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To be honest, we do not know about the effect—the most recent year that we have data available for is 2019-20, which was just before the pandemic hit. There were 75,616 ABIs in that year, which was 23 per cent more than the standard that we asked people to aim for.

We need a fuller picture of what has happened with ABIs over the pandemic. The committee knows from previous evidence sessions that I am a huge fan of Near Me, and there is an opportunity to use that technology. If ABIs can be a useful tool virtually as well as in person, we will try to get the evidence to support that going forward.

The work that is going on with Public Health Scotland to review ABIs began before the Covid pandemic. It will reflect on the experience of the pandemic across Scotland, and the actions are well under way, so I expect the strategy group to be convened in the summer.

It is difficult to have immediate actions to take and levers to pull, because we do not quite understand what happened or what the barriers were. We need to understand what led to the increase in deaths, which occurred across the UK, before we know what will be effective at reducing deaths in the future. We also need to understand whether such an increase will be repeated—whether it was the result of a consistent behaviour change or a one-off.

The situation is frustrating. I am desperate to solve the problem and I am keen to do what we can—the need is urgent. Every single one of these deaths is a tragedy, but we need to understand the situation better before charting our way forward.

I am satisfied that an effective process is in place. I hope that we do not reach the point of triggering it. For all that the impression that is given is that we are regularly in conflict with one another in the four nations, we actually work together closely on a number of issues across the board in health, and we have strong working relationships, particularly in my portfolio. Therefore, I expect us to be able to avoid triggering that conflict resolution process.

I will bring in Jennifer Howie to talk a little bit more about the detail of how the process will work should it be triggered.

Although the act was passed in 2020, it is still bedding in. We are still trying to understand the impact of that piece of legislation on our public health decisions, and I cannot at the moment think of an area in which we would be looking for exclusions.

The framework allows for divergence and respects the devolution settlements. For public health reasons, and all reasons, we prefer that mechanism for resolving issues of divergence.

We are very aware of that issue. Angela Constance and I work closely together, as do our officials. I will perhaps ask my officials to explain just how that works.

We recognise that there is learning from the national drugs mission that we need to apply in exactly the same way to our alcohol services. Some of the criticisms that are made of drugs services—that they are not person centred and do not respond rapidly enough—could equally and easily be made about our alcohol services. We are determined to learn the lessons.

Because of the way that services are structured, treatment for alcohol problems and treatment for drug problems usually happen in the same location. The services are co-located or are often the same services, so investment in one will benefit the other.

One of the pieces of the joint work that we did was the work to tackle stigma, which was quite successful. Stigma is a problem in relation to treatment in both areas, and taking a joint approach on that issue has proved to be quite helpful. Recently, we had an advertising campaign that talked about stigma, which covered both alcohol and drugs. I think that the campaign landed quite well and will make a difference to perception.

We are keen that we have a patient-centred, rights-based public health approach. We want people to be able to access those services easily and for there to be no judgment as they do so. That applies across the board in relation to addiction.

We are also keen to learn lessons. When we have the UK clinical guidelines for alcohol treatment, the work around medication-assisted treatment will be helpful when we think about how to implement the guidelines and ensure that MAT is adopted quickly and used on the ground. Maggie Page is in the drugs team, so I will ask her to come in and say a bit more.

Thank you. First, thank you for inviting me along to the committee to discuss the two provisional common frameworks. Officials in my team have been working with our counterparts in the UK Government, the Welsh Government and the Northern Ireland Executive to develop a four-nations approach to the delivery of the European Union repatriated functions on common areas of interest in the frameworks. The ministers of the four nations have agreed the content of the provisional frameworks, which were published on 2 December 2021.

Policy on organs, tissues, cells and blood safety and quality were and continue to be highly regulated at EU level. The purpose of the frameworks—and what they give Scotland, to respond to your question—is to ensure that, post EU exit, there is a joined-up approach across the UK to the continued maintenance of high standards of safety through the delivery of regulatory functions in these areas. That includes agreement as to how divergence will be managed within the UK, as well as governance and decision-making processes.

Throughout the process, we have committed to continuing to work collaboratively to develop common frameworks on the basis of consensus and in line with the agreed principles of the joint ministerial committee on EU negotiations as of October 2017. The provisional frameworks have been operational on an interim basis since the end of the transition period and they will remain provisional until the parliamentary scrutiny by all legislatures has been completed. I am happy to take questions.

I think that that question is probably best put to the two ministers who will be in front of you next. However, I must challenge your brass neck, frankly, given that we have spent so much of the past 10 or 11 years talking about the impact of austerity and welfare reform.

You called it the attainment gap, but its full name is the poverty-related attainment gap. You cannot close the poverty-related attainment gap without tackling poverty. We have detailed very carefully in just how many areas the party that you represent and support is undoing the work of the Scottish Government.

I am not saying that we are powerless, because we are not powerless in this situation. The investment in the 1,140 hours of free early learning and childcare, for example, is one of the many ways in which this Government has shown its commitment to and delivered for children and young people in this country. Laying the increase in the poverty-related attainment gap at the SNP Government’s door when the Westminster Government has increased the level of poverty in the country is a difficult one to take.

The evidence is that, of the four UK countries, Scotland has the lowest level of poverty. The policies that we are enacting are making a difference. We have more affordable housing, which is one of the ways in which we are making a difference to children and families. Food bank use is increasing in all the other countries in the UK; in Scotland, it is decreasing.

Our policies are having an impact, but we are attempting to solve the problem without switching off the tap of appalling and damaging policies that come from Westminster.

I will try not to talk for a long time—I will take your guidance on that, Ms Baillie.

I think that, for all of us, the pandemic has shone a light on inequalities, including pre-existing inequalities and systemic inequalities for black and minority ethnic communities globally. It is almost as if the scales fell from our eyes and we realised that, in some cases, we were perpetuating inequalities rather than tackling them.

The Scottish Government has a strong history of working with communities and ensuring that the voices of those with lived experience are at the heart of the development of policies with regard to children and young people. You may wish to ask Clare Haughey about this, but we have done a lot of work to ensure that children’s voices are right at the centre of policy development. However, although I think that we are making some efforts, I would not go so far as to say that we are having the impact yet that we desire.

I have a couple of points in response to Sue Webber’s questions. One of the key roles in this whole picture is that of school nurse. We are investing to increase the number of school nurses, and 250 extra school nurses will be recruited. Their role is very much to support school-age children and they play a vital role in improving their health and wellbeing. There is evidence that investing in school nurses can reduce the requirement for CAMHS, so we are continuing to invest in preventative work.

If I could pick up the issue of bikes that Sue Webber raised, we have a number of bike pilots going on around Scotland that are looking not just at getting bikes into the hands of children and young people but at the barriers that they might face to cycling. Do they have somewhere to store the bike? Do they have someone in their community who can fix the bike? Do they have access to cycle routes? In those projects we are also exploring ensuring access for disabled people, who are another group in society that faces health inequalities and is unable to participate in sport. We are determined to use the learning from those pilots. Clearly, Ms Webber is not aware of those pilots, so I will make sure that, in our follow-up letter to the committee, we give you some information about that. That will improve things.

The final thing that I want to mention is that sportscotland has a strategic partnership with the Scottish Association for Mental Health, which is a leading mental health charity, to consolidate the work across the board between sport and mental health and ensure that everything that we are doing is as impactful as it can be. A couple of things have started already. For example, more than 1,300 staff members of the Scottish sport workforce, including active schools co-ordinators, have attended a total of 110 sessions, including maintaining wellbeing reflection sessions, sessions on how to have a mental health conversation and mental health awareness workshops. All that work is important and it is vital for the preventative work. Sport on its own is good for your mental health, but we are trying to maximise the impact of sport by working smartly with partners to enhance the work that is going on, and I think that we are seeing some benefits.

You are absolutely right. When children are being dropped off at nursery, that is a real opportunity to do something with the parents. Again, you may want to ask Clare Haughey more about this next week, when she will be here to give evidence. We have certainly seen such programmes being offered—for example, the peep learning together programme, which encourages education, learning and qualifications. That fulfilment of the parent’s potential has a benefit for the children.

There is no doubt that, over the course of the pandemic, parents have felt more socially isolated than ever before. We have seen some innovative work to improve that situation, such as outdoor walking groups whereby parents use online social media groups to connect and get out together. As a public health minister, I have to say that very few positives have come out of the pandemic. However, if we become a nation that socialises through exercise, that will be a real positive, and I think there are opportunities to facilitate that.

As a mum of three, I know that it is not always easy to walk up to a stranger at the school gate and say, “Do you want to go for a walk?” If that can be facilitated by venues such as school nurseries or by health visitors, who used to run real-life mum and baby groups, that can definitely provide a huge opportunity for parents—it is not just mums; it is dads, too—to engage in that peer relationship, which is absolutely vital to good mental health.