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As I am sure Sandesh Gulhane knows, NHS Ayrshire and Arran remains at level 3 on the escalation framework, which is a serious position for it to be in. That is specifically in relation to financial management. As you would imagine, we continue to act in line with level 3 escalation, and we are undertaking scrutiny and the provision of support in line with that framework. Of course, financial recovery remains a priority for those boards, and the focus has been on the response to the pandemic, which has undoubtedly impacted on their financial recovery plans.

We maintain a regular dialogue with NHS Ayrshire and Arran. As you can see from the budget for 2022-23, it is in receipt of additional funding, but we have put in place additional monitoring for that board and the other escalated boards to ensure that appropriate steps are taken in terms of cost improvement and efficiency in advance of 2022-23.

I remain concerned about NHS Ayrshire and Arran and also about NHS Borders and NHS Highland. NHS Highland was recently, of course, subject to a section 22 report in relation to finance.

There are a number of other ways that we can look to recruit and retain. Under this Government, there has been an incredible increase in the number of medical consultants since 2006, which we are pleased about. However, I take the point about retention.

We are looking at a number of avenues—one is to make sure that people are well remunerated, and another is to look at pensions. Some of that is within our gift, but a lot of it is within the UK Government’s gift, and I have been having discussions with it about potential pension changes. I think that Dr Gulhane is a member of the British Medical Association, so he will probably know that it has written to me about whether the Scottish Government can do more in relation to pension changes that would help with retention.

There are a number of other avenues that we can look at instead of distinction awards, which we have not provided for a number of years. I will work closely with the BMA and others to ensure that Scotland is a competitive place when it comes to not just recruiting but retaining more consultants, which is key to your question, Dr Gulhane.

Every health board is receiving an uplift, which is important. I completely accept that you will go out and bat for NHS Lothian, given your role. Why would you not do that? However, every single health board faces significant challenges. When I look at the figures, of course I see that the A and E department at the Royal infirmary of Edinburgh faces a challenge. However, if I look along the M8 to the Queen Elizabeth university hospital, to Forth Valley royal hospital or to Aberdeen royal infirmary in NHS Grampian, I see that A and E departments across the country are under significant pressure and are significantly suffering. Our NRAC formula, including the funding that we use to ensure that boards are within 0.8 per cent of NRAC parity, assists health boards across the country.

The funding to the non-territorial boards is vital. You mentioned the funding for Public Health Scotland. When we think about how crucial that board has been to our fight against the virus over the past 20 months, I do not think that anyone would argue—and you are certainly not arguing—that we should take money away from it to spend elsewhere.

All boards, territorial and non-territorial, are important. We have record investment of £18 billion in the health service. This is the first time that we have been able to finance health and social care to such a level. There is significant funding.

I give you an absolute promise that I meet NHS Lothian very regularly and I have a great amount of faith in the ability of the management team, the chair and the board to put the money to good use to improve what is a very difficult situation right across Lothian.

I am more than happy to bring in Richard McCallum in a second, but, to be absolutely clear, that funding is in addition to the £61 million reducing drugs deaths budget, which includes the second tranche of £50 million of additional funding as part of the commitment for £250 million over five years from 2021-22. It is specifically aimed at supporting an additional response to our collective challenge on drug deaths.

The increase of £1.2 million in funding on alcohol and drugs for 2022-23, to which you referred, brings the total budget to £24.4 million. That includes investment in an alcohol harm and treatment policy team to deliver our alcohol priorities with Alcohol Focus Scotland, Scottish Health Action on Alcohol Problems and the Scottish Alcohol Counselling Consortium. It also provides funding for specific alcohol services that will be delivered to support the Simon Community Scotland to deliver a pilot managed alcohol programme.

That funding is in addition to the £61 million reducing drug deaths budget. I hope that that is clear. Richard McCallum might have something to add to that.

You are right to say that that is an important commitment. The issue has become even more important, given what we have been dealing with during the pandemic. We know that sport is good not just for physical health but for mental health, so it is important that we live up to the commitment to double our investment to £100 million a year by the end of this parliamentary session, which we intend to do.

How will the money be spent? It will allow us to rebuild capacity and resilience in the sector following closures during the pandemic. One cannot be unaware of the impact that the pandemic has had on sport. The impact has been felt at the local grass-roots level—for example, a daughter’s football club that she goes to on a Saturday, which might have been hit hard by the pandemic but not have reserves to reach into—right through to the biggest clubs in the country. That has been the case not just in one sport but across myriad sports. Sport has been affected by the lack of people coming through turnstiles, for example. I will not pre-empt anything that the First Minister will say this afternoon, but omicron is clearly causing us great concern in that respect.

We work closely with sportscotland and other partners to understand how we can best increase investment in physical activity and sport while ensuring that we also address inequality. To be frank, I note that some sports have been better at dealing with inequality of access than others; other sports and sporting bodies have a little bit more work to do in that respect.

That is a good question. The national performance framework informs the budget. The impact on outcomes is, of course, considered when we make commitments. That, too, in turn informs our budget. We know that increasing health and care spending will directly contribute to the health and wellbeing of the nation.

The First Minister often talks about the fact that we cannot separate health and the economy—although people sometimes ask us to do so—because they are intrinsically linked. An increased workforce contributes to the economy, as does increased capital investment in health, which generates jobs and moves us towards our net zero goals. Our commitments to fair work and pay contribute to outcomes on poverty, and health has a role in each and every one of them.

The national performance framework sets our budget priorities. As I said in my previous answer, the framework is a consistent thread that runs through our entire consideration.

I agree entirely with Carol Mochan’s assessment and her plea to every decision maker and policy maker that tackling poverty and inequality has to be the root of our mission in Scotland, because it touches on every portfolio in the Government. That is without a shadow of doubt.

I will not rehearse everything that I said previously about the good work that we are doing with the Deputy First Minister. However, to answer the question I say that the issue absolutely requires us to be politically brave and bold. We are up for that challenge. We have committed once again to doubling the child payment, which Scottish Labour had been calling for and has welcomed. There are a number of initiatives. Carol Mochan will know that we have committed to the family wellbeing fund for this session of Parliament. It is a significant investment that is designed to tackle child poverty.

There is no getting away from the fact that some of the investments will take the course of the parliamentary session to work. Of course, if we were able to meet our child poverty targets sooner, we would absolutely do that. Ms Mochan is probably aware of the detail of the child poverty targets, so I will not rehearse them. However, I give her the absolute commitment that regardless of whether we are in health, education, transport, housing or social justice, we are all absolutely at one on the drive to reduce child poverty. As the person who is responsible for the largest share of the Scottish budget by quite a distance, I am not unaware of my responsibilities in that respect.

There is no doubt that the omicron variant causes more difficulty. The emergence of a new variant that is more transmissible means that we are facing an even greater challenge.

As Gillian Mackay will know, when the first omicron clusters were found in the Lanarkshire area, we ended up in a position where entire departments in our acute sites in Lanarkshire were worried about staffing levels. They were able to cope, and I pay tribute to the management and the health board for managing the situation, but it looked really difficult and challenging at one time.

The emergence of a new variant not only has direct health impacts—although it has those, and we have to factor that into the recovery—but affects our staff. An exemption process in now in place for NHS and social care staff. However, if a staff member tests positive—and positive cases are increasing, as we see in the recent daily numbers—that will still have an impact on the health service.

Those are both good questions, and they are intrinsically linked.

I agree with Stephanie Callaghan’s opening remarks about the job that NHS Lanarkshire has done. It has not been without its challenges. Indeed, there are a number of challenges that NHS Lanarkshire often faces, given its geography and the pressures that it is under. It has coped admirably well. As you can imagine, we are working with NHS Lanarkshire very regularly to see how we can get it de-escalated from the highest level of escalation, which it is on at the moment.

Stephanie Callaghan makes a good point about the effectiveness of the interventions and of the money that we spend. Any funding that we allocate is delivered against really clear criteria. The recipients of the funding have to report on its impact and on the outcomes that we agree. We have on-going regular engagement with stakeholders around the use of resources to deliver outcomes and what the risks may be. There can be unforeseen risks in a funding application that cannot be accounted for when it is received.

As the member probably knows, we have committed to refreshing our long-term mental health strategy. That work will build on the evidence of success that we have seen from interventions and on engagement with stakeholders and—crucially—people with lived experience, to identify what the future priorities will be. In turn, that will help us to know what our funding priorities should be.

The second part of Stephanie Callaghan’s question was also really good. It was about the balance between adult services and child and adolescent services. The first thing to say is—my goodness—what an impact the pandemic will have had on all those services. That is not to say that there were no challenges before; I readily accept that there were. I will not be the only MSP on this call who had a constituent who was in need of and on the waiting list for CAMHS. That list was far too long—I am not going to pretend otherwise—but there is no doubt that the situation has been exacerbated by the pandemic.

Our mental health transition and recovery plan, which was published in October last year, reviewed the priorities. An additional £120 million recovery and renewal fund was allocated to support the delivery of that plan, and decisions on its use were based on an assessment of proposals, set against those priorities, that was carried out in discussions with key stakeholders.

It is difficult to get the balance between adult services and child and adolescent services right, but that is something we are continually looking at. Making sure that we get that balance right is part of our NHS recovery plan ambitions, but it will require significant investment.

Yes, we do. Looking at my tables, I see that we are at about 6 per cent. That is a good first step in that direction. You are right: we have that commitment, I would be confident of meeting it, and that is a good step in the right direction.