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It was helpful. Do you have any insights into how the reporting process could be optimised? How can we make it consistent at a national level?

That was an interesting insight into the extent to which demand has increased and how that constrains your freedom in relation to resource allocation. We will need to consider that further.

Capital and revenue budgets have been split since 1998, and there is a proposal to have preventative expenditure as a third component. In Glasgow, the situation around homelessness services is particularly acute—I understand that there is an overspend in the current financial year of £27 million, and that is forecast to increase next year. Preventative expenditure could act almost as a kind of automatic stabiliser, because there is a statutory obligation to meet that need, which can create an uncontrolled spiral in expenditure. We must also consider the opportunity cost with regard to capital investment in housing stock and the expansion of housing acquisition and supply and so on—I accept that that is not necessarily within the control of an IJB-HSCP. We want to achieve our mental health goals, but one of the foundations of good mental health involves meeting the hierarchy of needs—shelter, housing and so on.

It is quite clear that we are treating a symptom of a wider structural problem, and the essence of preventative spend would involve punching through that silo and taking a cross-cutting approach to dealing with the immediate crisis. How is the particular scenario that I mentioned playing out? It seems to me like there is quite a looming crisis in Glasgow, and it is probably the case in other parts of Scotland as well. However, we appear to be in a straitjacket with regard to our capacity to bring public resources to bear to deal with homelessness in a structural and preventative way by, for example, building new stock rather than simply treating the symptoms by renting hotels.

I thank the members of the panel for attending today. I think that we have already heard consensus among the panel that the current data on mental health budgets does not give a clear picture of activity at a national level and that there could perhaps be an improved connection between budget allocations and stated priorities for mental health at national and local levels. Feel free to correct me if I am wrong in that assessment.

Our main source of data is Public Health Scotland’s costs book, and the latest figures are for the financial year 2023-24. The 2023 report from Audit Scotland on adult mental health highlights that

“Limited data and inconsistency in how spending is categorised make it difficult to track spending on adult mental health.”

The Mental Health Foundation’s submission also highlighted the issue of data gaps and inconsistencies, and it is not clear that the Government has responded to those data gaps.

Perhaps Mr MacLeod could highlight what we need to do, or what the Government needs to do, to improve the data picture. It is one thing to criticise the lack of data, but what would good look like? Could you hint at what that should look like? Are there other countries or other methodologies that we should emulate?

To summarise, Professor McKay, are you saying that we need more qualitative data and perhaps more contextual data?

I have heard that there is data that is not being utilised to give a picture but that there is an audit trail that could be potentially helpful in drilling down into outturns. Who takes responsibility here? The issue is the span of control. Often, there is a dissonance between local IJBs, health and social care partnerships or boards and the collation of data at a national level . Where does the optimum balance sit? Does anyone have a view on what that should look like for the control, collation and publication of data?

Thank you. The rest of the panel members are nodding.

My thanks to the panel. I am finding this really interesting, because in the mental health context, it can be quite tricky to reconcile different approaches. What might suit a logistically rational top-down approach—say, a diabetes screening programme or vaccination programme—might not work as neatly with a mental health programme. There might be much more gradual and interrelated impacts with regard to housing, urban planning, the community, employment, training and so on. How rich is our data on mental health budgets and their impact on and interfaces with other public services to support the use of a top-down, analytical, gradual, PBMA approach to allocating resources at a local level?

Okay. I am just thinking about this from an urban planning perspective, which is a personal interest of mine. An American urban planner in the 1960s, Jane Jacobs, contrasted what she called cataclysmic money—that is, a sudden influx of capital spending to do something like slum clearance and building a new housing estate—with gradual money, or community-based investment made over a longer period. The latter might preserve a lot more of the rich, organic, intangible activity that is valuable, but it is the sort of activity that does not trigger any signals that might be recognised by urban planners looking down, godlike, on a situation. They might see building new housing as the simple solution, but it actually destroys rich activity and value in the process. From your own perspectives, are there any such risks in using PBMA in a mental health setting, given the much softer and more gradual and intangible aspect to how it works?

Who would own the gathering of that data? Does that need to happen at every level at which the data is gathered? Central Government, local government, local health boards and so on often dispute who is responsible for gathering such information. Moreover, is it always appropriate for transparency—including, say, putting it in the public domain—to ensure accountability with regard to the data picture?