Hansard

I could wax lyrical and extol the virtues of social prescribing—as most members will, I am sure. I am delighted to open the debate on behalf of the Scottish Conservatives, because, as members will know, it is on a topic that I am extremely passionate about.

As we have heard, the Health and Sport Committee conducted an inquiry into the social prescribing of sport, exercise and physical activity. At the end of the evidence session, we went into private session to discuss what we had learned. We all agreed that it was a very good session, with excellent evidence from an invited panel of experts. However, it is fair to say that our understanding of the topic grew by a grand total of zero. Who knew that social interaction and physical activity would be good for our health? That knowledge is hardly a breakthrough. We also discussed how many conditions are routinely medicalised when an alternative approach could lead to a better outcome in both physical and mental health. Again, that is hardly a revelation, although that approach will dovetail nicely with the work that we are currently doing on medicines. I am prepared to stick my neck out and predict that we will conclude that patients are being overprescribed medications when alternatives or a combination of medicines and activity would produce better results.

Presiding Officer, perceptive as you are, you might detect a hint of frustration—and you would be right. We have been discussing the desire to shift to a preventative approach since I entered the Parliament, nearly four years ago. I entered with such hope and, as it transpires, such naivety. There I was, thinking that in this place, among all the political posturing and wrangling, we might be able to make things a little bit better for people in Scotland. The reality is that, in that time, nothing of any note has changed save the relentless increase in the cost of preventable conditions. I am thinking of conditions such as type 2 diabetes, a recent report on which suggested that the number of people in Scotland with the condition—which is preventable for the most part or, at the very least, manageable—continues to increase. Type 2 diabetes and related complications already account for more than 10 per cent of the NHS budget, and that does not take into account the loss of productivity.

We are all aware of the huge rise in poor mental health, and evidence from both the Health and Sport Committee and the Public Petitions Committee highlights overprescribing of medication and a lack of access to alternative social solutions. In its submissions, the Scottish Association for Mental Health highlights its strong evidence-led belief that physical activity is a major contributor to a more stable mental state. I agree with the convener of the cross-party group on culture, Joan McAlpine, that the list of socially prescribed alternatives goes wider than sport and could be of significant benefit to those who suffer. There is music, for example, but—wait a minute—access to free music in schools has been cut.

As the convener of the cross-party group on arthritis and musculoskeletal conditions, I confirm that we are about to undertake a piece of work highlighting the need for better access to better self-management options, appropriate physical activity being key. The list goes on.

The keys to making social prescribing successful are as follows. Access to activity has been highlighted by the Health and Sport Committee’s convener, who rightly said that, if someone opts for medication, they can get a medical prescription that will cost them nothing, whereas, if they are socially prescribed something, the chances are that it will cost them money. There is space for a little bit of creativity. Instead of spending the money on medicine, we could spend the same amount on social prescribing—because there is a problem in accessing physical activity and travelling to physical activity, as Lewis Macdonald said.

The closing of council facilities, predominantly in rural and poorer areas, is a major contributing factor to inequality. Healthcare professionals need to understand what is on offer in the community. Evidence that was given today as part of the committee’s medicines inquiry strongly suggests that most GPs are unsure of what is available in communities as a possible alternative to medicalising a condition. We also heard that they need time to offer social prescribing, even if they are aware of the alternatives that exist.

The briefing from Barnardo’s Scotland suggests that the inclusion of children and young people in the committee’s investigation would have added weight to its conclusions, and I agree with that. Social prescribing at the earliest opportunity would be the very best form of prevention. Introducing social prescribing for children at pre-school and in school, in the form of physical activity and play, would be an excellent and important first step in reversing Scotland’s worrying health trends. As I have said before, schools need to be seen more as community hubs. Because of the closure of local facilities, the facilities in the school estate are becoming more important, so we need to make them accessible, which we are currently not doing.

Social prescribing also needs to include access to volunteering—I make no bones about it. A friend of mine, Dr Frank Dick, who was the director of coaching at British Athletics, wrote a paper on the recruitment of volunteers from among people who are approaching retirement—which, in itself, is another form of social prescribing. We have to make sure that those opportunities are available.

I will talk a bit about active travel. I hear that the active travel budget has been increased. However, trunk roads are supposed to have an element of active travel in their development and I have not seen any evidence of that so far. The transport minister agrees with me that there is a huge discrepancy in access to cycle routes to work and other places between the better-off parts of our country and those that have lower earners.

I have talked about the closing of facilities due to cuts in council budgets. According to the Convention of Scottish Local Authorities, the budget that has just been announced will cut £230 million from councils’ discretionary spend—and that is if councils opt to raise council tax by the maximum of 4.8 per cent.