I thank the Finance Committee for its detailed and thoughtful report on the draft budget for 2014-15.
I would like to look at the moneys that the Scottish Government is giving to change funds, which is an issue that is of particular interest to me, as deputy convener of the Health and Sport Committee. In the three years up to 2014-15, £500 million is being invested in change funds. As the report that is before us notes, the draft budget for 2012-13 said:
“Together it is anticipated that national and local government and their community planning partners will invest up to £500 million through these change funds to support the greater alignment of budgets across the public sector on a preventative and outcomes-focused basis.”
I suppose that that leaves us asking, “What does that actually mean?” For my part, it means reforming public service delivery in a way that best delivers the outcomes that we all want to see.
I have a particular interest in active ageing and the health of our older population, so among the outcomes that I would like to see being achieved—to which the Scottish Government has a clear commitment and to which I am sure that members across the Parliament have a joint commitment—are older people being happier and healthier and staying in their own homes for longer before having to move to a residential setting, if that is necessary; their making fewer unplanned visits to hospital acute services because of slips, trips, falls and so on; and fewer of them being stuck in hospital wards for longer than they need to be as a result of delayed discharge.
In recent weeks, Alex Neil, the Cabinet Secretary for Health and Wellbeing, has talked about having a seven-day healthcare service to help achieve those outcomes. We are trying to achieve quite clear outcomes using change fund money. I hugely welcome the use of £420 million in the change fund for older people between 2011 and 2016, including £70 million in the budget that will be before us early next year.
However, we also have to scrutinise the good and effective use of those moneys in achieving those outcomes, some of which I have mentioned. For example, we want to ensure that change fund moneys transition into the core financial budgets that health boards and local authorities set in order to better mainstream any initiatives that are developed through the change funds.
As the Finance Committee has said, we need to examine how we can encourage local authorities to make a greater contribution to the change funds. Health and social care integration for older people is currently being legislated on through the Public Bodies (Joint Working) (Scotland) Bill, which is before the Parliament, and we need to think more carefully about how we carry out robust budget scrutiny of single accounts under the bodies corporate that will involve local authorities and health boards. We have to come to terms with scrutiny in relation to that issue as well.
The outcomes are easy to measure but they are challenging to achieve, and the framework that I mentioned will be important in ensuring that we can achieve them. The Finance Committee’s report refers to what the Health and Sport Committee said about the lack of a clear link between the draft budget and the indicators. I have been on the Health and Sport Committee for a number of years and there is almost a necessary tension between the budget and the indicators, given that individual health boards have local strategies to identify and address some of the indicators and that there is also a disconnect between when the Parliament sets the budget for health boards at a national level and when health boards set their own budgets. There is a scrutiny issue in there, too. I think that we can improve, but I see a necessary tension as regards how we can go further. I think that it is up to Parliament to suggest how we can do that better.
I will come to the Barnett consequentials in a second, but in relation to the moneys in the budget that we are considering—the existing moneys—I have noticed that not one person from the Labour Party has said how one existing pound would be spent elsewhere, despite Labour’s repeated demands that we spend lots of money in lots of different places. That critical fault line runs through the Labour Party’s approach to budget scrutiny.
I see that Mr Rennie is in the chamber. He will be delighted to hear that my commitment to extending childcare has not waned; in fact, it is stronger than it has ever been. However, I have had a commitment to kinship care payments and to the roll-out and extension of free school meals for just as long as I have had a commitment to extending childcare. Each of those commitments has to be individually funded and paid for on an on-going basis. There are challenges in that regard, and there are decisions that everyone has to make—including me, Mr Rennie.
The free school meals pilot, which was carried out by the Scottish Government in partnership with local authorities, was pretty successful, but it was discontinued because of cuts from the UK Government. That is an example of a pilot that was brought to Scotland by a Scottish Government but which was directly undermined by UK Government spending decisions. We have to bear that in mind.
As we look at the budget, it is worth putting on record other potential spending consequences for the Parliament. We know that there is a cross-party effort elsewhere in the UK to take £4 billion away from Scotland by scrapping the Barnett formula. We also know of estimates of a multi-billion pound saving from the NHS in England with the greater use of private funds there. Those two examples have potential spending consequences that put Scotland at risk financially. Yes, I want that step change in childcare—I want to dramatically improve childcare—but I want to ensure that we get that improvement not just for a short time but in perpetuity.