by the evidence from Dr Philip Wilson, who answered the conundrum by saying that we need universal services for screening and identifying the families and children who have problems, whom we then target. That is the key insight into the tension between targeted and universal services.
Let us refocus on nought to three. Let us build consensus around that, starting with the committees of the Parliament. I want also to say—this is a bit more controversial—that we need concerted central direction. As has been said, a lot of the evidence pointed in that direction. Again, I was going to read a quotation from Detective Chief Superintendent Carnochan at column 2574 of the Official Report of the Finance Committee meeting on 26 October, but I am in my last minute so I had better not. He said, controversially, that we may have to reconsider ring fencing money for the early years and ensuring that all local authorities prioritise that work. I realise that that suggestion is controversial and anathema to many people in the chamber.
What is not controversial is the fact that we need to lead on preventative spending. Whichever way we think that leadership should be given, the Parliament has to lead on the agenda. Recognising the strength of the evidence that we receive, we must shift investment as far as we can to nought to three. I say “as far as we can” as I recognise the financial difficulties of the time that we live in, but if we shift investment to the early years we will save in the short term as well as in the long term. If the next Government—whoever it is—will not lead on the agenda, I hope that the Finance Committee and the Parliament as a whole will do so.
15:30
This is an important report from the Finance Committee, and a significant development of our work. The Parliament knows a great deal about what we spend—in fact, we on the Finance Committee know everything about what we spend—but we know very little about what we save. We need to become very good very quickly at the science of preventative economics and I hope that the Finance Committee report makes a small contribution to that.
Preventative spending goes much wider than the early years and health and social care, but there are good reasons for concentrating on them in the report. Briefly, in relation to health and social care, we have talked about the issues with a growing elderly population for many years, and we have also talked about shifting the balance of care and, in particular, trying to cut escalating emergency admissions to hospital through preventative and continuous care in the community. Indeed, that was the central theme of the David Kerr report. However, the fact is that, despite great progress in health over the past decade, we have not got anywhere with that agenda.
It is important to flag up both that point and the various issues that are connected with it in the report. It is a big challenge for the next parliamentary session. I believe—if I can be slightly partisan for five seconds—that Labour’s proposal for a national care service will help on that agenda, but the issue is wider. We will need more than that to shift the balance of care and balance of spending.
The most important evidence and recommendations in the report are on the early years. That theme was repeated in a conference in this chamber on Friday morning. I recommend in particular the words and wisdom of Dr Suzanne Zeedyk and Detective Chief Superintendent John Carnochan. Their evidence was given on 26 October and 2 November 2010, and members can also read their speeches in the transcript of last Friday’s conference.
I will start with a brief quotation from John Carnochan to the committee:
“the most important four years of a child’s life are those up to age three.”—[Official Report, Finance Committee, 26 October 2010; c 2555.]
I wish that that was written up on the Canongate wall. We know that it is not just somebody’s opinion. Other members have quoted some of Dr Zeedyk’s evidence, and she explained the neuroscience behind the truth that we all know that
“Children’s brains develop more quickly between birth—really conception—and the age of three than they ever will again.”—[Official Report, Finance Committee, 2 November 2010; c 2614.]
The brains are in place at age three, which is why we need to refocus on the years nought to three—or, we should rather say, conception to three. We were told that the quality of early interactions is particularly crucial.
People say that if we concentrate on the early years agenda we will get results only in the long term. We will get results in the long term—we know that investing in the early years, particularly nought to three, will have implications in improved mental health, reduced crime and so on—but we should also point out that there would be benefits in the short term, too. Suzanne Zeedyk was particularly strong on that point. I do not have time to read out the quotation that I planned to read from column 2614 of the Official Report of the meeting on 2 November, but she made that point. That is important for politicians. It is difficult for us to invest now for benefits in 20 years’ time but, as she points out, we will have benefits within a very short timeframe—within one year—if we invest in the agenda.
Another theme was the tension between universal and targeted services. Derek Brownlee mentioned that with reference to health visiting, but—to mention a third witness—I was struck by the evidence from Dr Philip Wilson, who answered the conundrum by saying that we need universal services for screening and identifying the families and children who have problems, whom we then target. That is the key insight into the tension between targeted and universal services.
Let us refocus on nought to three. Let us build consensus around that, starting with the committees of the Parliament. I want also to say—this is a bit more controversial—that we need concerted central direction. As has been said, a lot of the evidence pointed in that direction. Again, I was going to read a quotation from Detective Chief Superintendent Carnochan at column 2574 of the Official Report of the Finance Committee meeting on 26 October, but I am in my last minute so I had better not. He said, controversially, that we may have to reconsider ring fencing money for the early years and ensuring that all local authorities prioritise that work. I realise that that suggestion is controversial and anathema to many people in the chamber.
What is not controversial is the fact that we need to lead on preventative spending. Whichever way we think that leadership should be given, the Parliament has to lead on the agenda. Recognising the strength of the evidence that we receive, we must shift investment as far as we can to nought to three. I say “as far as we can” as I recognise the financial difficulties of the time that we live in, but if we shift investment to the early years we will save in the short term as well as in the long term. If the next Government—whoever it is—will not lead on the agenda, I hope that the Finance Committee and the Parliament as a whole will do so.
15:30
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...