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Our intention is to get there, but it will be challenging to do so in the present financial environment. We will do what we can in this parliamentary session to try to get to that 10 per cent target. I do not have the clarity right now on what budgets will look like next year or the year after that—there is a level of uncertainty about that. However, that is certainly the target that we are aiming to deliver in this parliamentary session and there is no lack of desire to try to achieve it and to ensure that that investment happens in this session.

When a health board puts forward a business case for a capital investment project, it will go through the normal process in Government for considering proposals, but it must be set alongside all the other competing demands in the capital budget—a capital budget that, I should say again, has been cut. We have to balance it against the competing priorities in NHS Scotland and the different proposals from different boards. If the board brings forward a proposal, it will go through the normal process, but it will also have to be considered alongside all the other capital projects in NHS Scotland.

I am absolutely confident that we will do everything that we can, but I will not sit here and say that all the financial challenges in NHS Scotland or the public sector will be magicked away—that will not happen. Across the UK, we are going through a period of austerity in the public finances, which is having an impact on our budget and means that we must try to manage the finances as efficiently and effectively as possible. You can be assured that we will do everything that we can to provide financial support where possible, but that will be within the limits of what is available to us to invest in the health service and other public services.

Obviously, inflation is having an impact on the NHS across a range of areas. From procurement of food through to drugs, equipment and maintenance costs, all areas of the NHS are, by and large, impacted by inflation costs, alongside energy costs. That is placing a very significant strain on NHS budgets.

I will get Richard McCallum to say a wee bit more about PFI and the inflationary impact. Inflation is having an impact across a range of areas within health and social care, outwith PFI.

There are a couple of points to make in that respect. First, NHS Scotland has, like the rest of the NHS across the United Kingdom, used agency staff at various points. If you look at the figures, you will see that over the past 12 months there has been a bit of a spike in the number of agency staff being used. Greater use of such staff largely reflects the significant recruitment challenges that the NHS faced over the course of the pandemic. In the past month, we have applied additional restrictions on boards in order to reduce our agency spend. To put that in context, though, I point out that our agency spend is a relatively small proportion of our overall budget: I think that it is less than 2 per cent.

If there is a need for flexibility in relation to staff, we would much prefer to work with NHS bank staff who are on NHS contracts and NHS terms and conditions. We have applied some restrictions on boards to make sure that they are focusing much more on using bank staff where necessary.

We must also make sure that the NHS is an attractive place for staff to work. That is why the agenda for change settlement was critical, through taking forward measures to address issues related to pay and conditions in order to ensure that NHS Scotland is seen as an attractive place to work and to take one’s career forward.

Work was also done through, for example, the nursing and midwifery task force to improve recruitment to and retention within NHS Scotland.

Those are all areas of work that are about retaining staff within the NHS and making it an attractive place to come and work. It is also about looking at new routes into the regulated professions.

Reform around workforce, training and planning, alongside work on pay and conditions and much greater focus on use of NHS bank, rather than agency, staff are all part of the combination or package of measures that we are taking forward to reduce our dependency on locum and agency work.

Health inequalities and the illnesses that are driven by those are the result of social inequality so, very often, our health service is dealing with the symptoms of social inequality that manifest themselves in health inequalities. It is important that we take forward programmes such as reducing child poverty—through, for example, the Scottish child payment. All those will have an immediate benefit for the individuals concerned, but they will have a long-term benefit in reducing child poverty, which can result in health inequalities.

In addition, through the work that we do on tackling tobacco use, there have been reductions, and we want to continue to build on that. On alcohol misuse, a report that was published today by Public Health Scotland shows that minimum unit pricing has helped to reduce alcohol-related deaths by more than 13 per cent. All those factors play an important role in supporting us to prevent ill health, alongside our social policy actions to tackle social inequality. All that will be critical to supporting us in the preventive agenda in health.

No single action alone would help to address issues around population shift and make our rural and island communities attractive for people to live and work; rather, a range of actions will have to be taken. You will be aware, for instance, of actions that have been taken in some rural areas on housing, as well of measures that we are planning to take to free up housing capacity in our rural and island areas. There is a combination of factors to consider, including transport infrastructure, housing, digital infrastructure, good-quality and sustainable health services, access to education and so on. They all play key roles in helping to make our rural and island communities attractive places for people to live and stay in. They cut across all Government portfolios, and some of the work that we are taking forward in Government is on trying to ensure that we take a consistent approach to delivering them and that we are prioritising them.

I am not sure; I would have to check for you. I will be happy to come back to you once we have checked whether we are doing any work on that.

Ideally, we would be in the position of trying to address as much of the backlog as possible to reduce the risk of its becoming a safety issue for patients or staff in a building, but the challenge that we face is that capital budgets neither provide for that nor allow us to achieve it. Boards work in a dynamic environment in which they address maintenance backlogs on the basis of priority, and some of that will relate to clinical safety purposes. They will continue to work on that basis.

Alongside the need to provide new facilities and deal with the maintenance aspect, there is huge pressure on our capital budgets. I expect boards to work dynamically to identify the critical elements that have to be taken forward and ensure that matters are being addressed efficiently and effectively so that they do not interrupt clinical services or cause safety issues. We continue to try to invest in our estate as we go forward, both in maintenance and in new facilities where necessary.

Good morning, convener, and thank you for inviting me to meet the committee this morning. This is my first appearance at the committee since I was appointed as Cabinet Secretary for NHS Recovery, Health and Social Care. I welcome the opportunity to engage with the committee, and I look forward to discussing a range of vital issues in the weeks and months ahead, as recovery and renewal of the NHS and social care services continue.

I also thank the NHS boards for continuing to provide information to the committee, which has been taking evidence about their performance in recent weeks.

Ministers and Scottish Government officials regularly meet representatives of all health boards to discuss matters of importance to local people. It is my strong belief that the Scottish Government should not only fund, but should empower and enable boards to make the decisions that they feel are most appropriate to their localities and areas.

We acknowledge the pressures that are felt by boards across the country as we all continue to deal with the aftermath of the biggest shock that the NHS system has felt since its establishment some 75 years ago. We continue to prioritise investment in front-line services. We have provided an increase of some £730 million for NHS boards through the 2023-24 budget and an additional £200 million in-year support above initial plans to support the financial sustainability of NHS boards. That means that no board is more than 0.6 per cent from NHS Scotland resource allocation committee parity.

In addition, we continue to provide constant support and guidance to NHS boards to ensure that they are doing everything that they can do to provide the best possible care for people in their localities. Our new prospectus for the year ahead demonstrates our collaboration, with a key part of our plan to deliver year-on-year reductions in waiting lists being to deliver additional capacity through our national treatment centres in NHS Highland, NHS Fife, NHS Forth Valley and NHS Golden Jubilee National Hospital.

Another good example is the work that is being done to increase the workforce through hiring an additional 800 staff from overseas. That was helped by £8 million of funding in October last year. We set an ambitious target of recruiting some 750 additional nurses, midwives and allied health professionals from overseas; I am pleased that, due to the hard work of health boards, we have exceeded that target. That is the kind of joint working between central Government and local boards that I will hope will go from strength to strength, as we go forward.

I am happy to respond to questions.