Committee
Finance Committee 09 March 2016
09 Mar 2016 · S4 · Finance Committee
Item of business
Prevention
Rachel Cackett
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If only life were that simple. In the comment that you mention, we were referring specifically to some of the issues that we raised with the committee when we responded to its first inquiry. Some of those issues certainly have not been addressed. Have there been changes on the ground? Yes, I would say that there have. On freeing up the acute sector, the issue is that we have an ageing population with complex needs. One of the difficulties that we have in freeing up resources is that everything in the acute sector becomes more expensive. The more we try to deal with people with complex needs at home, the more complex the needs are becoming in our acute sector. The specialties and the number of staff that we will need will become more expensive. It is not a simple equation of freeing up money from the acute sector and putting it into primary prevention and primary care. If it were, perhaps politicians would have already gone down the line that Mr Mason is suggesting. However, to date, that has not seemed particularly palatable as a way forward, so I would hesitate to say that it is a simple equation. What we have to do is be clear about what we want our acute sector to do in the future; and to do that, we also need to be clear about what we want to provide in the community. We have to be much clearer about our priorities. That comes back to the work that we did with the Academy of Medical Royal Colleges last year on sustainability, and the work that the RCN has continued. I hope that committee members have seen our recent work on targets, which we are continuing. Unless we are absolutely clear about what our priorities are as a country and unless politicians are clear about the priorities for the public sector and beyond and ensure that there is a single, coherent framework that sets out the priorities, is clear about what success looks like and allows those with control of the money to choose where to spend that money wisely for the best ends, we are probably on a hiding to nothing. Some of those questions will maybe answer your questions about what we choose to invest in and, indeed, what we choose to disinvest in, because there will be hard decisions to make over the coming years.
In the same item of business
The Convener
SNP
Our second item of business is to take evidence, in a round-table format, on prevention. We have been monitoring progress throughout the current session on t...
Rachel Cackett (Royal College of Nursing Scotland)
Thank you for the opportunity to open the discussion. I emphasise that it is our opinion that there is an awful lot of good practice around prevention. That ...
The Convener
SNP
Thank you very much.
John Mason (Glasgow Shettleston) (SNP)
SNP
I enjoyed the paper from the RCN, as usual. You say that you feel that very little has changed in the past five years. I would be interested to know whether ...
Rachel Cackett
If only life were that simple. In the comment that you mention, we were referring specifically to some of the issues that we raised with the committee when w...
John Mason
SNP
Thank you.
The Convener
SNP
Thank you. Colin, to be followed by Justina.
Justina Murray (South West Scotland Community Justice Authority)
I think that everyone sitting round this table today will largely reflect what Rachel Cackett has been saying in terms of—oh, sorry; did you say Colin, follo...
The Convener
SNP
The discussion is free-flowing.
Justina Murray
I give you the floor, Mr Mair.
Colin Mair (Improvement Service)
I think that Justina Murray was going to be much more interesting than I will be. However, I want to pick up on two of Rachel Cackett’s points. I focused bri...
Justina Murray
I will come in now. A lot of people around the table will reflect what Rachel Cackett and Colin Mair said about all the themes across different policy area...
Alan Staff (Apex Scotland)
In the third sector, there is a strong feeling that there can be no decisive shift in policy unless there is also a shift in the way that funds are allocated...
Professor Nick Watson (What Works Scotland)
I would like to open by endorsing what all the previous speakers have said. We see a lot of evidence of prevention from small-scale projects such as operatio...
Elaine Wilson (Lloyds TSB Foundation for Scotland)
I want to talk about the third sector. Lots of really small organisations are doing significant pieces of work that are fundamental to prevention. That is wh...
Aileen Bryson (Royal Pharmaceutical Society)
I echo and reiterate everything that has been said so far on the themes of using the resources that we already have and being much smarter about how we do th...
John Mason
SNP
I have two follow-up questions on two of the contributions so far, the first of which is for Alan Staff. I am a fan of the third sector, but I will be devil’...
The Convener
SNP
I will let Colin Mair come straight back on that specific question.
Colin Mair
To me, prevention is about how we prevent negative outcomes from happening to people and how we promote positive outcomes. The Community Empowerment (Scotlan...
John Mason
SNP
So prevention is the same as outcome.
Colin Mair
We often use different languages in quite similar ways. The language around co-production, for example, is often about saying, “Do it this way because the wa...
The Convener
SNP
I see that Alan Staff wants in. I will let you in, Alan, but there are a few people ahead of you, I am afraid.
Andrew Strong (Health and Social Care Alliance Scotland)
I agree with what Colin Mair has just said. Our submission to the committee highlighted a number of examples of preventative work in the third sector. For ex...
John Sturrock QC (Core Solutions)
I do not have the subject and sector-specific knowledge that many colleagues round the table have so my remarks are probably more general. I am struck by the...
The Convener
SNP
As we all have. Laughter.
John Sturrock
It is writ large in this world. Love prevails. As a mediator, I am interested in what I think is a global trend, which is a move from unhelpful competition ...
The Convener
SNP
That brings us swiftly on to the challenges that lie ahead. I hope that folk will look to ensure that there is a shift towards prevention in addressing the c...
Mark McDonald (Aberdeen Donside) (SNP)
SNP
It is handy that we have moved on, convener, as my questions are tailored around the second theme more than the first.
The Convener
SNP
I hoped that they might be.
Mark McDonald
SNP
I am always happy to help. My first question is about how we tackle the silo mentality that still exists. I am not necessarily talking about a silo mentalit...