 I welcome everyone to the third meeting of the Health, Social Care and Sport Committee of 2022. I've received no apologies for this morning's meeting. The first item on the agenda is for us all to decide whether to take items 4 and 5 in private. Are members agreed? We're agreed, thank you. Our second item today is an evidence session as part of our short inquiry into health and wellbeing of children and young people. This session will focus on health and wellbeing in schools and education. I welcome to the committee this morning Dr Josie Booth, the senior lecturer in developmental psychology at the University of Edinburgh, Mike Corbett, national official for NASUWT, Judy Edwards, service manager for Stirling Council, Kevin Cain, policy and research manager for YouthLink, Scotland and Scotland, the head of school and community sport for Sport Scotland. The clerks have allocated one member to leave questioning on specific areas that we want to cover this morning. If any other member wishes to ask a supplementary question on anything, you can use the chat box and put an R in it. If I have time, I'll come to you. I'll do a bit of a round robin of the panelist to get their initial views, but if members can direct their questions to individuals and if other panelists want to come in and add to that, you can also use the chat box just to flag it up that you want to come in to me and I'll come to you. I really want to go round the panel and ask about... The schools are often seen as the contact with the children and young people for over many years of the day, for five days a week, obviously pre-pandemic. It was always physical and there were no restrictions on that. We welcome on to Covid with some questions from our colleagues later, specifically. To what degree are our schools in a position to intervene early on the issues of wellbeing that pupils might have and promote health and wellbeing within that school week? I know that there will be a varying picture throughout the country, given that local authorities are in charge of education in each part of the country. However, if I can go round the panel and get your varying thoughts about the position that schools are in to do that and any issues there, can I go to Dr Josie Booth? Hi, good morning. Thank you for inviting me along this morning. Your question is about schools being in a position to support positive mental health and wellbeing. One of the key challenges is that schools lack resources. Teachers often lack training, both pre-service and in-service, while they are acting as teachers. They do not have the support in order to promote positive health and wellbeing. One of the key challenges for teachers is that their own health and wellbeing is perhaps not optimal. They need to be supported in order to be at the forefront of helping children and young people to develop positive health and wellbeing, as well as to support those young people where there might be challenges. Dr Booth, you mentioned that teachers do not have mental health training, and they do not. However, there has been a bit of intervention in those early days on having school counsellors available to every school. Is that being an important intervention? Yes, absolutely. Anything that can be done at the moment is really positive. At Moray House, we work with a mental health charity place to be to support student teachers when they are developing their skills so that when they go into the service, they feel more equipped. Even while they are on placements, they have some support. However, that is not across all training capacity. It is truthful when teachers are actually in the service that they do not have the support. They are having to support many people with sometimes very complex challenges to their health and wellbeing, and they need to have the resources and support in order to do that. We know that CAMHS has very lengthy waiting lists and are really at capacity. Schools are at the forefront of supporting people even before they get to CAMHS but also while they are on those waiting lists, both for assessment but also for treatment, and then maybe after they have had a diagnosis as well, schools are the ones supporting young people. We need to have whole systems approaches for doing that, so we need to be able to support young people, their families, their schools, working with CAMHS and across the whole system to develop positive change. Hi. Historically, schools have been an excellent position to help young people and to help them with their mental health and wellbeing. That is from class teachers with their day-to-day contact through well-established guidance and pastoral systems, which are often very good personal and social education. That has always been there, but I think that, historically, schools and teachers have often felt that many things have just been left to them and there has not necessarily been more outside help. For example, you touched on the expansion of school councillors, which is obviously a very good thing. The other thing that I would touch on, as well as a lack of resources that has already been mentioned, teachers at the moment feel under enormous pressure. Many of them have suffered physically and mentally during the pandemic, so they are sometimes not in an optimum position to give what they used to give to their pupils. They feel under enormous pressure. I think that more support is needed there for the workforce, which then can help the pupils themselves. Good morning. I would say that schools are well placed to support children and young people with health and wellbeing, and at the moment, certainly in the authority that I work with in mental health and wellbeing is a top priority for us. I agree with my panel members that that is not just for children and young people. Our staff wellbeing is also a priority for us, and we are endeavouring to support our staff the best that we can through this really challenging time. I agree that training and resources can always be improved. Given that health and wellbeing is one of the three key areas of the curriculum, it is not unusual that we would strive to do that. At this time, the landscape has changed slightly because of the pandemic, and we certainly are in a position to be seeking to improve resources and training and also to strengthen our partnership working to support the challenges that we have. Judy, can I ask you about your local authority? Do you see schools ever using peff money to provide extra support in particular schools? Absolutely. Most schools would be using peff money to support health and wellbeing in some way. And, of course, some additional funding that has come to schools in terms of Covid recovery has also been most welcome to support this area of the curriculum and others. It is a fantastic question to open on, so thanks for tabling something so significant so early in the committee session. Any focus on wellbeing in schools needs to consider the role of other practitioners in supporting wellbeing and bringing about the best outcome for the young person in schools. Worth noting that not every young person's experience of school takes place in a classroom or even a school building. Without youth workers, far too many young people would not be in school. We have ramens of quotes from young people who have said exactly that. As committee members will know, there is a curriculum review on going. One of our recommendations is that there needs to be a refreshed narrative of the definition of the curriculum. Youth work is education, but it is often described as education. We also want to ensure that the education system is as inclusive as it possibly can be, and youth work practitioners can help us to deliver that in the school, around the school, after school. A couple of good examples are St Mungo's academy in Fair Scotland. He worked in partnership across the school setting. The focus was on building long-term relationships with young people who supported their wellbeing skills achievement and included sessions on children's rights, leadership and open discussions in peer-led training sessions on wellbeing. The headline stat for the committee is that 84 per cent of the participants described improvements in their health and wellbeing. Another example is Scout Scotland. We have seen voluntary and local authorities working together here in Kirkcaldy high school. They used outdoor adventure days to support enhanced transition between S1 and S2 pupils, and those primary 7 pupils that missed out, residential pupils, due to Covid. More than 500 young people benefited. The key thing for the committee is that they all said that they had improved physical, mental health and wellbeing as a result of those experiences. As I was preparing for the committee, I was thinking, can you imagine what a transformative impact a project like that could be if we scaled it up on a national level? We have to pay some homage to the youth work education recovery and outdoor learning funds. They have been fantastic. We have brought together practitioners under the umbrella of getting the best out of a young person in a manner that suits them. There are two final points to make that we have seen across several years of the Scottish attainment programme, that it is not one service or one practitioner alone, but the effect of collaboration across the system, which better supports young people. We believe that we need to continue this shared vision and capture the best of what was a chaotic situation that we saw such innovative approaches. We saw youth workers to the floor and carry that forward into the future. There is an on-going issue of youth workers accessing facilities, and that needs addressed imminently. Otherwise, it will preclude our severely limited services that are available to young people. Our message from the sector is that there is still a lot of variability of access to premises. I ask the committee, the work alongside your colleagues and the cross-party, and even with the Government, to address that, because if it is not resolved, it will continue to impact negatively on the development of young people, especially for those who are already in a deprived position. We know that Covid has increased inequality. There was an Oxfam report to that effect just recently. Thank you very much. You flagged up quite a lot of things. Transition in particular is something that we are acutely aware of. It has been a particular issue. It is great to hear of that example from Kirkcaldy, where they have had collaboration to jump in and help to give young people outdoor activities that they missed out on with residential programmes, and they have been taken away with them because of lockdown. Thank you for flagging that up. Can I come finally to Jacqueline Lynn? Good morning, everyone. It is nice to be here. Thank you very much for the invite today. I think that it is a great question as well, Gillian, in terms of all of that. I believe and we believe that at Sport Scotland that schools play a significant role in the wellbeing of children and recognise that it is a challenge for all the things they have to do. As Sport Scotland, it is our ambition that we get more people taking part in sport and particularly children and young people to make sure that they have an active and healthy lifestyle as they work through the different stages of schools. We work across the 32 local authorities, the leisure trust, to make sure that sport and physical activity is at the heart of school. We have an active schools network, sports development network and community sport hubs that provide opportunities for children and young people before school, lunchtime and after school, with a real clear connection to physical education and the link to the curriculum for excellence and health and wellbeing. That whole P-pass agenda is really important to everyone, and what that does is shows the partnership working that we work with the local authority, leisure trusts, governing bodies and the third sector to have that whole systems approach to the health and wellbeing of children. We recognise that it has been a challenge over the pandemic. Before the pandemic, we had over 320 individual young people taking part in active schools in their school environments in their community. We are just waiting in some of the evidence to see what that looks like as the restrictions are easing back. As part of the pandemic, it is important to recognise that there was a flexibility in active schools, community sport hubs and sports development, and they just worked locally in the childcare hubs to make sure that they get food parcels to families and whatever was needed in the communities. That helps to strengthen relationships around different practitioners that perhaps active school sports development hubs did not have. There is a real opportunity here for us to work as a national agency with local partners, schools and a whole range of other local and third sector partners to make sure that the health and wellbeing of our children are at the heart of this, and we make sure that they recover positively. Jacqueline, you mentioned that you do not quite have the evidence of how strongly it is coming back. That is something that you are obviously monitoring to see as we are coming into the endemic phase of this. We will have that. We are just looking at term 1 in the stats and we are just waiting in the final stats coming out. We will let people know that, and we will work with the local partners on that. Thank you very much. I will go to my colleagues now. I am just checking that we have Stephanie Callahan. Stephanie, are you there? Yes, I am, Jacqueline. I am not sure if there is a wee problem with my camera there. We cannot see you, but we can hear you, and that is the main thing. Okay, well, when I have done my question, I will come off and come back in and hopefully that will improve things there. The morning panel is really good to have you here with us today. We have already heard and mentioned that physical wellbeing is vital in the role of our mental health and wellbeing. My question is, how well have universal interventions worked, such as targets for PE, free school meals and access to school councillors, how well have they supported health and wellbeing outcomes for our young people? I would like that to be the question. They have absolutely supported their young people. It will be wildly known and recognised by the spook, the importance of, if children are fed and are well nourished, then there is a better place to learn. That has made a difference in universal support. I think that the on-going challenge is that there is just never quite enough. It was mentioned earlier about the benefit of, for example, our pay pass work and what we are at a local level. We are certainly aware of the growing gap between what we are focused on trying to get the most inactive active and a real focus on girls in sport. We are certainly hearing evidence now from our schools and nurseries that that gap is growing and that the impact on young people's wellbeing, as a result of the lack of our ability to have the extra curricular programme that we had, to have the support services in schools to support our young people, is having an impact. We are working with our schools and nurseries to look at creative ways to continue as best we can. Obviously, as restrictions relax, we are currently discussing how we work to get our extra curricular programme, for example, back up and running and have our volunteers, our sports leaders back across their schools supporting that work. Dr Bruce, would you like to come in? Thank you. I hope that he can hear me now. As I said, one of the issues that we know in Scotland is that we lack nationally representative data about the health and wellbeing of our young people. The active healthy kids report card that was published last year said that there was inconclusive data to report on many of the health challenges that we have. For example, they were not able to report on factors such as fitness, diets and obesity, because we do not have nationally collected data that is representative of our population. Prior to the pandemic, the health and wellbeing was among some of the lowest in Europe. We know from studies in other countries that those health factors have decreased and the gap is exacerbated due to Covid. However, we do not know a real representative picture in Scotland, so that is one of the challenges at the moment. We think that things have got worse, but we do not really know. We have small studies that collect data, but we do not have anything nationally representative in either our physical health or the mental health and wellbeing of young people. I will be as quick as I can with this one. Just to say that youth workers tell us repeatedly that they want to be part of a holistic approach to wellbeing. In advance of this session, I managed to get a really good example of that in practice from Shetland Island Council, involving two high schools and the Mind Your Head mental health charity. It provided two additional youth workers to increase youth work provision in school and a wider community that focused on social, emotional and mental health and connected issues such as attendance. 1,481 young people accessed support through workshops and that included one-to-one support for young people with complex needs. All the young people who accessed the service—that will be a bit of a theme today—said that they felt that they had improved health and wellbeing. You can see that there is a bit of magic that happens when you bring together knowledge and learning from across a wide variety of services that are collaborating around the core aim of improving the health and wellbeing of young people. Right in the middle of all that is the principle of universality, but not just when it comes to mental health and wellbeing, but taking a universal approach to youth work. It is so impactful on all the areas that we are discussing today. I think that it would be fair to say that universal interventions do work. I think that there is certainly room for improvement, but if we just continue to build on that whole-school approach to the P-PASS agenda, where it is about physical education, physical activity and sport and how do we get the teachers and the active school coordinators, sports development coaches and youth workers working together to have the child at the centre and making sure that the physical and mental wellbeing is there? We know from evidence that we have got back from active schools that 98 per cent of the children involved in the active school programmes feel healthier because they make friends that help their wellbeing. We also know that the leadership programmes that Judy mentioned around young ambassadors and a whole variety of leadership programmes give the young people the chance to have their voice at the heart of that, drive that and look at how that can support. One other thing that we have worked across the last few years is our young people's sport panel, so that we have a national platform that allows them to look at what is the voice of the young person, what do they need, and they are very clear that accessibility and having a young person's voice is valued in making sure that sport and physical activity is at the heart. There are a lot of those interventions there. I think that there is always room for improvement in the sectors working together in this partnership approach to make sure that the young person, particularly around inclusion, can have a targeted approach. Through the pandemic, we have found that some of the areas because of the work of active schools, particularly in Renfrewshire and Aberdeenshire, have been given additional resource because of the work that they have had with young people throughout the pandemic, so there are good examples that we can show where quality work is taking place. I will come to Mike Corbett. On the principle of universality on free school meals, we do not think that there is any doubt that that is helpful in improved matters, and there is research evidence to show that. On the physical activity side, we would say that evidence seems to be a bit more anecdotal, and I echo Dr Booth's point about that. We could perhaps have more research on that side, but what we have seen suggests that that helps, but it would be good to have a wider picture on that. Stephanie, do you want to come back and ask anything specifically? That would be great. There are some really comprehensive answers there. I think that they are very interesting in work-while interventions. I suppose that you are all leading me on to my next question, which is how are health and wellbeing outcomes being measured? How can we, as policy makers, evaluate that impact in the preventive approaches in the early interventions that you are talking about here today? Who would you like to direct that to? Initially, I could direct that to Judy again. The assessment of health and wellbeing is challenging, and we are hoping that the current health and wellbeing census will help us with that. Health and wellbeing is being assessed in schools in terms of looking at the assessment approaches within curriculum for excellence and obviously tracking and monitoring children's progress through the levels of the curriculum. Sometimes it is difficult, as was mentioned earlier, if we are thinking about, for example, the impact that sport has on other aspects of a young person's development. It is quite difficult to actually evidence that that is what has made the difference. However, schools take a holistic approach to assessment, and it is trying to bundle some of the ease and those together to then gather evidence. Going back to the first statement that I made, it is challenging to assess health and wellbeing, but it is something that schools are doing as part of their core work. Is there anything for more qualitative data? Is there anything specific that you would be looking for? As I said earlier, it is difficult sometimes to evidence. If we are talking about sport earlier, if we are talking about mental health and wellbeing, it is sometimes quite difficult to measure that and to a portion where the improvements have been made and what made those improvements. I think that, when I talked earlier about the census, we are going to be able to gather more data and good data from the census to help us to improve our programme and curriculum and where the gaps are and what better support is needed. That will then help with our assessment of the curriculum. We also mentioned earlier about resources and training, and I think that further staff development and training around assessment and health and wellbeing would be most welcome. For example, we are working collaboratively within our regional improvement collaborative, looking at recreational drugs. How do you assess that area of our work? However, in collaboration with partners, we are trying to find a way through that. The more resources, the more support from partners—for example, our health colleagues—is supporting us to do that. I echo those sentiments about the challenges of actually determining health and wellbeing. How do we measure that? We know that, for some populations, measuring mental health is really challenging. There is a study recently done in Scotland where the young people are neurodiverse young people. There is a large group of children with autism and the rates of depression vary hugely from nothing to 83 per cent and it seems to be due to the way that that was being measured. We know that some of the existing ways of measuring mental health difficulties do not always give a representative picture of the challenges. I think that that probably speaks to this whole system and holistic view again, that we cannot really tease apart the impact of some of the interventions on physical health and mental health, because the two are intricately related. We know that our physical health will support and be preventative and also beneficial for our mental health, but we know that our mental health is really important for helping us to undertake positive physical health. For example, we are unlikely to want to take part in sport and extra activity if our mental health is really challenged. The two are really intricately related and we need to have a holistic view when we are thinking about mental health, both physical and mental health and wellbeing, and how we even measure that and try to determine the impact is really quite important. That is why we need to have this whole systems approach, so bringing schools and families and CAMHS and health professionals together in order to be able to look at this. As you are asking, we do need more qualitative data, but we also need more qualitative data to really be able to look at a representative picture. We know which groups of young people are more resilient and where there are particular risk factors in order for us to be able to support those young people as best we can. I come to Mike Corbett before I bring one of my other colleagues in for a quick supplementary. Mike? Obviously, along with numeracy and literacy, health and wellbeing is one of the responsibilities for all teachers to review and assess, but, as others have said, that is a challenge here. It is not a percentage, it is not as simple to measure. Consequently, there is probably not quite as much confidence among some teachers in what the actual standards are or the expectations in terms of the assessment of progress of, for example, mental health. We have been looking for some time for additional support from Education Scotland in terms of establishing a standard, but I think that there is an opportunity here because we have a forthcoming review of assessment, which the headlines have been all about national qualifications, but that is going to be a review of the order assessment in curriculum for excellence. That seems to be one of the key areas that we need to dig down into and get a bit more support in terms of the understanding of how we can measure those things and give a bit more confidence. Thank you. Paul Kane wants to come in. Thank you, convener, and thanks to the panel. We have spoken there about universal intervention, but also the importance, I think, of knowing young people and getting the data right. I was quite struck by reading that 15-year-old girls continue to be the group with the lowest wellbeing scores, so maybe just, Kane, if we have a bit of time to explore the factors driving that and, indeed, do panellists feel that tackling gender inequality across policy areas is something that we absolutely have to do in order to make a difference. I do not know if perhaps Dr Booth maybe wants to say something about that. Thank you. I think that one of the issues is that it is a multifaceted problem, if you like. We know that the physical health issues are exacerbated, often during that transition period, but we know that some of the decline in physical activity happens even earlier than the start of secondary schools. Some large data studies show that even seven or eight-year-old children see a decline in their physical activity levels and an increase in sensory behaviour. We know that transition is important. We know that transition from primary to secondary is marked often with decreases in mental health, and often for girls especially, but we know that the impact is across the board, if you like. It is not just girls, although a lot of the data highlights girls in particular. It is not just because of physical health. We have mental health challenges and there is a wide range of contributing factors. In the evidence that we submitted, we were talking about the fact that bullying, social media, expectations and lack of support all contribute to mental health challenges and lack of physical activity. I feel like I am saying the same thing. It is about this whole systems approach. We know that, if we want to encourage young people to be more physically active, for example, it is not just about what they do in school. It is also about what they do out of school, not only through taking part in sports, but things such as active commuting. If we do not have good infrastructure, young people are not going to cycle or walk to school. They are not going to go and be physically active out of school. Similarly, they are not going to do the same during break times and things like that. There are a number of programmes that we are looking to try to include in the whole system. That might particularly support young girls, especially if there is a charity that aims to support young girls in terms of providing infrastructure where young girls feel safe to be active. Good lighting is safe spaces where they feel more able to be outside and to be moving around. All of those things will work together. Your question is about inequality. There is gender inequality, but it is also an issue across all of our young people. Thanks, Paul, for bringing that up. It is a fascinating topic. We have heard testimony from young people about particularly girls being put off physical activity as they came to their teenage years. Can I come quickly to Kevin Kane? To echo some of those comments on poverty and inequality, we know that that exacerbates a number of issues for women in this country and globally. That is an issue that needs to be tackled in its own right, absolutely. However, it is symptomatic of structural issues as well, which at the root of a lot of those issues is poverty. That is the first point on the discussion about enhanced focus on community-based support. Youth workers identify and tailor responses to young people's needs all the time. Not come as a surprise to the committee that I am arguing the case, but it is an easy case to argue because they do it all the time. They would look at the issue for a woman in the context of her world and the social environment and family environment that she is in. Interestingly, youth workers in North Lanarkshire told us during the initial lockdown that they never had more demand to work with parents, young mothers and families as they did in the initial phases of lockdown. They were able to pivot into that space because they were used to working around bureaucracy and breaking down barriers being innovative. They are also trusted in the community as well. We have examples from our food and securities pilot, where the youth work approach helped to break down barriers to engage them with the whole family to the point that the relationship building became as crucial in the primary motivator for people to get involved rather than the food provision. The access to support was secondary, and that has a de-stigmatising effect on people as well. More broadly, at the First Committee session, there was talk of children's strategic partnerships, which recognised the need to pool resources and take an asset-based approach to building community capacity. The youth workers are promoting that approach right now, with an understanding that the young person's wellbeing in the context of their situation is fundamental. Can I come to Jacqueline Lynn before moving on to Sandish Gohani? Probably two things. First, we undertook research in 1920 on the contribution of the Active Schools to the Active Scotland Outcomes Framework, and we got over 9,000 respondents to that across 10 local authorities. We know the numbers of the 320,000 young people, 7 million visits, 23,000 volunteers and 100 activities, but the more important that was that qualitative stuff around the young people feeling healthier, the young people making friends, but also the young people feeling a bit more confident to then go out with the school and participate in clubs and activities in their communities. I think that there is some opportunity there. Again, it goes back to that whole-school approach to physical education, physical education, physical activity and sport. Just going on around the whole girls and women, that has been a challenge for all of us. How do we work together to do that? We know through the participation in active schools that that continues to be a drop-off point, but where we have been working locally was putting in interventions with speaking to girls and a number of girls committees across the country, Aberdeen, Aberdeenshire, where there is amazing work that is really going on to the girls who are really working on the P-pass agenda with the PE teachers, with active schools to change the curriculum to revisit the environments that are in and to really put what the girls and young women want at the forefront rather than that traditional PE curriculum that you either loved or loathed when you were at school yourself. I think that there are interventions and there is still a long way to go, but again, if we can have that collaborative approach across education, sport and health, we can really make a difference for our girls and young women in that as well. Great, thank you. Can I move on to questions on Covid-19 from Sandish? Thank you, convener. Covid has had a must-be negative impact on the mental health of our children from missing schools lockdown. Is there to a fourfold increase in mental health wellbeing issues? I note that including submission stated that there is a lack of evidence for how school-based interventions lead to a reduction in health and wellbeing equalities. Dr Booth, your submission says that you feel that teachers need to be clear to concentrate on their core responsibilities of teaching. Dr Booth, my question is, what should we do to improve our children's wellbeing and mental health? That is a very big question. What should we do to improve it? As we are saying in some submission, and others have said today, it is about this whole system working together. Schools and teachers are at the forefront of supporting children and young people, and we know that teachers need to also have good training, as I said earlier, but also support for their own mental health and wellbeing. If they are overly stretched and overly burdened, they cannot support young people to the best of their abilities. We also know that they are inextricably linked factors, so we need to support our physical health as well as our mental health. If we want to close the attainment gap, we also need to prioritize how they are wellbeing, because our children will learn well if they are not healthy and mentally well. We need to listen to young people and find out what their views of the challenges are, and where they feel that support is necessary. There have been a number of studies, such as James Linda Lyons and the Triumph study that has been looking at young people's voices and finding out what their perspectives are and what they think of young drivers here, not only for understanding where the problems are but also how best to support them. One of the strategies that we think is important is taking cross-diagnostic views, rather than the traditional approach that has to be followed through CAMHS, of thinking about children who might have particular areas of difficulty looking across a particular child's difficulties. Seeing the individual young person and thinking about where their own challenges are and how we can support them on an individual basis. We need these whole-school approaches for supporting positive health and wellbeing, rather than just reacting when there are challenges. We need to increase our physical health. We need support for positive and strategies, if you like, for our young people, so that, when they encounter a challenge, they can show their resilience, because they are not able to be resilient always if their mental health is challenged. Can I bring in Mike Corbett? Yes, thanks. Before I go on to talk about mental health, I mean, I don't think that we should forget about the impact on the physical health of some pupils and the fact that some are suffering from long Covid. Indeed, at the moment, the key group where cases are still rising is primary school-age children. There may still be further physical impacts for pupils, and that obviously causes difficulties for them in terms of absence and for teachers, ensuring that they have the ability to patch up when they return or if they are able to do remote learning. All of that adds pressure to teachers and to their workload. There has a lot going on there already before we consider mental health of pupils and how that might be improved. I do think that there is still room for a more comprehensive approach to researching what exactly the issues are before we decide what the responses can be. For example, in the USA and the Netherlands in particular, they seem to have committed quite significant funding on research and evidence-gathering, developing questionnaires, carrying out diagnostic assessments to try to identify what are the actual issues for pupils across the board, and then they are deciding what to do in response to that. Does that mean that we need small group tuition for some pupils? Does that mean that we need improved reading comprehension support for some, with others where it is mental health? Is there additional social and emotional support needed? Does some need improved access to technology if they are off with long Covid? It is a huge question to answer, but I think that doctors have talked about whole-school approaches. I think that many things have been left to individual local authorities, and they are doing good work. However, I think that there needs to be more of a national approach, first of all, in gathering the evidence and then formulating the strategies and getting the appropriate resources behind that to help pupils. I might just focus on physical health. We are in an obesity crisis here in Scotland, with a 6.8 per cent increase in primary 1 children at risk of being overweight in one year. Covid has undoubtedly had an impact on that, but the Observatory for Sports Scotland tells us that general sport activity has been reducing from the age of 11 upwards. There is an understanding that council-owned sporting infrastructure may be too expensive for inclusive engagement. I want to ask Jacqueline Lynn how we combat this worrying trend, as our current policies do not quite seem to be tackling it. That is a great question. We recognise that that challenge is there. What has happened in the pandemic is the gap between the children and young people that can afford to take part in sport and physical activity as widened. How do we create that opportunity for all children and young people? For us, it is around where we work. I will keep going back to the P pass agenda to the physical education, which is the right of every child in school. There is a network of teachers there to do that. The active school coordinators have opportunities in their schools, after schools and in that safe environment for children. The pandemic stopped that, but the active school network and the children are trying to do that. As the restrictions ease, we want to get that back up and running so that children and young people have the opportunity to do that. The challenge for us is how do they continue that all in terms of into their life and the club environment and where we go into the community. It is a challenge because there is a cost to that. That is a problem for the sector, how we have to pay for that and how children and young people have to pay for that. However, we will keep going back to that whole systems approach and that collaborative approach. If we can work together, then we have got more chance of helping, but we cannot do that in isolation. We know that sport Scotland from a sport and physical activity has a contribution, but we need to be working with Education Scotland around the whole agenda there. We need to be working with Public Health Scotland, and we have just recently signed a partnership agreement with them around those eight investments for physical activity and how we can have a whole systems approach to general health and wellbeing and then that whole school approach to them. Finally, transport, I think that the infrastructure is really important as well. Active Schools have had walking buses for many years, but you know that still kids get dropped off in cars. How do we make the streets safe and how do we use that infrastructure? I think that, like most, it is about us working collaboratively with Scottish Government, with COSLA, local government, Community Leisure UK Scotland, really all pulling together so that we can provide lots of quality interventions for our children and young people at a cost that they can all get involved in. We can train our workforce to do that. One thing we did just to finish off as we have a partnership with SamH, and that was something that we formed before the pandemic, but that has been really helpful for us as we have come out of the pandemic. SamH has helped us to train the Active Schools, Sports Development, Community Sports Hub and our governing body network to understand mental health, because it is not their bag and how we can then begin to have conversations and really help the children and young people and our volunteers to deal with this and really provide quality opportunities. It is a hard one, but I think that in Scotland we are big enough or small enough to be able to work together to do that. Thank you, Jacqueline. It is really interesting to listen to things a little bit. The net zero agenda and the free travel for young people and all those things that sit in another portfolio outside health would have an impact on health as well. It is interesting to listen to you pull that together. I come to Dr Booth and then to Kevin Cain before we move on to questions from Emma Harper. I just wanted to echo Jacqueline's sentiments about bringing together all those different approaches. To improve the physical activity levels and the health and wellbeing of our young people, it is not just about participation in sport, it is about physical activity in a holistic way. Active commuting is key, but also being physically active throughout the day. We know that there are good things taking part in schools, and one of the big things that is coming out from research is thinking about physically active lessons. The old idea that children need to sit down to learn is really being challenged. We know from the evidence that children can learn just as well when they are doing things physically and that sometimes they learn in a better way when they are up out of their seats learning things. That is often down to the innovations of teachers where they are getting pupils outside and they are moving around or they are using sports halls to engage movement and pairing it with learning outcomes. We need to move away from thinking about physical activity as being separate from academic attainment. Seeing the two can be combined and they will support physical health as well as our school attainment rather than seeing the two as completely separate. I would like to echo that it is about thinking about the whole day and not just compartmentalising school and thinking about building activity into the whole of the young person's day and how we can do that and how we can support all aspects of their learning. I agree that that was wonderfully made points. It is important not to lose sight of physical wellbeing and sport. That also ties to the role of outdoor learning, which was so crucial during periods of lockdown. There has been recognition from OECD and now Scottish Government that outdoor experiences should be accessible to young people. That is where a little bit of vision is required in terms of the initial question about facilities. The association between physical wellbeing and emotional wellbeing and all the transferable skills are well known. For our part, youth workers ensure that activities are inclusive and fun. That contributes to the overall confidence and wellbeing of those involved. I can speak anecdotally to the local YMCA facility, religiously manned by a chap called Archie near my home in criminal athletics clubs as well. I wouldn't have continued in competitive athletics and done my coaching awards. My skills in dealing with people, groups and working in teams would have been diminished if not for that time and space being available to me in the heart community, particularly at a time between age 15 and 17 when I was taking part in activities that were bad for my health. I had a diversionary element to it as well, ignited my enthusiasm in sport and just kept me going. Everybody needs an archie in their life and everybody needs that right to access what was, thinking back on it, a youth work opportunity, but it was the facility that made it possible on my doorstep. Right now, there is an SNP commitment sitting in the manifesto for the last elections about strengthening the statutory basis of community learning and development. That is sitting there and there is an opportunity if we push on an open door, get the right people around the table and we get the direction of the travel of the discussion on a right to providing that opportunity. That would give young people and youth workers and those who are behind the notion of people having this wonderful potential on their doorstep a reality. Right now, they cannot access a right to something because it can easily be shut down and it can easily be budgeted against and can be deprioritised. However, if you have a right to something, it changes the game entirely, as we have seen with the incorporation of UNCRC and the culture shift in how we approach a wellbeing economy. I would ask the committee to be thinking about if it is your own colleagues or if it is a cross-party basis having this discussion about that education authority's duty to provide youth work and what that means. We could strengthen that. That would mean bringing a lot of people on the table, including CLD standards, council and others. I hope that that looks back round to the initial question. If you start from your vision and what you are thinking about what do we need to do, then you start to talk about how far away does a facility need to be, what are the openers, who benefits, is there a rural dimension to do that, and so on. Thank you for that. Can I come quickly to Mike Corbyn before I go to Emma Harper? Yes, just briefly. It was just in terms of the talk of getting pupils up and about in lessons inside the classroom, and that is part of physical activity. I was teaching up until the October break before I moved into this post, so I have talked through much of the pandemic. Particularly in the secondary sector, with the mitigations and the kids not being able to work in groups and in rigid rows, which is all absolutely necessary, it was really difficult to build on some excellent work that had been done in previous years on getting kids up and about in lessons. Absolutely, there have been efforts in schools to try and do more outdoor learning, but look at the wind day, and that is not particularly appealing some days in the winter in Scotland. That is another challenge that we have had, that a lot of kids have missed out over the past 18 months in that kind of lesson, but hopefully that is something that we can address. Thank you, Mike. Can I come to Emma Harper? Thank you, convener. Good morning, everybody. It has been quite interesting hearing everybody's thoughts so far. I am interested in a couple of questions about collaboration and multi-agency working, and some of you have mentioned that already. Kevin Cain mentioned the Scout Scotland, and Jacqueline Lynn described Sport Scotland and that role. I know that we have an aim to have multi-agency working. I wonder if the panel can provide examples of where there has been good collaboration with schools to support health and wellbeing, and maybe what some of the barriers to greater collaboration would be, please. I think that because Kevin Cain has been mentioning lots of youth workers in Scout Scotland and also rural, we will come to Kevin Cain first, convener, if that is okay. I remind him for anyone else who wants to come in on that to use the chat box. Kevin? That is great. I am so glad that you asked that. We have got so many great youth work examples that the trouble that we are preparing for today has gone through them all. It also says to me that there is a lot of quantitative evidence out there that we would be happy to provide. One of the examples that we have is from Perth, Kinross and Ganaghe Trust universal youth work partnership, where funds were targeted to those in greatest need. It involved YMCA, Eastern Perthshire Youth Alliance, Logos, Island Perthshire, Breed, Aberfeldy and Kyth youth work. It was their commitment to collaboration that saw them deliver a really dynamic programme. They managed to reach out to new members and locations against a backdrop of Covid-19 restrictions. They were proactively building local authority and third sector partnerships under the umbrella of meeting communities where they are. The difference that that made was that it provided youth work to areas at a time when other services were being curtailed. It has been really refreshing to see that East Lothian Council's new strategy is aiming to capture the best of the multi-agency crisis responding and model that up. It has also taken the approach that mental health and wellbeing is everyone's business. That is the name of their strategy as well. You can look it up, it is everyone's business. It is really aptly named. It is relevant to the overarching question about schools, because they now have a mental health youth worker in each secondary school cluster. That is full-time youth workers, six of them. They are linking that to the East Lothian mental health and wellbeing triage group, including NHS MyPass, Voluntary and CLD workers. Cleverly, they have synced it with their Covid youth work recovery funding referrals on wider youth work offers. That means that we can bring in sports, arts, outdoor education and awards beyond just sitting and examining and getting that kind of recognition. We know that it is absolutely crucial. The awards network in Scotland is a fantastic job of putting together that programme. The process, crucially for us, is aided by youth workers. They have acknowledged that, during the pandemic, that approach helps young people to maintain healthy relationships. If I may, it is very quickly in terms of partnerships, because that is relevant as well, and it is example-based and crucial to furthering the agenda. The time and space that we talked about for young people, we need that time and space for youth workers. It has been hinted at by other witnesses. A great example that we have from the Outdoor Education Recovery Fund is the Branching Upwards project in the Scottish Borders. It created a forest school with 77 local primary schools. At a crucial age, we play in youth work intersex. It collaborated and learned in and around nature. Pupils got their Outdoor Achievement Award. 76 per cent of participants said that they improved confidence and, significantly, all had improved their physical and health and wellbeing. That was reinforced by the teaching staff. That also happened in the new tracks project, a partnership between youth community support agency in Govan Hill, involving three local secondary schools, voluntary sector groups and Glasgow Life. They worked with 120 young people between 10 and 19 and, through Outdoor Projects, focused on art and sport. 83 per cent of young folk reported being more engaged in learning. Not only were they getting the breadth of learning experience, it was an informal setting that was impacting on them as well. Their self-esteem has improved, and more than half of them went on to achieve their John Muir award. Obviously, what we are saying here is that partnerships, collaboration, intervention, prevention are built into the youth work approach, and it will be intensely needed as we move forward and we continue the discussion on Scotland recovery and renewal. Before I give some examples, I would like to echo the theme of the discussion that absolutely schools and nurseries cannot do this alone, and the whole system approach, which is being discussed, and the value of further strengthening partnerships is absolutely the way forward. In terms of some examples, we have obviously heard from Jacqueline Lyn this morning, and I would like to reinforce the benefit of the active schools programme. I mentioned earlier our work on focusing on the inactive to the active, and our active schools colleagues have supported us in that work in identifying data to give us evidence of where we need to focus our efforts. Also, our work with active schools has shifted the much more of an equitable provision, so we have focused greatly on our young people in areas of deprivation. We have also had a focus on inclusion, and, for example, we have shifted our priorities around the Duke of Edinburgh awards scheme to trying to get those young people in those areas of deprivation or those that need to be more included having that support. Another thing that I would like to mention as an example is the get into summer funding, which we had last summer, and I know that there are some national meetings about that coming up over the next few weeks. We had over 30 third sector organisations in Stirling supporting that, again focusing on, for example, the supporting of those children in the transition from primary into secondary during the pandemic, and those children who were identified by our schools and nurses, perhaps, as having some mental health challenges. That has been another example supported by some additional funding to allow us to further engage with our third sector community, which is an invaluable resource in this area of work. A couple of organisations that I wanted to focus on are active life. We have done some award-winning work with young black children and intercultural youth Scotland as well. We have also done some great work to work with minorities. The key issue is resources. For many organisations, resources are perhaps to take them beyond the central belt, because there are a huge number of organisations doing great work, but many of them are doing that in the central belt, not beyond and not as able to move into rural areas. That would be an important thing to look at. We absolutely support the idea of multi-agency work. As I said before, schools cannot do all of that on their own, but we should not forget the college sector, which is vitally important. Again, we have evidence of, just from local authority to local authority, different approaches being taken. In some places, colleges work with the local authority and school timetables across the local authority in order to make it easier for pupils to get out to college on particular afternoons. Other authorities are the individual headteachers timetable, and they do not get that level of collaboration. That is just something else that is important and can be improved and expandable. I guess that it is just that very supportive of the multi-agency work. There are probably two things from us. One is more a higher level of strategic forum that we set up, which brings together local authorities, leisure trusts, higher and further education, Public Health Scotland, Scottish Government and our governing bodies to say, how do we help to recover, and where do children and young people fit in that? We have four themes that have come out of that, but one of the things that you were saying was that we all believe in multi-agency work, but one of the challenges is that we all come together, but what do we do together? I think that that is something that we need to have action out of some of these, so that forum has 12 recommendations and we are beginning to get action. I think that if we can do that, that will help us to work better. The other one that I would like to raise is similar to Judy. I think that Get Into Summer has shown that we are a bit of additional resource and shows really good collaboration locally with a whole range of partners that we did not work with before. In our local authority and third sector partners, there are great examples, and I know that the evaluations have just come out from the Scottish Government on that, so it is just to highlight that as well. Like everyone, the more we can work together and drive, the better. Emma, have you got any follow-up questions? I will come to Evelyn Tweed after you. Just a quick follow-up. It is about the collaborating work in the third sector and all the different roles that we have. I think that it is really important that Mike Corbett mentioned minority groups, because we do not want to leave anybody behind. Is there more that can be done to improve how everybody understands what everybody's role is? Yes, we get everybody around the table, but how can we make sure that everybody understands what everybody's role is? Emma, have you directed that to anyone in particular? I have not, but I think that maybe Dr Josie Booth? Thanks. I think that Kevin Kerr might have more good examples here than I do of how to establish people's role. I think that everybody is combined in talking about wholesome approaches and working together being particularly beneficial and maybe seeing that roles are not separate and that actually we've all got this combined interest. I don't know if I've got a good example where somebody would be leading that. My experience from the research evidence, from the Jamesland Alliance report and from the Triumph report, when they brought together young people, their families and teachers and those involved in health, shows that listening to the young people and letting them drive in and then determine where they need the support and what is most beneficial is probably key for overcoming some of the challenges that we're facing at the moment. Emma, can I move on to questions from Evelyn Tweed? Thanks, convener. For the record, I am currently a councillor at Stirling Council and good morning panel. My question is what can be done to promote greater co-production of services that actively involves young people and their families? It's great to see Judy Edwards here today and I would like to pose that question to Judy. What can be done to greater co-production? I think that was your question, councillor Tweed. One of the things that we strongly believe in as a local authority, I'm sure others are the same, is that we have to listen to our young people. We have to involve them in policy making and decision making. I mentioned the health and wellbeing census earlier and I think that that's one way that we can do that. We had what we call a gathering of our young people a few years ago to really listen to them. We did it in collaboration with our health colleagues to really listen to young people about what is it that they need, what is it that they won't, what would help, how can we involve them more? Obviously, we have to be having discussions with our partners about the practicalities of that but we need to hear from our young people what is it that we're getting right, what is it that we're not getting right and what do they think we can do to help that. Moving forward, it is about taking that information, whether it be from an event such as a gathering or from data gathered from a census or from however else we get it. We have to take that information and we have to take it with us as leaders, as citizens and we have to take that into our work and find ways that we can co-produce with our young people. They are the future and they are the ones that will tell us what they need and what they want. It's our job to take that information, as I've said, into everything that we do and find ways. There are ways to include them and co-produce with them. My second question is about Covid and what lessons we can learn from the experiences of co-laboration during the pandemic and what is being done to embed those lessons for the future. I would like to ask Jacqueline Lynn, please. Thank you very much. I think that we've learned lots of lessons already in the kind of two years that we're there. I think that what we've learned is going back to what Councillor said earlier. It's about understanding each other and understanding the different roles that we play, but more importantly understanding the needs of the children and young people and the families, particularly the vulnerable families. Throughout the pandemic, that has given us all the opportunity to refocus and to look at that. I think that we can't underestimate the challenge of that. I think that we go back to learning. There's a whole workforce out there in sport and we hear youth work, but we don't all have the same skills. How do we upskill our workforce to be able to meet the needs of those people and work together and learn? You hear, Judy, that we have great relationships with Stirling Council. How do we make sure that the teachers are working with active schools, with the sports development, with the third sector, with the clubs in the areas and the volunteers that are putting on sport and physical activity? I think that we've learned those lessons. I think that what we need to do is to make sure that we then take them forward and come out the other end and recover them in a positive way. How has this been done to embed? I mentioned earlier about the work in Renfrewshire in Aberdeen, where we know that active schools teams have been given quite significant budgets and in Fife to start to demonstrate where they can provide sport and physical activity for the more vulnerable families. Already, I think that we see things happening. I don't want to paint it all rosy because we know that we've got a long way to go, but I think that these are great examples of where we can really make a difference for the wellbeing of our children and young people and sport and physical activity can play a contribution towards that. I'll bring in Mike Horbett and then Dr Booth and then we'll need to move on to questions from Gillian Mackay. We've talked a fair bit about financial resources, which obviously are vital, but I think that in terms of embedding anything and, in this case, collaborative work, time is the key resource. The OECD review pointed out that Scotland's teachers have more class contact time and larger class sizes than almost any of our competitor nations. I appreciate that there has been a commitment to reduce people contact time for teachers, but that commitment is by the end of the Parliament, so we would be pressing for that to be done sooner rather than later. I also think that a reduction in class sizes is needed to create that space for teachers to be collaborating with all of the other great organisations that we've been talking about. However, if that time is not there and you've got stressed out teachers with excessive workload, a lot of the good work that's been done could be lost unless we get that commitment. I'll come to Dr Booth. I was going to say that one of the issues that is engaging is that teachers don't have the time necessarily, and they're under increasing pressure. When there's a rhetoric of them having to improve academic performance, their ability to focus on health and wellbeing can sometimes be given a sort of backseat, if you like. As I said earlier, we need to prioritise health and wellbeing because children can't learn effectively if they're not healthy and well. Teachers need the time to be able to do this. They need the resource to be able to do this, and part of that resource is about them having adequate training and support in service. The school council is a great thing, but they're also having opportunities and training from experts in how to engage children in physical activity. Not just in telling children that they should be doing, but about them having a holistic view of what a healthy life is, and about positive health promotion rather than just a reactive sense of dealing with issues. How do we all support a positive health healthy life? Part of that is about role modelling. I completely agree with Mike that teachers need to have pressure taken off them for prioritising things. They also need to have time to undertake training, time to engage in these multi-partner discussions and how to invest that. I completely agree that we need to support teachers to be able to do that. We're going to move on to community and family approaches. Gillian Mackay, you've got questions here. Thank you, convener. Has the pandemic undermined attempts to take a whole family approach? Are schools finding it more difficult to engage with parents after remote learning? Can I come to my corbit first on that? We don't have comprehensive evidence of that, but it's definitely an issue. I could give you examples of my own time when I was still teaching. We tried to do as many live lessons as we could, but quite often I would be sitting there not just with the black screens of cameras off from the people who were there, which was slightly perturbed, but we got around it, but quite often with 10, 12 of my class of 30 not actually turning up for that live lesson and all sorts of reasons behind that, which schools did try to address and try to make contact and made contact with some families. We were able to address that, but in other cases, we were just getting nothing back, and that sense that many were going into a protective cocoon almost. There doesn't need to be some work to re-establish some of those relationships, but quite how extended that problem is, I'm not sure, but certainly we have some anecdotal evidence that it is there and needs it. During the pandemic, I would say that our schools and nurseries found amazing and innovative ways to engage with families and facilitate and offer online learning, but in terms of support and relationships in working with families, it wasn't the same online, and for some families it may be was okay, but for many families that they tell us and our schools and nursery staff tell us that they felt they weren't having quite the same engagement, the depth of engagement, when it wasn't face-to-face. Without a doubt, I think that there's been a detrimental impact on that area of our work. Prior to that question being asked, I actually wanted to come in and say—I think that it just coincided with the conversation moving on to that question, but I actually wanted to come in to say that in the round of what we're considering at this meeting today, I think that we have to absolutely keep an eye on family learning, because while we talked about health and wellbeing, there has been a curricular responsibility of all, obviously the health and wellbeing of our young people is the responsibility of all, the partners that we've talked about earlier, our schools and nurseries and also our families. If we're thinking about something, even just nutrition for example, we have recently used some funding that we had from a partner agency to provide soup recipes and ingredients to make soup. It sounds simple, but for some of our families, that's been eye-opening on what they're telling us. It's the first time they've made homemade soup, so I think that we have to keep our focus on how we are educating our families to improve the health and wellbeing of our children and young people. I mentioned a wee bit about families and food insecurity and stigma in an earlier answers, said too much. However, it was interesting that one of our members working in children's homes reported that some of the young people are engaging better during lockdown because of the less formal approach to learning. For many of the practitioners, they could see that there was an impact then on the wider family, and it led to discussions around the need for greater recognition of the need to engage and continue that approach. The question of how we do that ties to the previous two questions on rights and recovery. There's been a lot of debate on a wellbeing economy in recent times, and we hope that that doesn't go away. We believe that a wellbeing economy can work, but we need to listen to what youth workers are telling us, and that is that partnerships—prevention, early intervention, whole community and family—respond in all that stuff that was to the fore during the crisis. If we involved in that successful partnership approach and get people around the table, we could develop a multi-sector, multi-agency workforce that is dedicated to people's health and wellbeing. That might ameliorate some of the challenges that have been highlighted around getting together, but not doing the action or going off and working in our own lane, because we would have that dedicated scaffold on the core that directs everyone of us around that national vision for a wellbeing economy and within that, that dedicated multi-sectoral workforce. As we have seen, there is so much good work that we can repeat on our upscale, but it will take time and patience as well, and that includes from politicians, because it can be very easy to react and continually react and fund, and then you get caught in that cycle, and that's competitive. However, if we agree to a core vision, I think that it strips away some of that competitiveness that's in the landscape. Dylunia, do you have a supplementary question? Do you want to direct it to anyone? Yes, please. Obviously, in the current context, different schools are working in different ways, depending on their situation with Covid and things like that. In that context, how difficult is it currently making to take a whole family approach when there's maybe one child in secondary school and one child in primary school or different children at different stages of their education? I don't know that taking a whole family approach is particularly an issue if the children are in different schools, because if we're talking about educating the fact that the parents, if you like, along with the child or educating the parents in whichever way we do that, I personally don't see that as being too much of an issue. There are things, for example, programmes such as the ESL programme, which is for English learners from other languages—I can't remember exactly what it stands for—where that would be a whole family approach that would happen out with the school day, and you'd have the children and the parents together learning. As long as there are types of activities like that, where it's appropriate and relevant that the whole family can come together, I don't see it as a huge issue that the children may be in different schools personally. Thank you very much, convener. I suppose that following on from that theme and that line of questioning, I just want to talk about the community approach. I think that we've already started to hear a flavour of the benefit that is associated with taking a community-based approach, but I wonder if Kevin Kerr might want to expand on some of the benefits of the role of communities in enhancing wellbeing of young people. Thank you very much. The question broke up a wee bit there, my apologies. Was that the question? Was that the role of communities? We're speaking quite powerfully just in the question before, Kevin, about that community-based approach. Are you just keen to get a sense from you of what more we can do in communities as well? I think that we have to listen to our communities first and foremost. At the heart of the discussion today, it's about what's best for young people. I'm aware that young people have more access, at least there's an intention that they access power in a way that they may be didn't before. It's a challenge to do that. If you look across the committee today, we all represent organisations and that's part of our role. We need catalyst organisations and people to bring together information and to advocate for a sector. What I would say is that if we could bring that advocacy, we could bring that voice to people more often in their local communities. Given the fact that youth work is positioned within the local authority in the voluntary sector and we're connected to thousands of young people right now, the right approach would be to invest in that infrastructure, but it would also be financially astute. We know from countless research, including from unison, that there's a social return for investing in youth work and that's not just money, that's people, that's facilities, that's careers, it's the time and space that we've spoken about and if we can do that, we can bring more young people to every level of decision making, which would be fantastic. That would also be in keeping with Scotland's ambition on UNCRC, which was received cross-party support, as you know. One of the best things I think I've ever seen happening in the Scottish Parliament will be going through a period of implementation and youth workers are keenly positioned within communities to drive some of that ambition forward. We had young people from—and youth workers from North Lanarkshire, Ayrshire, Shetland, just to name a few—cocking directly to the equality committee on their priorities and hopes for incorporation, but they also do that at a community level as well because our sectors rights-respecting, rights-promoting and we're unashamed about it. There's youth councils built in to local authority structures and the cultural shift from UNCRC is such that more people are looking at diverse innovative ways to bring communities together. When I say communities, that's young people, that's whole families. The intergenerational potential of the sector to tackle social isolation, to bring communities together around a cause, as we saw in Mary Hill the other day, people power to the fore and they kept the library open. That's phenomenal. We believe for that to happen that it's the youth workers that can enable the young folk to realise their article 12 right to be part of the decisions that affect them and ultimately be the change that they wish to see. I'm smiling along because I was in the committee that scrutinised the UNCRC and I remember your evidence then and the amount of work that we did with young people and how strongly they felt about it, so thank you. Can I come quickly to Jacqueline Lynn before Paul Huw put a supplementary, then I'll come back to you. Jacqueline? I think it's just the importance, Paul, of that pathway in sport and physical activity and that community-based approach is where the sport happens in our clubs and in our community sport hubs and we've worked since 2014 the legacy of the Commonwealth Games across the 32 local authorities and we've got over 200 community sport hubs, which did start off very much as sport, but as they've evolved over that duration they've become very much community-based organisations and if we just take from chapel, which started off as gymnastics and table tennis, a pathway of turning young people on to the club and the performance stage, that's now a whole community-based approach which has got classes and programmes for older people, for people with mental health issues and it becomes a social space for that committee, so it's the community-based approach is really important as we move out of Covid and making sure that particularly the children and young people out with school, where do they go, how do we use the facilities which are in our communities to really provide those opportunities and more importantly is how do we get the young people and understand what they would like in these facilities in the community, so the community-based approach from a sport and physical activity is really critical to where we are and how we drive this forward. Thanks Paul, have you got our supplementary question to anyone? Yeah, I think maybe just a supplementary to Mike just on the role that a school plays within the kind of community approach because I think schools are, in my patch, I'm always really keen to enhance that strong community approach. I think I'm having to do more with less and work with community organisations that are also experiencing the same but I wonder if Mike had any reflections on the role of the school in terms of the community approach. Yeah, I mean you touched on something there Paul, that was working really well in many areas before the pandemic, you know the whole notion of community schools and has been touched on the idea of opening up the facilities and schools to the whole community being important and obviously that's something that's been missing for a while but I think it's probably easier to get back to you but the only other thing I think I would just touch on briefly because I know we're short for time is that notion of how you get the not just the pupil voice but the family voice involved and I think we have to be careful that when we do questionnaire surveys etc and you know as schools and other organisations that we're not just getting if you like the usual suspects responding that I think you know we did a bit more work to reach out and schools have always done this to reach out to those who maybe are not turning up to the parents meeting or are not signing off the school report etc and I think that point stands more broadly in terms of reaching out to a number of families in the community and genuinely finding out what they want and what we can do to help. Thank you. I'll move on to the final theme on deprivation, barriers to wellbeing and the questions from David Torrance. Thank you, convener, and good morning to panel members. We've heard about partnership working in evidence this morning from the panel members and we've seen highlights, highlights of several examples. Around the areas of deprivation and the barriers that creates to children and young people's health and wellbeing, what role should public services play in bringing together key partners in creating strong networks and deprived communities and how can that be achieved? I'll go to Kevin Cain first just because there's positive comments about Kirkcaldy High School and Skates Scotland. I thought you might, Kevin. I'm feeling a bit back at the pressure to be positive which will well be because we're campaigning around a vision here. I can hear from the committee members that are keen to drive us agenda forward. In fact, a short answer is huge. It's absolutely huge. The local authority elections are coming up. We will have a youth work manifesto with aims very clearly stated in there. I would put it back to parliamentarians to say that there's that unite the national message with the local authority vision and invest accordingly in public services and make the statement that they're sacrificed. They're not going away, embed it into law even. It's absolutely crucial that every step of government is written into strategies and plans. Our vision is that young people are supported through key relationships with youth workers to achieve their potential. There's a youth work strategy coming up. During the Fairer Scotland assessment, which is one of the equality assessments that sits alongside it, we've been doing a lot of work on youth work's approach in that space. It's crucial that any Scottish Government or local authority plan, regardless of political hue, recognises youth work's integral role in delivering for young people and communities and delivering being the launch pin around any local anti-poverty strategies. I went short answer to long answer, but it's a bit emphatic. Absolutely yes, David. It needs to be clear. There's a PR exercise in there as well, so that's communicated with the public, and that ripple effect is taken out there for people who also believe in public services to repeat that message among their people. Thank you. Carol Mocken has got some questions about poverty. David, did you have anything else you wanted to answer? Hi, thank you. I found the information really, really useful. I am particularly interested in young people from poorer backgrounds and how we can encourage them to take part in all sorts of activity, sport, use of green spaces. Some of what was said before was music to my ears around local services and local government funding. What are the barriers, in particular for young people both at the schools and out with the schools, access, sport and activity? Is it that we, as parliamentarians, need to try to break down those barriers and give people that opportunity to take part, particularly, as I say, from people from poorer backgrounds? We might go to Jacqueline Lennon on that first of all, Carol. Thank you. That would be great. Thanks very much, Carol. In sport Scotland and with our commitment to the third two local authorities, we are fully committed to driving inclusion and reducing the inequalities in sport and physical activity, particularly for children and young people for poorer backgrounds. The barriers are probably quite well documented where we are and it is what are we going to do. Those barriers are sometimes just confidence to be able to go along and take part and be part of it, and also to have the skills and abilities to take part. Fundamentally, I think that the other thing is that there is the opportunity of money. There is not the money, so the poverty and low income are huge across all the local authorities at the moment, and we can really see the difference. We have evidence from some of our research that in actual schools, the opportunities from deaths from 1 to 10 are fairly equal to some dips, but when you go into that community, into the clubs and into the community organisations, there is a real difference, and that is because of confidence, skills and funding. I think that the other thing that we have to remember about young people is that they also have choices, and they want to make that choice, so we need to listen to them and go back to the choice. Just at the moment, the last thing for me is that we have targeted 10 local authorities who have really put projects around where we are driving inclusion, and one of the ones that is really interesting is down in North Ayrshire, with the active schools teams down there, and their whole systems approach has put a dedicated person in to drive inclusion in active schools, and they are working with probably about six families just now, and they get into summer money really helped them to provide opportunities that the families had never had, going to swimming together, taking patterns, bowling, 10-pin bowling, so I think that there are opportunities, and that would be where we are, they would be the barriers that we see carol, and again that multi-agency approach to driving and working together to take away some of those barriers would help. We have done some research in the past about the problems with the cost of the school day generally, and things like school uniform, equipment, money for school trips, etc. The same applies here if you are looking at sports. Sometimes money for sports kit, money for sports equipment, money to travel to where the sporting activity is taking place, equally is an issue for many. That campaign that we have had in the past about poverty-proofing the school day could be applied more widely to sports activities and other areas. I think that that confirms some of the staff's issues and the work that we need to do, so that is really helpful. I have a final committee member asking questions. We have Sue Webber, Sue. Good morning, panel, and thanks for coming on this really informative session. I should declare an interest as a councillor in Edinburgh, but also as a mad keen hockey fan and umpire, and I have seen first hand the role that sports clubs and their teams of volunteers can play in addressing those inequalities. I get a sense that it is down to the hard work of the clubs of more so than policy that is assisting with tackling the inequalities, so I am just truly trying to figure out in my head. Do you get a sense that the Scottish Government's focus on supporting equity in schools is dovetailing with other policies that are supporting the health and wellbeing in deprived communities and families? Who would you like to direct that to first? Jacqueline Lindhurst, thank you. I think that you make a great point. No clubs have been there for many years, they are run and driven by volunteers, committed and dedicated people that give up their time, and I think that you are right, they are the ones that do all the hard work to really get people involved. Government are trying and working hard to tackle that. I think that there is a recognition that needs more to be done, but if you take the programme for government recently about the opportunity to double the budget to £100 million for sport and physical active living, I think that there is an opportunity here. How do we work with the clubs, the governing bodies, with the volunteers to make sure that they are supported through this journey? There is policy there, we need to keep driving those policies, and for us it is going back to the Act of Scotland outcomes framework, we have great policies, but how do we drive the practice and turn that into action so that the children and young people have got their opportunities? We have excellent examples of where clubs have done fantastic inclusion work in Edinburgh, across the country and the work of our governing bodies. I think that there are opportunities there, but it does need resource and we need to really look at how we tackle for the young people that live in poverty and low incomes. I think that that is really hard in terms of all of that. I just wanted to bring this back a little bit to some of the evidence that came from Covid. One of the positive things that was reported was that many families were saying that, due to the restrictions and the permissible one acting a day, many families were saying that they actually spent more time going out for a walk, for example, as a family than they had done previously. When some families were not taking children to lots of different clubs, they actually had a little bit more time to go for a walk together or to access the wonderful outdoor resources that we have in Scotland. That is one of the key things that is not being discussed as much. Obviously, we touched on outdoor education. Potentially that is quite an important role here, but it is not just about the use of clubs, although I am not saying that they do not play a huge part, especially for areas of high deprivation. Encouraging a view of the outdoors as being something that everybody can, if we support them, everybody can access. That has a huge role to play, especially for young people from more deprived areas, where they are not able to go to different sporting clubs as easily, if you like, as young people from more affluent areas. Potentially embracing that outdoor education is being really key here, is quite important. Have you got any more questions that you would like to put to our panellists? I am fine, thanks, convener. Thank you very much. I want to thank our panellists for the time that they spent this morning. Your evidence is hugely valuable and very much echoing quite a lot of what we have already heard from other panels that we are doing in this inquiry. I am going to suspend this meeting until 10.55 to allow our next panel to onboard. Thank you. Welcome back to the Health, Social Care and Sport Committee. Our third item today is an evidence session on the national planning framework for, and I welcome to the committee Irene Buterman, who plays a well-being partnership leaf for improvement service, Dr Matt Louther, head of communities and local partners of Public Health Scotland, and Professor Jamie Pearce, professor of health geography and the School of Geosciences from the University of Edinburgh. Welcome to you all. Livable places are one of the things on the strategy that I think we are quite interested in, in terms of how they are going to be designed for health and wellbeing. First of all, I would like to ask the panel, what do we know about those spaces and those livable places? Do we have enough information as to what those will look like and what things we should be striving for? Is there a particular aspect of the framework that will have a particular impact on our nation's health and wellbeing? I will go around everyone, if you do not mind the fact that I might go first of all to Irene Buterman. Thank you very much and thank you for the opportunity to speak today. Livable places are up there high up in the strategy, which is to be welcomed. The link into public health and into keeping us healthy is almost joining together the two ambitions of planning, which is about managing the land and use of buildings in the long-term public interests. If we want to look at what that public interest is, it sits there within public health. I feel that that is what gives us the evidence and the research that tells us what we need to be doing in places and what every place needs for it to be more livable, for it to enable us to use places in a more preventative manner to keep people well and to also have them thriving and to be dealing with other inequalities that Scotland is facing at the moment. In my role, I have been doing a lot of work on linking together what the improvement service does to help councils and particular planning authorities to deliver those kinds of places, to link in with all of the evidence that sits within public health to see what are the things that we need to get right. We have spent a number of years pulling together a set of place and wellbeing outcomes that we have submitted into the parliamentary ask for views a couple of weeks ago at the beginning of January that sets out what every place needs in order for everyone in those places to thrive. They move around different themes and give a lot more clarity perhaps than I can see within the text in the national planning framework at the moment around how we move around our access to space, open space, streets and spaces, our access to facilities, amenities, affordable homes to work and our ability to take part in society, to feel safe, to have a sense of belonging. All of those aspects come into the behaviour change from somebody stepping out their front door that will mean they have that opportunity to lead a more active life that will help their physical mental wellbeing but also that changes the decisions that they can make that impact on whether they are living in poverty or not. Whether they feel socially isolated or not or feel supported when they perhaps have trauma or any kind of issue in their life, whether they feel supported by their community around them as well. An important aspect as we look at our ageing population as well. There are evidenced links there. We have submitted them in around the place and wellbeing outcomes. An overall set of comments that I have been hearing is a lack of clarity at the moment in the national planning framework to help us to hit the ground running. That is a document that is going to be used by development management for big decisions being made as soon as it is taken on board. We could really hit the ground running and help to deliver places that are delivering on all of our crises at the moment around climate, inequalities, health inequalities, Covid recovery and so on. I think that there is a bit more clarity that we could be getting right and being clear that we need all of them, not a debate across 32 councils of what we are using 10 or what we are only using four. All sectors need that clarity and confidence. I think that you just hit upon the fact that it is at council level. What are local development plans? Obviously, we are about to have council elections. Maybe new councillors coming into that role have not been councillors before. Do you think that there is a need for them to have a degree of training as to what MPF4's goals are and what they do and the decisions that they make? Do they need to be dovetail into that? Absolutely. Yes, there definitely is a need for training. As we can see, the national planning framework has a new set of outcomes that have not been there before for planning to be delivering upon. We have outcomes now around health and wellbeing and not just delivering on housing and delivering on growth, but delivering for a raging population, for biodiversity and for climate. To do it together and not to be often silos delivering on one aspect of a climate crisis and how a place contributes a healthy town versus a climate-based town, it has to be combining that up. The skills to be able to understand that link up and to be adding that level of scrutiny when officers and councils are moving things forward. I think that it is highlighted even this week, where I have seen a lot about one of our councils approving an out-of-town retail centre at a time where we need to be moving and thinking about car-orientated development, how we move that hierarchy. We need to have that buy-in and understanding so that we can also be truly representing all of our society as well and their needs. Understanding that link to decisions need about an out-of-town housing development has an impact on those living in the town who have no access to a car. There is a link there and understanding about that. Thank you. Can I come to Dr Mac Louder? Yes, thank you and good morning everyone. First of all, I guess to Public Health Scotland, we really welcome NPF4 and really welcome the focus on health and public health. I think that this is probably the first time that this document or this planning framework has really had that focus on health, and it is to get large throughout the document. From a public health perspective, that is really welcome to see. We have recognised for quite a while the impact that good quality places can have on health and long-term health outcomes. To see that formally recognised and embedded in such an important document is really welcome. You specifically asked about the living places. Of course, that is where the majority of the health stuff sits. I guess that health is woven through and can be woven through other elements. Sustainable places will have an impact on health, productive places and distinctive places. All of those things will ultimately have an impact on health. You asked specifically about the components of a neighbourhood and a place that affects health. There are lots of those. When we talk about a place, we have a fairly broad definition of a place in relation to health. We will maybe touch on the place standards. That has 14 different themes. All of those 14 themes have place-based and have evidence to sit behind them that show the impact on health. We know the way in which our neighbourhoods are designed. Obviously, that is where people live and work and play. How those neighbourhoods are designed can have quite significant impacts on health. They can improve the way in which people interact socially. They can improve levels of physical activity. They can reduce health quality. They can improve access to services. Another key element is housing. Housing can impact on health through a whole raft of different mechanisms. We will maybe come on to talk about housing later in the session. We have a food environment and a local environment that affects our lifestyle in relation to access to good-quality foods, access to alcohol and other substances that potentially can harm our health. The place policy can have a significant impact on those things. We also know lots of good-quality evidence that I am sure Professor Pierce will touch on around access to good-quality natural and sustainable places. We know that that is not only good for our mental health but also good for our physical health. Being in contact with nature and having access to nature is really good for our mental and physical health. Finally, another key element that is important to health from a place perspective is transportation. How we move around, how we access services, how we can increase our levels of physical activity through active travel and active transport. There is a whole variety of different mechanisms, but overall we are really welcome to focus on health in the policy. Thank you. That is really helpful. Can I come to Professor Jamie Pierce? Good morning, everybody. Thank you very much. It is worth reminding ourselves of some of the public health challenges in Scotland in connecting it to discussion. As the committee is well aware, we have some of the most significant challenges in public health in Western Europe. If we think about what some of those challenges are, we will probably identify mental health, alcohol, tobacco use, drug use, lower life expectancy, high health inequalities, both socially and spatially. Clearly, there are a range of processes that explain that and things that we can do. The planning system is integral to that. As previous speakers have said, we are very much welcome to focus on the planning system and the significant opportunities that it offers us to improve the health of everyone in Scotland, not least in terms of reducing inequalities, which is an important part of that. Certainly, as that was just alluded to just a moment ago, there are many elements in the NPR documentation that will offer some welcome steps that can add benefit to the health of people in Scotland. The green spaces, the access, the quality of those green spaces are a really good example of that, whereby we know that green spaces are really beneficial for health throughout the full-life course, right from birth through to older age, and we know that those formative experiences in terms of green spaces have life-long impacts. We are really welcome things in that. As a public health researcher interested in the connections between health and place, I would argue that this is quite a piecemeal approach to thinking about those connections with some aspects that are represented really well and some that are largely overlooked. I guess that one of my take-home messages would be that there is an opportunity here to think quite holistically about all the key challenges in terms of public health in Scotland. What are some of the underlying aspects of the planning system that are integral to addressing those, and how can we bring those things together to make a really large-scale impact in terms of improving the public health challenges in Scotland? Jamie, you would be remiss of me not to pick you up on the stuff that you think that has been overlooked. Are you able to articulate that for us? I think that there are some interesting things here in terms of looking at the food system. For example, we know that obesity is one of the big challenges in addressing the proliferation of highly saturated food in our communities. Improving access to high-quality food is important, and that I do think that we are starting to come through. On the other hand, there are other commodities that we know that are really bad for our health. Alcohol and tobacco are two of the remaining big health challenges in Scotland. For example, one in five deaths in Scotland is tobacco. However, the availability of tobacco and alcohol are not represented in the document. It is an important part of the planning system to ensure that we support our communities to have those healthy lifestyles that we all aspire to. That is an example of where there are some really good opportunities here to make a significant difference. That is very helpful. Can I move on to questions of the place of health in the framework, specifically to dig into that? Emma Harper. Thanks, convener. Good morning, everybody. You have talked a little bit about what the national planning framework contains, as far as aspirations for supporting health and well-being. Do you think that the framework has enough priority to give health and well-being the support that it needs in reaching planning decisions? I suppose that might be for not sure who would like to speak. You can go back to Professor Pearce, first of all. Yes, thank you. I think that that is a key point. You were not surprised to hear me say best upon what I think. The priority is really important. The climate, carbon zero and related policies are really important. I would like to see health up there as being a very high priority in terms of the opportunities that we have for improving public health in Scotland. There are certainly elements of health that have peppered through this document, but I really think that we would benefit in Scotland from seeing health take a very high-level priority and having a real strategic priority in terms of planning. That is the way in which we are going to make sure that all Scots have access to a healthy environment in a way that will support their health and well-being and reduce inequalities. I would like to see that health as a very clear priority and that being to transcend through the whole document. Emma, I want to find out where our whole panellists want to come in. Just a bit of housekeeping that I neglected to mention that if other panellists want to come in and have not been addressed by our committee members, there we go, are in the chat box. I will come to Eileen Buterman. I think that that is a really good question about the specific addressing of health and well-being and what Jamie Sayes says about it. It is peppered throughout the document, but there is an emphasis stated even when we get to the actual policy that will sit there and planning policy for Scotland that says that it is guided by principles around climate and nature. That surprised me because I feel that it needs to also be guided by principles of what is happening in Earth Scotland in respect of the health inequality that Jamie was referring to and to poverty as well as climate and nature and all of the outcomes that it has been asked to deliver on. While there is a policy there around health and well-being, it is fairly high-level. It does not really get to the meeting and it gets on very quickly to talking about health and social care facilities, which is only one small part of how we are addressing health. I feel that there is almost a need for a further policy in there that is a little bit akin to what Wales has about asking us to think about the long-term impact of all our decisions on preventing those persistent problems that we have in the country. Yes, that is climate change, but that is also including other inequalities such as poverty, the role of place and the places that we create. I can have a huge impact on that. Likewise, health inequality as well. It is perhaps an overarching policy that is missing there. Certainly, simply having guiding principles that are around climate and nature are laudable, but that, again, public health is missing from that. I will come to Dr Matthew Luthor. Obviously, one of the six outcomes for the national planning framework is around public health, so that is to be welcomed. Obviously, the framework itself is a fairly high-level document and I suppose sets the tone, but with those things I guess the devil is always in the detail. I know that there is going to be guidance that is being developed that sits alongside it that maybe gets into the detail about how those things are going to play out. For me, the key question that we need to ask ourselves—and maybe this is a test—is if a local planer wants to refuse development on the basis of health, does that document allow them to do that? We know in the past that that has not been the case. For me, that is a critical question. I know that there is a requirement for local development plans to conduct a health impact assessment, which again is to be welcomed. I know that major developments can be subject to health impact assessments, which is to be welcomed. However, it does not really say much about that level of decision-making on the basis of health and approving or rejecting applications specifically on the basis of health. However, if it could be quite detailed around that, I think that that would be really helpful. I will make it really clear that if a local plan department or indeed a local public health team have concerns about development, there is not going to be an impact on health, what is the mechanism for making that decision? With some clarity on that, I think that that would be really helpful. I have got one brief wee supplementary, if that is okay. It probably is for either Irene Butaman or Dr Matt Louther. I am thinking about one of our questions that talks about whether it is sufficiently clear which developments generate significant health effects. I am thinking about how mental health and wellbeing can be impacted by living next to derelict buildings or vacant and abandoned land. Research says that abandoned buildings and shops can make us feel unsafe and run-down environments contribute to anxiety and low mood. If we are trying to support planning to help mental health, should we be trying to expedite planning to deal with the derelict and vacant buildings that are affecting mental health as well? We have got a number of them across my region, Fishtrin, Rar, Tid and Bar. I am thinking about the George hotel in the town centre, for instance. Do we need to make sure that the developments generate significant health and wellbeing effects and then deal with the derelict buildings as well? I am not quite sure who would like to come in and talk about that specifically. I will go to Jamie Pierce. I can read your support, because there is evidence, including work in Scotland, that we know that derelicts and brownfield sites have detrimental health impacts. It has also been shown very clearly in Scotland that crime and perceptions of crime are also closely linked to mental health. I think that that is a nice example of the way in which the planning system can bring forward those issues with a public health lens, very carefully focused on them, to ensure that the developmental needs also meet health needs. That is where the framework does need to support that. I will come to Ile Butamen. I will repeat what Jamie Pierce just said and what you were referring to about the evidence of vacant and derelict land on mental health. However, I would also go so far as to say that most development has the potential to have a negative impact on mental health or physical health if it is a substantial-sized development. There is an opportunity there to make sure that the consequence of that development is considered in light of its impact on physical and mental health for different age groups, particularly for our ageing population. I am thinking about things such as outer centre development and housing development, a big aspect of what the MPF is there to deliver on. If we are continuing building low-density housing estates on the edge of town, where there is very few access to facilities without the reliance on a car, we are building in inherent mental and physical health problems, particularly as people start to age in that area, but also for those who can potentially feel socially isolated because they are not out walking around building that community feeling and community cohesion. All large developments need to be thought through for their impact on physical and mental health. It is a good question. I would agree with Irene and Jamie that all developments have the potential to impact on health. The point that I wanted to make was about the definition of a major development versus a local development. A lot of the focus, particularly around health inequality or health impact assessments, is on major developments and national developments, but we know that the majority of developments are local developments, so that is developments below 50 homes. They are really significant. There are literally hundreds of those across Scotland and they really have the potential to have an impact on health. As I understand it, the policy only focuses on the major and national developments. Again, there seems to be a bit of a gap around those local developments. The devil is in the detail with those things. Can I move on to questions from David Torrance? Thank you, convener, and good morning to panel members. Around local living, do you expect 20-minute neighbourhoods to have a significant positive impact on health and wellbeing, and if so, in what ways? Can I go to Dr Matlow with her, please? In a word, yes. Again, I welcome the concept of 20-minute neighbourhoods. Over the past couple of years, with our experience of Covid, the power of living locally has really come through. As we were just talking about earlier, having good access, good quality access to good quality local services is really important for our health and wellbeing, and it is really important for our communities. Anything that can increase our levels of physical activity and increase our social interaction, which is what 20-minute neighbourhoods can do, is really important for our health. Obviously, there are issues and potential questions about how many of our communities can become a 20-minute neighbourhood, but I think that the underlying principle of what the 20-minute neighbourhoods are trying to achieve is really good and really welcome from a health perspective, and that is just creating much better local access to the key quality services that people need on a daily basis. I think that they have one of the most noticed impact of realising living locally and the benefits of it that we have had in the public domain for quite some time, so it is totally welcome. We can look across other parts of the world to see what are the elements that they include as being important as a 20-minute neighbourhood. Given the national planning framework provides policy where we can immediately start to assess large applications, there is an opportunity to pin down those elements now. I have unfortunately seen already many communications where there are developments claiming to be 20-minute neighbourhoods because they have put in cycleways and they have one local shop. We are really talking about more than that. If we do not pin that down, we risk taking a planning system and certainly local Governments who are under-resourced at the moment to deal with the duties and responsibilities that they have and having fairly endless debates across other sectors about just what is a 20-minute neighbourhood, so support expressed in the national planning framework for them, but without saying exactly what makes them 20-minute. Let us think about other aspects such as density of housing, such as people feeling they have a sense of control and influence over their place outside their doorstep. That is about more than purely active travel. We could spend an awful lot of time debating that and taking up a lot of planning officer time that they do not have, debating that even into inquiry and cost, where we could pin that down. That again was why we submitted in the place and wellbeing outcomes that we have looked at and tested as the wording that could pin down exactly what a 20-minute neighbourhood needs to be. Everyone across Scotland is starting from the same standpoint. There is consistency and there is a comprehensive approach. That would give a lot of confidence to all sectors who are taking part in the planning system. Thank you. David, are you happy with that or if you get anything else you want to ask? A small supplementary question, please. How will the benefits of 20-minute neighbourhoods be realised in more remote, rural areas of Scotland? How can we achieve to get this? I will go to Dr Matt Law to start with again, please. I wanted to commend on that specifically, but I will come to Dr Louther first. It is a good question about the rural aspect. For me, it is about how we encourage and improve our services in those communities so that we can make sure that people can access the services that they need, the daily services that they need, on a daily basis. That is why I am so drawn to the concept, because it is about trying to improve access to good quality services for everyone. We need to be realistic and pragmatic about it. Some of our rural communities will not be able to walk to all our services within 20 minutes, so I do not think that we should necessarily get too hung up on the 20-minute aspect of it. For me, it is about improving the quality of access to the key local services. That is what we should be aspiring to do. I will come to Aileen Buterman. Thank you. It is a very good question given how much Scotland is covered by rural areas. It is very much about whether, if you live in a house on its own in the countryside or a hamlet of 17 houses, you will relate to your nearest settlement. You will say, I live outside of. It is making sure, when you get to that nearest settlement, that you get as much out of that place and what that place delivers that stops you having to go beyond and on to another settlement that is 50 or 100 miles away in order to meet your daily needs. It is accepted that not everybody can have that on their doorstep by that 20-minute living, but when we come to rural areas that local settlements are treated as 20-minute hubs, we think of them like that. We do not think of them as places that can then spread and sprawl out because they are in the countryside because they are the 20-minute neighbourhood hubs of the future and for the area around them. We build appropriate densities. We still look to provide all the aspects of a 20-minute neighbourhood within those hubs so that people can choose to either live within them or to live without them, but once they get to them, they can park up that car that they have needed to get there and move around and access everything that they need in the same manner that they would do if they were living in a more urban environment. I think that there is a lot of opportunity to think about how we are developing those rural towns and to address that rural depopulation ask that is in the national planning framework. I am digging into the rural areas a little bit more deeply. We have got Sandish Gohani Sandish. When housing developments are green, there is an assessment to its impact to schools, but there is no assessment as to whether primary care can cope. We know that there is a historical lack of staff in rural areas and a lack of homes and transport infrastructure that makes it less likely to attract staff. Should that framework include an assessment of a minimum requirement for health and care services to be provided alongside new developments—I have a supplementary answer to that. Professor Pierce, I will ask you first. I guess my response is that the range of services that a community needs for a healthy, fulfilling life and, certainly, primary healthcare services is part of that. I guess I would say that the national planning framework, the good intention would be to look quite enlistically across all those needs and, of course, those needs that are coming back to the previous question in rural communities. That might look quite… We appear to have lost Professor Pierce. Can I come to one of our other panellists first when we are trying to get him back, if we may be coming to Dr Louther first? I guess my response is that the quality of services and access to services is something that could be picked up through those health and equality impact assessments or health impact assessments. When the LDP is being formed, what the HIA can do is look and think about how the development and the planned developments can have an impact on health. Part of that is an assessment of access to services such as health and social care services. Through the provision of an HIA, looking at LDPs, I would hope that that would be picked up and taken into account. Just quickly, the framework mentions looking at the provision of health and social care facilities. I think that it is something that it could say a little more on about closer relationships with our health and social care partnership in order to ensure that there is provision there. I know that, in some councils across Scotland, that happens to perhaps less better-formed connections in others. In my own experience of 28 years previously working as a town planner, a different set of approaches as to whether that was bottomed out before looking at the growth of a particular area. It could be something that is in here about making sure that there is that kind of evidence looked at across working more closely in building a relationship with a health and social care partnership to establish where there is capacity and where there is a need for a matching up of the provision to meet where an area is perhaps growing. Thank you, convener. Sorry, I said that Professor Pierce is back. Oh, Professor Pierce is back? Okay, if you want to ask a supplementary question, and then I'll come back to Professor Pierce first, he can round off his points where earlier and then address your supplementary, if that's okay. Absolutely, so Irene was talking a little bit about this, but can we really use planning as a tool to improve health services, especially in our rural areas? If we come back to Professor Pierce, we heard most of what you were saying, I think that you just dropped off at the end, so it's good that you've been able to come back. Sorry, I'm not quite sure when I got cut off there, but I was making a case of a holistic approach to health services. In rural areas, on the points around relating to 20 million, I see that more as a principle and a metaphor. I think that we should be applying that to our health services as well. What are those services that we need? How do we make sure that they're as accessible as possible to those communities? The spatial planning framework helps us to do that, because it makes us think about what it is that we need within reasonable access for our communities. I'm sure that it'll be a helpful step towards that. Thank you, and can I come to Irene? Yeah, thank you. I think that we can, yes. I think that what we've just been talking about with the role of 20 minute neighbourhoods in local living would mean that part of looking at our existing areas and any future new areas that we make sure that there is access to. Those daily, weekly needs of not your hospitals and so on, but that access to health services can be planned in as you're moving forward. Again, that's closer links with health and social care partnerships to ensure that that's happening. There's frequently a breakdown of sending a local development plan off to your director of public health and your health and social care partnership once it's been prepared, yet there are so many councils doing great work who are talking to them up front and planning around what's already there and thinking and taking that into account. The emphasis on local living and local facilities can only prove to support that as we move forward. Teritorial boards are key agencies and are required to be consulted on in relation to local development plans. I think that that makes sure that that relationship is strong right at the beginning so that when we are producing our local development plans we are doing it in light of what are the whole health and social care needs of our populations at the beginning, so it's about making sure that those connections are strong right at the beginning of the process. That's great. I move on to talking about health inequalities and Sue Webber. Thank you, convener. I'll be interested in some of your comments about the 20-minute neighbourhood being more than about active travel. How in your mind is the national planning framework for account for the needs and the experience of disabled people in Scotland? I know that 39 to 40 kilometres of segregated cycle lanes have been put down in Edinburgh under the premise of spaces for people. That's caused a lot of concern for disabled people and those with mobility issues in Edinburgh. What can be done to build more inclusive settlements going forward? Great question. I want to go to Dr Leather first. Yeah, it's a great question again. As I said earlier, the devil is in the detail with these things. When we're starting to provide the guidance that sits alongside how NPF4 is going to be implemented, it needs to be really clear about how developments can be produced in a way that is accessible and truly accessible to all of our communities. As I said, the document at the moment doesn't say a huge amount about that, so I think that that's really an area that it potentially could be strengthening. Potentially, you talked as well or mentioned inequalities. I think that there's a real opportunity for the plan and system to have a real impact on health inequalities. We'll maybe touch on that later in the session. The guidance that sits alongside is going to be really critical in terms of getting that right to make sure that it really is truly accessible. Where I struggle a bit, Dr Leather, and maybe the next country to address this, is that all the documents go from walking to wheeling. There's an awful lot that happens before someone walks and ends up in a wheelchair. I really struggle with that. It doesn't seem to allow for those who are striving to walk and want to get out. Do you understand where my approaches and my thoughts are? Yes, absolutely. That's what I was trying to say. We really need to be really clear about this with the guidance that sits alongside it. How can we really make sure that it is? For me, that comes back to the whole idea of health and equality impact assessments, not just health impact assessments. The whole idea of a health and equality impact assessment is that there are tools and guidance that allow us to do that. We can very specifically look at those sorts of policies and think about how they will impact on all of our communities. That's what I would particularly push for health inequality impact assessments as well as health impact assessments. I think that they will pick up those sorts of things. Precisely because of that, I can be known to rant a little bit about using the term 20-minute neighbourhoods and folk going on and on about 20 minutes, because it is about different population groups and it is about people walking and travelling through their urban and rural places at different paces, and we need to take account of that. The place and wellbeing outcomes that we've inputted into the process so far, we are very clear at the end of that that we have to see that through the lens of all of our different population groups, and that includes different mobility abilities almost, and how people can be moving, and also the touches in more so on what Matt was saying also about other groups in our population and considering how we deliver places with an eye on all those different aspects of a population. That's why we really need to be talking local living, because it isn't just about some arbitrary number of minutes, although that has captured the attention. Where we've used those place and wellbeing outcomes to assess a place and how it's moving forward, we have run it through the lens of not just the national outcomes and the place and wellbeing outcomes, but all of those different population groups, including changing mobility, particularly because of our ageing population. I think that we do need more on that, and I would certainly like to just see it now, because then planning authorities can, as I say, hit the ground running on assessing this and getting that change to happen now. Thank you. Siw, have your questions been answered? I've got one more question, convener. Again, I mean that we're alluded to this as well in terms of one of the state of aims around the planning framework is about increasing the density of settlements, but we've known through the pandemic as well that the valuableness of our green spaces in our urban areas. How is that going to be balanced a bit more with the need to support active travel and public transport while protecting our green spaces, which might be the spaces that are used to create those active travel routes, etc? Oh, we've got to go back to hearing on that. Not sure. Professor Pierce, maybe? We'll go to Irene first. Can planner hat on? Thank you. Density is really important, but it doesn't have to be a huge increase in density. We're not talking up to high density, we're just talking about pulling away from the sorts of detached, large villa sprawl that we are tending to see around most of our towns in Scotland at the moment that don't enable us to live more densely, to walk more, to support a local shop. You need a certain number of households and population to do that. If we wish people to go and use that shop, then we need things just a little bit closer together in order to achieve that. That is talking about a mix of types of housing, of having terraces, of having colonies, of having flats, of making more use of lower ground floor flats for our aging population. If we think about many of the great places in cities, I'm sitting in Edinburgh and it's places that have a mix of big, large villas in with tenements, in with colonies, in with semi-detached and achieving more of that mix, but always, yes, still having access to open space being absolutely crucial that it's not at the cost to that. It's at the cost to just building individual blocks all the time that aren't necessarily what our housing needs are as we move forward with an aging population anyway. They just tend to be what, when we rely on the private sector, what they tend to make the most profit for their shareholder out of. That's their business model and that's absolutely fine, but it isn't always then meeting what's the greatest place that we're creating. It's both of them and it's just a change in the uniform spread that we can tend to see. I move on to questions on conflicting interests from Gillian Mackay. Thank you, convener. Does the panel recognise that there are conflicting Scottish Government aims and ambitions highlighted by the framework? For example, how does the action to support the whisky industry in order to provide sources of local employment line up with a public health aim to reduce alcohol consumption? That could equally be applied to other areas that we've spoken about in terms of road building and things in other sectors and their impact on public health. Does the panel feel that public health should be prioritised over some of those other aims? Can I go to Dr Lither first? That's a very difficult question to answer. We know that economic investment is incredibly important and has public health outcomes. It's difficult to provide a definitive response. From my perspective, from coming back to the area that I'm particularly responsible for, it's about creating the right places. Part of that is about creating economic investment. Of course, that's really important. I guess that it's also making sure that all of those decisions are based on the evidence and the science, so we can model how those things potentially impact on public health. For me, it's about taking a proper evidence-based approach to those decisions. They are very difficult decisions, as I said, because we know that economies are so important for local public health outcomes. Apologies for not answering that question definitively, but it's just not a simple response. That's great. Thanks, convener. That's me. You seem to have lost the convener. Paul? Thank you for coming on to my questions anyway, which is maybe deeply timed. I'll kick off this section where we're looking at national development. I just wanted to reflect on the fact that, within the national developments of the NPF, there are 18 national developments. That seems to me like quite a lot. I think that, very often, those things can become quite cumbersome. I would be keen to understand what kind of impact do we feel that those 18 are going to have on health and wellbeing, and I'll maybe start with Dr Leiser. As part of the process for developing the NPF force, we did an evidence assessment that looked at the potential for the national developments and how they impact on health. We concluded that all of the national developments have potential to impact on health. From a public health perspective, I think that the developments do have the potential to have an impact on health. In terms of the actual number, that's a difficult question to answer. I've only looked at the individuals as individual developments. I'm fairly comfortable and quite positive about what they say about health impacts. I'm not seeing any other panellists wanting to come in at this stage. I'll maybe move that question along a bit. Should the impact on health and wellbeing be given equal consideration to, for example, the impact on the climate, and the climate emergency, because we know that there's a huge amount of focus on that at the moment? I can see that Irene Butaman will bring you in at this stage. I think that the impact of the national developments, of the policy of the strategy, in every case, we need to be looking at the impact on both of them and achieving that triple wind that we keep talking about at the moment. When we're looking to do something that is focusing on climate, and the MPF is quite clear that its primary guiding principle is around climate, we make sure that we're not having unintended consequences that are negative on health, but we can achieve them both. It's more important that we work in collaboration to make sure that we're delivering on them all. It shouldn't be at the cost of one or the other or prioritising one or the other. I believe that we can be doing both of them. If we give ourselves a little bit of time to collaborate and talk through around knowing what it is that we need to achieve in those places and how we can do both. Thank you. Jamie Pierce wants to comment on those issues as well, Jamie. Thank you. I very much agree with what Irene Butaman is saying. I would also add that applying a public health perspective on the national, the 18 national developments, the question arises to me as to how were those chosen. It comes back to your supplementary point about making sure that health is a key principle there. If health was a key principle in selecting those 18 national developments, it would be good to know how those decisions have arrived. Perhaps it's been slightly sceptical that health wasn't a key principle in deciding upon them. For me, it comes back to our conversation at the start of the committee meeting that we make sure that health is up there as one of the key strategic drivers here. We think through the benefits of health and wellbeing inequalities in a forensic way and target them throughout each of those national developments. Thank you very much. The convener is just in the process of re-bitting, so we will continue with myself. We are going to move on now to questions from Stephanie Callaghan, and Stephanie is going to look at outcomes. Thank you, Paul. Earlier on, I already mentioned the work that the Improvement Service and Public Health have done around spatial planning, health and wellbeing outcomes. How can the outcomes proposed there be embedded in the framework so that they are going to be consistently used? Yes. Where we already have a set of policies in part 3 of the national planning framework, the place and wellbeing outcomes provide an awful lot more clarity than what is given at the moment within those sets of wordings. We have aspects such as policy six talks about the design and the quality of a place. I think that that is absolutely crucial. I think that we could be using the place and wellbeing outcomes wording itself to give much more clarity on what are the consistent, comprehensive things that we need to be considering in order to make sure that everybody is starting from the same hym sheet, essentially, rather than debating it over time. That is where they can be embedded into that policy. At the moment, we have wordings of things like sense of joy and a feeling to want to play. Those are not wordings that planning officers determining major applications for change in areas can use. They need actual wording that can enable them to confidently make decisions. They need that backed up with evidence about the inequalities and health inequalities in an area. Very much they need that confidence of wording that is now being established in the national planning framework. My memory back when we began the process was that the national planning framework would take a lot of the burden of local development plans by putting a lot of the policy once for Scotland up there nationally that could then be used so that we could be producing slimmer and more agile local development plans in order to speed things up and move things on. I just do not think that the level of clarity that is sitting in the national planning framework at the moment could be used like that. That is certainly what I am hearing from others across the board. Taking the wording of a very strong example of what we could be doing would be beneficial and seeing if that needs to be augmented into the specific interventions that would need to be taken in order to deliver on those place and wellbeing outcomes. I think that what is important is that if you looked at every local development plan across Scotland right now it would have some of those elements in them but it would not consistently have them and it also has from my own experience talking to planning officers across Scotland because we support them with a planning skills series and we support heads of planning as well is that they frequently do not have the confidence to apply them. Back to what Matt was saying earlier they did not feel they had the teeth to confidently say that you are not providing a good density with good quality open space and all of the elements that we need that we know we need to create a really successful place, you are not doing it so we are going to turn you down. Where councils have built a reputation of doing that they can eventually start to make a turn in the kind of applications that are coming into them but that takes time and that is what concerns me is that we need to get going now so embedding that kind of wording and that quality would enable us to do that now. That is really helpful, thanks Irene. I should say that I am a councillor at South Lancer Council still currently as well, not longer on the planning committee but I was previously there too. Okay to just follow that up convener with another short question there. Yeah sorry, I will just step in at this point and say that the convener is now with us again so after my five minutes of fame I will pass back to convener. Thank you. Stephanie, before you ask your question, Dr Leather and Professor Pearce wanted to come in on your initial question. Can I bring in Dr Leather first please? Yeah thanks, so just very quickly on top of what Irene has just described, what the health and wellbeing outcomes allow us to do is very clearly describe what a healthy sustainable place looks like in its totality. I do not think that that is really clear in any of the documentation that is being produced. So the health and wellbeing outcomes are very, very clear. If you want to produce a healthy sustainable place, these are the 14 things that that place needs to achieve. It is really clear in that respect. So I think that there is an opportunity to embed those places of wellbeing outcomes in the guidance that is being produced and consulted on the moment around LDPs. Potentially in one of the annex we could list those outcomes just so that local planners, so that local developers, those involved in the planning system, can really properly understand what a healthy, sustainable place looks like. Thank you. I will come to Professor Pearce. Thank you. Just to add that I think it is important that these are tied to the ways in which the planning framework can affect very concrete pathways. So, for example, obesity might be one that is identified. It is important that we think about the pathways, so one of the pathways might be about improving access to nutritious food. That might be one way that we capture it, as well as the health outcome, which might be reducing obesity levels amongst school-age children. That would be an obvious example. I think that it is important to think through the steps and stages through which the planning system can affect it and the strength of evidence connecting the two and making sure that those are informing whatever those outcomes are. Thank you. Stephanie. That is great. Thank you very much to all of you there. Now, earlier on, we had Dr Booth and Jacqueline Lynn—I do not know if you were all here for the beginning of the committee—for the first panel that we had there. They mentioned and really stressed the need for infrastructure for women and young girls to be able to be active in their communities and feel safe when they are out in the community. I wonder if you feel that that is something that has been adequately addressed or if there should be some more focus there, thank you. Thank you. And again, I go to Aimee. Thank you. I think that that comes back to what I was saying earlier about mobility as well, is that when we are looking at any major proposal for change, we need to be running it through the lens of different population groups. That is why, at the bottom of the place and wellbeing outcomes, it lists those population groups, one being women, one being young people. I think that it is crucial that we know that open spaces require a different set of requirements if we are going to get young girls in particular to take part because they have a different set of asks from that place. We need to be considering that, and we need to also—and that comes to comments that are made within the policies about equalities as well, where it says, you know, we need to talk to communities in an appropriate and I can't remember the other word, manner. We really need to be finding, making sure that we are talking to all parts of communities or talking to our community planning colleagues who are aware of all parts of communities and their needs as well, so it is an important aspect. It comes back to that wellbeing economy measure, doesn't it, of Catherine Trebek, about 12-year-old girls being able to cycle to school as a way of monitoring the success of a country, rather than it being purely about GDP. That is absolutely crucial. Thank you. I did promise if we had time at the end that I would allow Emma Cymru to come back in for her very targeted and very brief supplementary. Emma, you wanted to ask Dr Leather a question? Yes. Thanks very much, convener, for indulging you. It is for Dr Matt Leather. He has mentioned the place standard tool, and he describes, Matt Leather describes, the 14 questions in this framework that aims to let communities and public agencies and voluntary groups find aspects of a place to target the health and wellbeing and the quality of life. This tool, how do we know that people are aware of it and that they are using it? Yesterday, I called the Ffrisian Galloway planning department and they were not aware of the tool, but they were certainly going to look into it. How do we ensure that tools such as this that can support better planning for public health are available and are used? That surprises me, because we know that every local authority now is using the place standard tool. We have a national alliance that brings together people using the tool. We have representatives in its local authority areas that we engage with about the place standard tool. It has been used literally hundreds of times across Scotland. We have a very accessible website. We have had international recognition for the place standard tool. It is used in literally dozens of other countries. Obviously, we can rest on the laurels. We will always need to do more. If there is something that you specifically think that we need to do to get that message out there, if people do not think that that message is not getting out there, that is something that we specifically can look at. However, I am quite surprised by that, because as I said, I know that we have a national alliance and that we have contact with all the local authorities and that they are all using it. That surprises me. It is good to hear that it was only one person that I spoke to, so it might be worth me following up on a wider area as well. Thank you very much. I want to thank our three panellists for their time this morning. Very interesting discussion that has given us a lot to think about, but that is the end of that session. At our next meeting on 1 February, the committee will take evidence from the Scottish Government on part of our inquiry into health and wellbeing of children and young people. We will also take evidence on two common frameworks, but that does complete the public part of our meeting today. Thank you all.