Hansard

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 commend the committee for its vision in undertaking the work that it has done. Like other members, I, too, wish the convener of the committee all the best for the future.

The report highlights the gains from preventative spending not only for individuals and their families but for society as a whole. I, too, commend in particular the evidence on universal benefits, which is extremely interesting.

Jamie Hepburn made a point that I agree with. It seems reasonable to at least start with the committee’s recommendation that

“a robust and measurable definition of ‘preventative spending’ that could be used across the public sector”

should be provided. That would allow for increased spending in areas that might have lacked resources in the past but which are vital to the preventative approach. We have heard a number of examples of those areas, but I want to highlight one in particular: support for and promotion of breastfeeding.

Sadly, breastfeeding services have been treated as something of a Cinderella service, and hard-gained local provision is suffering from the current cuts agenda, which is unfortunate. There has been much mention today of giving children the best start in life, and breastfeeding does that. It has not been mentioned much in the debate, although Joe FitzPatrick did. As the children who were involved in the Dundee longitudinal infant study are now around 20, it would be interesting to look at that study for examples of where preventative spending has achieved results.

During a debate on early intervention last month, Richard Simpson told members about the fantastic work that was undertaken by breastfeeding support nurses in Wishaw general hospital in assisting his daughter-in-law. Unfortunately, the 22 breastfeeding support nurses in Lanarkshire are facing redundancy by the end of March, as the funding from the Scottish Government’s CEL 36—chief executive’s letter 36 of 2008—programme is coming to an end. Sadly, public bodies and organisations see such services as an easy option to save money, which is unfortunate because their impacts are measurable. The community mothers project in Lanarkshire was also under threat due to the local authority withdrawing its funding, but it has been given a temporary reprieve, as the health board has picked up the costs. Going back to what Malcolm Chisholm said earlier, I think that that might be an argument for a degree of ring fencing. Such funding is exactly the sort of funding that needs to be continued and prioritised as preventative spending.

As we know, spending on breastfeeding projects results in significant cost savings in both the short term and the long term because of the obvious and undisputed health benefits that are associated with it for mothers and children and because it lowers the risk of certain illnesses. UNICEF pointed out an example of that some years ago. It is not a Scottish example, but it nonetheless gives an indication of the cost savings. UNICEF pointed out that the NHS spent £35 million a year in England and Wales on treating gastroenteritis in formula-fed infants, and that, for every 1 per cent increase in breastfeeding at 13 weeks, £500,000 would be saved on the treatment of gastroenteritis. We should be investing heavily in such services because they deliver long-term health benefits, particularly in areas that suffer from a legacy of poverty and ill health.

Sadly, a negative attitude towards breastfeeding remains that continues to hinder its rates, so preventative spending must also cover education and training across a range of public bodies and awareness raising. It is important to give an example of why that is needed. I have dealt with a case involving a new mother—Sacha Moonsammy, who is a paediatrician—who was subjected to verbal abuse. She was told by a senior member of staff in TK Maxx in Sauchiehall Street to stop breastfeeding, was ranted at by a customer and had to leave in a distressed state with a very hungry baby. Strathclyde Police charged two individuals with contravening the Breastfeeding etc (Scotland) Act 2005, but the procurator fiscal issued only a warning letter—a slap on the wrist—to the company, although that was a traumatic situation that no woman or child in Scotland should face. The Procurator Fiscal Service should treat such incidents more seriously, given their propensity to put women off breastfeeding, which will have an impact in future. It is a strange world in which we are—rightly—willing to prosecute football supporters for shouting across stadiums but a woman who is forced to suffer horrific verbal abuse and is told to stop breastfeeding is not afforded justice.

Spending on education is essential to eradicate negative attitudes and to encourage positive approaches, which contribute to prevention. In 2004, pupils from Rosehall high school in Coatbridge undertook a series of awareness sessions. A subsequent report demonstrated that such spending on education produced improvements in young people’s attitudes. Following the sessions, positive attitudes to breastfeeding improved from 10 per cent to 48 per cent in secondary 1 and from 13 per cent to 58 per cent in S4. It is a bit worrying that the figures were so low to start with but, given those positive outcomes, such schemes could be integrated into curriculums. The outlays would be well worth it in comparison with the longer-term benefits and savings.

Susan Deacon’s report criticised the amount of money that is spent on new strategies and initiatives when front-line services are being cut. She said:

“Bluntly, if the choice is between a policy analyst or a play worker—I know which I would choose.”

I would do the same as her—I would choose the community mothers programme and breastfeeding support nurses over another infant feeding strategist.

I will finish with a good quotation from Children 1st’s briefing for the debate. It said:

“We also urge Members to commit to creating a child-friendly Scotland in which every child is valued, respected and protected in our society and where they grow up in families and communities which are confident about nurturing them.”

That ties in well with the preventative spending agenda and with breastfeeding. I hope that the committee’s legacy paper will receive the support that it deserves.

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