Hansard

I welcome the commitment to investing in our public services, particularly in my portfolio of health and social care. Far from being a burden on the economy, growth in public spending as a proportion of the economy has had a persistent positive link with gross domestic product for more than a century. The mechanisms that link public spending and economic growth include investment in and maintenance of infrastructure, supporting an educated and healthy workforce and redistributing income. There can be no sustainable economic growth without prioritising and properly resourcing our public services. That is why the increased investment across public services is very welcome.

However, the investment must be strategically deployed to address key challenges, including workforce capacity, service accessibility and a focus on preventative care. I recognise that there are pressures, but striking a balance between those financial constraints and the consequences of reducing spending on critical services remains an immense challenge. Scotland’s public finances face significant pressure, which must be met with bold action to ensure the sustainability and long-term stability of our public services. I would also like to point to the role that the Scottish Greens have played in securing progressive income tax reforms in past budgets, ensuring that lower earners in Scotland pay less tax than those elsewhere in the UK. That progressive approach underscores our commitment to fairness and equity in public finance and a commitment to bring about transformative change.

I agree with one of Michael Marra’s points. I do not do that particularly often, but he is correct that reform in the NHS urgently needs to be worked on. If I have time, I will come back to that.

Many members have referred to the UK Government’s decision to increase employer national insurance contributions. The impact of that move cannot be overstated, especially in Scotland, where public services depend on the hard work of more than 600,000 people, who make up 22 per cent of our total workforce; that is higher than the UK average of 17 per cent. The UK Government’s increase in employer national insurance contributions poses a very serious threat to third sector organisations, care providers and charities across Scotland, many of which are already grappling with surging demand and escalating costs as well as declining funding and declining certainty in that funding. There are several estimates that the increases will cost Scottish third sector organisations an additional £75 million in 2025-26. Hospices, homeless shelters and care providers could be hit the hardest.

Several charities have highlighted and described the devastating impact that additional cost will have. The Health and Social Care Alliance Scotland has pointed out that 62 per cent of its members anticipate needing to cut services, with 58 per cent expecting to reduce staff. It has reiterated the calls to exempt third sector organisations from the national insurance contributions increase, and it has pointed out that several providers have noted that such relief could be game changing.

Hospices have also opposed the increase, and a joint letter from 14 Scottish hospices warned the Chancellor of the Exchequer that rising costs could force them to turn people away from their essential services. It is the same story for social care providers. The increase is projected to cost organisations such as Turning Point Scotland £1.1 million annually, pushing them further into deficit. Nearly 48 per cent of care providers that were surveyed reported that service closures are a real possibility without additional support.

I was grateful to attend the Scottish Care care home conference, along with Brian Whittle, Jackie Baillie and the cabinet secretary, where we heard about the impact on individual care homes. Some said that the additional cost of the national insurance contributions could be £300,000 per care home and some expressed doubt about whether they could weather the additional cost for more than a year.

What happens if we lose some care homes should be a real concern to us all. The impact that that could have on our local authorities and the individuals who support the care homes is staggering, and we need a resolution to that. That is without even talking about the impact on GPs, councils’ arm’s-length organisations and commissioned services within local authorities. The Labour Government’s decision to prioritise a national insurance contribution increase over other tax reform exacerbates those issues. Aligning UK income tax rates with Scotland’s progressive system could raise an additional £11 billion.

It is important to recognise the scale of the challenges that we face and to double down on efforts to safeguard Scotland’s health and social care systems, and public services more generally, for generations to come. The investments that we welcome today are a step in the right direction, but they must be met with concrete action. We need sustained, focused funding that prioritises prevention, supports overstretched services and ensures equitable access to care. That means shifting from a system that reacts to crises to one that proactively supports good health and wellbeing. I echo the cabinet secretary’s calls on the UK Government to do its part by fully refunding the additional costs of employer national insurance contributions for the public sector. That is about protecting vital third sector organisations, sustaining our hospices and ensuring the resilience of the entire health and care system.

I sincerely wish that the chancellor would show more willingness to listen to the concerns of third sector organisations in the same way that she seems to have listened to and acknowledged the demands of the non-dom community recently. At the same time, I reiterate my call on the Scottish Government to tackle the harms that we see across public services and to ensure that health and social care services are properly funded, that we have the plans to tackle the on-going issues that we are seeing and that we have Scottish public services that generations to come can be proud of.

I move amendment S6M-16237.4, to leave out from “notes the importance” to “sustainability” and insert:

“further calls on the UK Government to fully fund the increase in employer national insurance contributions in commissioned services and arm’s-length external organisations; notes the importance of the public service reform programme to drive future financial sustainability; further notes the success of the four-day week pilot trialled by South of Scotland Enterprise, and calls on the Scottish Government to expand the four-day working week within the public sector workforce”.