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 Smith
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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 communities that are being served, and then services should be focused on how to best serve those communities. Whether that is through the processes of budget tagging or community planning, we should identify exactly how the resources that are being given can be used in the best way to improve the health of a specific population.You are right that our populations and communities are not homogeneous. As an independent adviser to the Government, I have advocated for a long time now for the greater use of proportionate universalism in how resources are identified and then used in the healthcare system. That approach has been used effectively, most recently with the production of directed enhanced services in GP practices for the prevention of cardiovascular disease. GP practices that serve communities that are more socioeconomically disadvantaged have been given disproportionately more funding to allow us to reach those communities in a better way than we have been able to do in the past.We need to have new techniques for engaging with communities. We would all recognise that one of the biggest barriers to improving health in Scotland relates to engaging with some of our communities in a way that is meaningful and starts to improve people’s health.Wendy Rayner and Phillip McLean, who are attending with me today, will be able to say a bit about the estate and how it is developing across the country. We are using available capital funding cleverly to ensure that we develop the NHS estate from which services are delivered in a way that serves community needs much better. As the committee will know, that might not be in the form of a facility purely for healthcare; it might be about making the best use of a building for community purposes by bringing in other services, with a view to ensuring that the estate has a net zero effect in terms of its carbon emissions. I will invite Wendy and Phillip to say more about the estate.
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.