Siarad gyntaf yn ddifio ar gyfer y 13 ymyrgyrch yn Gwithgavensbaith, y camera gynnwys ygaf wahanol i chyfnod digwydd ein blynyddu i dangos y pelbyn i fynd i'r ffordd o'r ffordd o'i fachodol, fel y gallwn cyffredinithu. Aello'r unrhyw ond mae'r meistagau beth oedd o'r ffordd oedd Gwyrraedd Cymru yw efo chi wedi gynnwys yr eich Gwyrraedd Cymru. Dac oedd Cymru, Cymru, Gwyrraedd Cymru, faelwyr wrth gwrs fel gyflymu yn canwys wrth IPinsol, ond esau wrth NHS Scotland.  The advantage of that was having within the one body not only the function that looked and synthesised evidence, but then trying to use that to translate it into usable knowledge to improve Scotland's health. Ieithaf, oes oes oeddaeth i chi'n ddweud i'r organisatio, fe wneud o'r strategiae organisatio ar 5 ymgylchedd, ac wedi gweld rhan o'r ffordd hyffredigiddau ysgolwyr. Mae'n ddifydd i'r cyflwynt yn y teimlo. Mae'n ddweud i'r cyflwynt pobl yma ar y dyfodol i ydy'r 2010 o'r 2011, wrth gwrs, o'r ddwylog ar yr enw i ychydig yn ddwyngiol ysgolwyr i'r newydd a'r newid yng Nghymru hefydolol i'r Minister ddwyngiol, ond describe health inequalities in Scotland has been Scotland's biggest health challenge. We took that as something of a cue and looked to try to develop the evidence that we both analyse and produce ourselves. Focused much more on the nature of health inequalities and even more importantly on what it takes to reduce health inequalities. Felly, we have just come to the end of that first five-year organisational strategy and set out with a second five-year term, very much sticking with that general theme. An important development within the last year has been following the Government's announcement of the health and social care delivery plan, plans for a new public health landscape in Scotland. We are both welcoming and enthusiastic about that because it follows on one of the main recommendations from the public health review in Scotland, which commented on the challenges of having the national functions for public health sitting with different bodies. We are bringing them together and we believe that we will strengthen the public health contribution to public services transformation in Scotland. That is about as far as I can work out delivering improved public health in Scotland. Over the last five years, what tangible delivery has there been as a result of the work of your organisation that any of us could point to and say that is what happened and that was good value? Let me start off with the generality. I think that concern about health inequalities has never been more central to the... The concern for health inequalities is very well established. You could fill this room with reports that have been written on health inequality and I worked with your organisation in producing one of those reports. The assistance that I got was fantastic, but we know the problem, we know the generality. What tangible difference is there? Okay, so what we've been doing is working both within the NHS but increasingly with public services more generally, trying to ensure that that evidence is able to be used both nationally and in particular locally. So we've worked significantly with a number of community planning partnerships about how they use both their local population health profiles but actually to use them to make different decisions. So we've worked with a range of community planning partnerships. More recently, along with a couple of other national boards, we're supporting integrated joint boards in helping them understand the population health challenges in their area in order to make different policy decisions and indeed resource allocation decisions. We've used a number of ways of doing that. We have and we've left you with a series of inequalities briefings which point not only to an analysis of the problem but ways of making different decisions, as I said. I think that the report you may have referred to, Mr Findlay, may have been about the triple I report. Was that the investments in reducing inequalities? I'm just looking at a number of reports that you've published. Okay, because that very clearly set out, I think, quite a different approach. So the actions that we need to take to reduce inequalities clearly go way beyond what we do to just improve the general average population health for the reasons that I think that this committee has rehearsed well. So one of the things that we've tried to do has been to produce less published information simply to distribute it to people and sit down much more with people about saying, what do you do differently with that? So we are now working with teams and a couple of examples of that would be, you'll be aware that there have been a number of fairness commissions across Scotland and we've been specifically invited to help with that. And as recently as the last couple of weeks, we had one of our senior staff involved as commissioner with the Perthyn Cynros commission, very specifically making contribution around the importance of good work and fair work towards improving health in a local community. So I think that there are just some examples. So I have to go back again. What I was asked before was some tangible example. So for example, in, let me pick, a random place in Scotland. In Perthyn Cynros, have they implemented a recommendation from you that makes a difference to reducing health in it? So have they done something in housing? Have they done something in transport? Have they done something in any field? Similarly in Highland or Glasgow or Edinburgh? Where have they done? Enacted something specific that you have recommended? Okay. So the Perthyn Cynros one is perhaps a little early because it was published literally just before the election period. I'll only pick that random one. No, exactly. But I can give you an example. So in Dundee where I sat myself as a commissioner on the Dundee Fairness commission, one of the outputs from that was that Dundee declared itself a living wage city and worked not only within the public sector but encouraged private sector employers to adopt the living wage, specifically because of the evidence that was introduced about the impact on health of a city whose health challenges are well known. Okay. Thank you. Yes, of course. If I could, I mean it is always quite a challenge to attribute specific actions to things we've done. We work with others and we influence others and whether Health Scotland was the main influence or not is sometimes in doubt but examples might include the place standard, putting the health dimension into physical planning and decisions around physical planning and also the process of involvement in defining a good place. Court evidence for minimum unit price. I think we have been a substantial supplier to Government lawyers or lawyers acting on behalf of the Government in the court process. On e-cigarettes, I think we've altered the balance of advice about the use of e-cigarettes in smoking cessation efforts. On child poverty, directing attention towards adverse child experiences and also rolling out an initiative called healthy wealthy children, which started in Glasgow but we have potentiated its effect, shall we say, across the rest of Scotland. Do you have a final example from me? We are aware that we have a long-term strategy to make Scotland a no smoking country. One of the challenges that the Government gave us was to help to lead the NHS as a model contributor to that and you might be aware of the policy position about removing smoking from NHS campuses, which was always going to be a big challenge. We led, on behalf of other NHS boards, a fairly major marketing exercise. You may have seen it as a TV advert, for example, which was never going to immediately stop smoking in and around NHS grounds, but we have seen a significant reduction in that as part of that longer-term programme. I will bring in my colleagues at the moment. Just to confirm it, you have worked with four community planning partnerships, haven't you? Who would like to come in? I will follow up on the place, which, to my mind, is important. I see that in my constituency and in other places around the country. Where has that got to in terms of having a specific impact on planning regulations or on processes? That is great, and we will agree with that. In reality, on the ground, it does not often happen because of the way that the planning process is constructed. If people make decisions on that, they fall on a set of rules and tick boxes that do not necessarily take account of any of that stuff and its impact on health. Where have you got to in terms of influencing that and making changes to the input to the planning review process that is going on or specifics where planning decisions have been changed and taking account of that impact on health? I do not think that the place standard was ever intended to influence legislation, although one would hope that legislation would be complementary to what it is trying to achieve. In a way, the place standard is slightly a misnomer because it is not about standards but involvement in the process of defining what people want in a good place. It was conceived and developed jointly with Architecture and Design Scotland and with planners in the Government. It is a shared ambition and it has also influenced well outside the health sector. What is it doing at the moment? It was launched to great support. We believe that there is quite a lot of work at local authority level and planning level to apply its principles and processes. The outcomes are, again, a little early to tell because its launch was only about a year or two ago, but I think that it will feed through and make the planning process influence the process in terms of bringing local people's say into the definition of what the place could be and its attributes and its positive features. We have tracked the local authorities who are actively using the place standard and 70 per cent of local authorities are now doing that. They are coming back to us for further advice. However, the importance of that is clearly in planning our new communities and indeed thinking about our existing communities and recognising that the environment in which our children are growing up has a direct impact on health. We have had an incredibly enthusiastic response from local government who are welcoming the fact that they have an evidence base to plan differently. You think that it can influence, but it is early days for that. It is just because I am on the reality that what you see does not reflect what you see is planning and going in, building lots of houses in their own place without regard to facilities or amenities or green space or anything just to get houses up. You are hopeful that that will influence at some point. My experience of sitting down talking to planners is that they often are the ones that are as concerned as any of the rest of us about some of those developments. What they need is a very strong evidence base to demonstrate why they might resist particular planning applications, but perhaps more positively about the value of the investment in, for example, a new area to live in, a new housing estate that has paid attention not simply to the needs of car users but to be physically active because of the way that it is designed. The benefits of having planned green space in new community development have an evidence base on the impact on health for it. It helps planners to shape some of those developments. I have been closely associated with the Go Well research programme, which has been led from Glasgow's centre for population health. Health Scotland has been a co-funder of that research. One of the big lessons from that has been not just the regeneration, and there has been billions of pounds within that programme in Glasgow, but not just about the bricks and mortar and putting up new accommodation and converting and improving it, but about how it is done, the process of how it is done. That is a very strong message that has now been put around a lot of Scotland in terms of lessons learned on regeneration and its relationship to health. You are not going to get an immediate health benefit from regeneration, but in the long term the lessons are that if you do not, health suffers. That is one of the studies that we have been jointly involved with between Glasgow's centre and ourselves on the Glasgow effect. I know what you are saying. There does not need to be changes to legislation or guidelines to make a positive impact, which I care a bit counterintuitive because I thought that you would need to do that. If you take, for example, the community empowerment bill, which has done stuff that has got the potential to make a difference in terms of how space is utilised, what you are saying is just by the process of influencing, do you think that that is enough to make a difference? We were jointly chaired a side meeting to the housing conference in March this year. I was particularly struck by the housing associations—principally about housing associations—how they have changed their culture and how they are reflecting on the change of culture towards being community empowering organisations and thinking about the quality of their service to tenants rather than just this major capital investment machine that they may have been perceived as. I think that they have changed a lot. I would like to think that that research has helped them to enlighten, describe and challenge them on the way through and, certainly, anecdotal accounts that I am getting suggest that that is the case. Okay, thanks. Donald? I am interested in that point. The cross-party group on health inequalities has had lots of evidence on the place down and I think that it is one of the most interesting things that is going on in terms of health and equalities. I want to take the discussion on the Scottish Government's health and social care delivery plan, which, as you will know, foresees that by 2019 there will be a new public health body. My question is, where do you fit into that vision? At the moment, there are a number of domains of public health. Health improvement being one of the very significant ones. We are currently the national body for health improvement in Scotland. We will go alongside the health protection function and the health intelligence function into the new body. We will cease to exist as health Scotland when those plans are implemented. Our hope and our desire is that we leave a very strong legacy for the new public health body on the basis of the work that we have been doing over the past 13 or 14 years. Thank you for that answer. One of the impressions that I have got over the last year or so, and we have seen a lot of the non-territorial health boards here, is that it is quite a cluttered landscape. There is a lot of overlap, a lot of duplication. In terms of your role and its survival, what reasons can you give for surviving, as it were? I think that in any orthodox approach to public health, health improvement would be seen as one of the important functions. The Government, indeed, in the review on public health, stressed the importance of the health improvement function, but that being operated and managed at a national level, at least in a separate body from the other important contributors, has been suboptimal. That is the conclusion of the review and the Government's response has been as a result of that. I have been very confident and optimistic that the national health improvement role will be strengthened by its inclusion in the new public health body. It is one of the reasons that our organisation has. I do not mean simply in the leadership of the organisation, but our staff across the board have been enthusiastic about the plan changes. If I may add to that, if you review the body of evidence about what is effective in tackling health inequalities, particularly health inequalities, yes, there are lots that you can do at local level, very local level, and there is more on that, but there is a great deal that you can do at national level on legislation, regulation and influencing policy. I think that a national agency such as ours needs to exist in order to press that case, to assemble the evidence, to influence fellow national bodies, for instance in the environment, natural environment, as well as things like planning and so on. I think that there is a role. I believe that there is a role at national level for an agency focused on tackling health and equality and improving health at national level. I mentioned the long-term monitoring of health and equality's headline in the years of October 2015. The Scottish Government noted that, in relation to health and the healthy life expectancy, there have been no significant changes to inequalities in male or female healthy life expectancy since 2009-2010. That is not a good legacy, so who is failing? I would like to say not us. It looks as if we are associated over our last five years with no change. Are we getting a message across? That is a question that we need to ask ourselves. Are we trying to improve or become more influential? Are we doing enough there or producing usable knowledge? I think that your message is crystal clear about how you change health and equality, but somebody is not listening and nobody is taking action. Therefore, as I said before, we could fill this room with reports on health and equality. This is the bloody, frustrating thing about the whole thing, that all of us have concerns about health and equality, yet they grow wider and wider and we see no action. Who is failing? We need to take radical and focused action, but we are not, so who is failing? I think that we are building consensus in order to try and succeed. That is our job, rather than we are building the evidence on which other people can take decisions. We are not a political organisation, we are a health service. Are they taking those decisions then? Are they taking those radical decisions that are required in your opinion?  Not all the decisions that we would like to take are taken in favour of health and equality. Clearly, we have a very keen eye on all decisions, whether in the health sector or the non-health sector, in many economic and social policies. Very few of them are potentially damaging to health and equality, but some, and especially some outside this parliamentary remit, I would argue, are risky in terms of whitening inequalities. Can we just add a couple of things? I think that it would be fair to say that we at times share your frustration around this, but I think that there are positive signs around this. In terms of the current work around creating a different approach to fair work and good work, we have been able to influence some of the thinking in Government and, indeed, we have made a number of contributions to the fair work convention. Those messages seem to have been taken on board. They are, I think, quite powerfully made by our own organisation since we have hosted the healthy working lives programme for a number of years now, so I am encouraged by that. Likewise, there has been an open mindedness about the extent to which some of the impact of the new welfare powers coming to Scotland and the ways in which they could be used in order to certainly mitigate at least some of the worst aspects of inequalities. We know—indeed, the World Health Organization would say that there are some very fundamental causes for that, which we are very familiar with. We need to then think about, with the powers available to us in Scotland, what can we do that would allow us to make different decisions? I remain optimistic that— So what would you do with the powers that we have got? I think that I would ensure that we do all that we can to reduce the levels of inequality in income. Give me a specific policy, then. Okay, so what would you do? Would you increase taxes? Cut taxes? I am not sure that it is for me as the chief executive of a public body to say that, but what I would do is certainly to say that in relation to much of the work that Andrew cited, the healthy and wealthier children, we know from the evidence that taking every step within public services to maximise the level of income that is available to families makes a difference in their health. We have supported Glasgow in that, but in the roll-out of that, about the benefits that we would accrue from ensuring a much closer integration, so that front-line healthcare and other public service staff are able to direct people to the sources of support in a much more integrated way to maximise their levels of income. In your publication, The Right to Health, Tackling and Equalities, it states that we are committed to supporting the Scottish Parliament and Scottish Government's efforts to tackle social injustice, working with a variety of partners to address the issues in this Can you tell the committee what is your relationship with the UK Government and what engagement you have with the UK Government? We have no direct relationship with the UK Government. Given that we are a national health board, which is an entirely devolved matter, our relationship would be, from a Government point of view, be directly with Scotland. That is an interesting intention to say that it is an entirely devolved matter, because in what causes health inequalities within the same publication, there is widespread agreement that the primary causes of health inequalities are rooted in the political and social decisions and priorities that result in an unequal distribution of money, income, resources and power across the population and between groups. The fundamental causes result in an unfair distribution of power, money and resources. That is often leads to discrimination against and marginalisation of individuals and groups. We know the impact of UK Government welfare reforms, and we know how cross-cutting and cross-sectional challenges to health inequalities are. Do you think that it is possible to achieve your aims of reducing health inequalities without engaging with the UK Government, particularly when many of the levers that they control and control solely have such a huge impact upon health inequalities? I appreciate that we will use the international evidence around the causes of health inequalities that go beyond the UK as well. We have a global phenomenon of that unequal distribution of resources. In terms of our own constitutional arrangements, we are responsible to this Parliament rather than to the UK Parliament. I appreciate that. What I am asking is, can you realise your goals of creating a fairer, healthier Scotland and reducing health inequalities without having any engagement at all with the UK Government? To give you one example, the family cap is going to divide thousands of children into poverty, but you will have no engagement for the UK Government and no input that will have not sought you advice in this matter. We are an agency of the Scottish Government and our primary relationship is with it. We work through it to try to influence the UK Government. We also work with our colleague National Public Health Agency, Public Health England, and they are constrained in the agenda that are set by their Government, and there are constraints around that. A number of years ago, I represented directors of public health as a professional group at the welfare and pension select committee in London. That is one way of finding a route to influence and comment on Government policy. We have also done solely amongst the UK health agencies, health improvement agencies, to work on the potential impacts of welfare on health. I have to say that it is supported by the other agencies because they do not feel they are in a position to do so, partly because the challenges of relating to a Government, which is set in a particular direction, we have distance and that brings with it some freedoms, limited freedoms, which we are trying to exploit. We have done work on the potential effects of welfare, and those effects are becoming evident, but I would say that the reports that we have produced so far have not been definitive on that, particularly the trends in mental health do concern us. We are trying to get our message across. We have also produced work on taxation and the relative effects of council tax rise or income tax changes. Our feeling is that we can present this evidence, but we cannot necessarily say do this, do that. I think that it is for parliamentarians, politicians to take judgments and the public and commentators to take judgments on what we say, the authority with which we say it, the quality of the evidence behind it, and we are there to influence what they do, what they think, how they act. In that case, would you accept that we are limited in what we can do within the confines of a devolution settlement? I will give you one example. I had a constituent come to a surgery of mine, a woman who was forced out of work due to chronic ill health, and she wanted to get back into work, but she needed time to recover, but she had lost a particular benefit that she was on, and having to go through the indignity of assessments, this was exacerbating existing hypertension. It was also affecting her mental health, where she was in tears at my surgery, telling me that she was feeling suicidal, but she didn't want to tell her son because it wanted her son who was unwell to get further stressed. Given that is something that we cannot fundamentally do anything about in this parliament, and it is having a massive detrimental impact upon her health, would you accept then, on that grounds, that we are limited to what we can do within the Scottish Parliament? The Scottish Government is limited, and ultimately, have I ever been able to, as the best way for it suggests, undo some fundamental causes where merely we just have to mitigate them? I am not inventing excuses for what we do and the limitations that we perceive of what we can do and the influence that we can have. We have seen changes, and we have described changes. Our work on welfare makes the point in the first report that we do not have certainty over the health effects, but we are looking in the following directions. Our second report showed that it was still too early to see changes. We have to accept that we look back on data about events that have already happened, rather than predict them because there is no modelling to help us to predict the effects of welfare. I entirely accept what you say about constituents and people's personal experience, and I use some of that from the deep end practices in my testimony to the Health and Pension Select Committee. We are extremely worried and frustrated by the direction in which welfare is going. That is a professional judgment, but we need the evidence, we need the data, and we will describe the data in future reports about what is actually happening at a population level, which is where our job is, and to square it with individual accounts, such as we get from your cells and from deep end practices and other research bodies and research knowledge to create a picture of what is happening. I too am extremely frustrated and worried at the direction in which welfare is going, but that would be putting it mildly. I will pick up on where Tom left off. I am thinking about issues such as the Resolution Foundation has commented that, over the next five years, it expects income inequality to grow, and in fact, for this UK Parliament—we are now going to get a new one, aren't we? The UK Parliament could be the worst for income growth for the poorest half of households since comparable records began, and the worst since Margaret Thatcher for inequality. We have a Government in Westminster who are decreasing benefits. The welfare reform has targeted disabled people, the poorest and most vulnerable in society. Today, we are talking about the impact of welfare reform on disabled people. Tomorrow, we will be talking about the impact of a reduction in housing benefit for 18 to 21-year-olds. It is nion impossible for this Parliament to tackle health inequality when income inequality is so impacted by the Parliament in the UK. Is that not the case? I accept that. We have limits to the powers that we can take to protect the vulnerable, and that is exactly what is happening. We are damaging the income prospects of vulnerable groups and vulnerable people. However, our job is to study, describe and advocate on the basis of the health effects that we know to be happening. My earlier point was that we are searching for these effects, but they have not. In terms of how they appear in data, they have not come up yet because partly it took time for welfare reforms to feed through. The real bite came in two springs ago, so we are now going to see the effects of these now at this time because they will feed through to health events, the sort of events that we will describe in future reports. I think that you will see from our publications that we are not likely to demur from the general principle that reducing individual or family income potentially has a negative impact on health, and that is our real concern. Our approach is to recognise that, in addition to some of those fundamental drivers, there are other things that we can do in terms of the decisions that we make. If we look at some significant areas of policy that are available to us in Scotland, the way in which we approach housing policy, for example, can have a real impact on individual and family health, and communities' health. When we look at the impact of, for example, homelessness on public health, we see the negative impact of that. Those are areas that we can draw attention to the evidence. In addition to Mr Arthur's description of the fundamental causes, we have a middle column around prevention. There are things that we can do where we could make different decisions that would have a positive impact on health, we believe. Across a number of areas of policy that are within our gift in Scotland. I know, but it is just so striking that the fundamental causes are not within our gifts. I look at this in the front page of this publication from you. What works to reduce health inequalities? One, introduce a minimum income for healthy living. We do not have control over that. Ensure that the welfare system provides sufficient income for healthy living and reduces stigma for recipients through universal provision and proportion to need very little control over that. A more progressive individual and corporate taxation, we have control over part of income tax, which is given to us in such a way that it is almost impossible for us to exert any different policy on that. The creation of a vibrant democracy, a greater, more equitable participation in elections and local public service decision making very little of this is within our gift in this Parliament. It is extremely frustrating. As I say, I am sure that you will not be surprised to hear that we would share that frustration. I would point out, though, that perhaps it is because I am an inveterate optimist, but partly because I would look to say, where can we make a difference? In some of the other briefings that you have with your pack, you will see that some of the areas we have been doing work to assemble and synthesise that evidence and say, what do we need to do differently? We have given you some examples of that today, but we would be happy to give you more and we will continue to look at various areas, particularly where public services in Scotland, responding to Christie's challenge, could make different decisions that would drive improvements in health in a way that was much more equitable. One of the reasons that we moved away from a focus simply on average population health is that our health, if you compare it across European countries, has improved at a slightly slower rate than many other countries, but, for me, the big challenge is that it is those whose health is poorest and whose health needs to improve most that are actually doing least well in all of that. That is fundamentally the challenge of why we are not making as good progress as many other countries in Western Europe. Miles Scott Thank you, convener, and good morning to the panel. I was interested, one of the documents in place in communities talked about community empowerment, and this is an area of work as a committee we've done quite a lot of work on in terms of all the organisations involved in health in Scotland and decision making around health decisions in general. I wondered if you had a comment on how people actually are being engaged in reforms around health in Scotland. Will that start? We are primarily an intermediary organisation, so we are a national agency working to help people at local level, and you've heard that we are engaged with specific community planning partnerships and so on. We have marshaled evidence, as you've just heard from your colleague, that community engagement empowerment is a very important part of creating improved health amongst individuals and communities. What's our part in making that happen? I think it's to supply the tools and means for people to take local action. It is to work with voluntary organisations at national local level to help them and empower them because they are in a very good position, close to people experiencing the effects of inequalities. We are looking at the potential of the community empowerment act and how one might evaluate its effects. Clearly, it's new, and it's quite a complex piece of legislation. We found out that people aren't particularly aware of it on the ground, so we've got a job to do to enable that new legislation to have an effect, and that's really starting from the ground up. Our job is to marshal evidence, advocate, facilitate, get people on the ground to modify their plans for action, influence practice amongst health professionals, particularly health improvement professionals. That would be my interpretation of our role on community empowerment. Maybe I can say a couple of other things. One specifically involves me personally. The North Ayrshire community planning partnership recently produced its community plan and formed an advisory group of people who are involved in a number of aspects of the business of community planning, including health. I was invited to join that. At the most recent meeting of that advisory group, a very specific discussion point was the extent to which local communities can be engaged in both identifying areas for improvement in their communities and finding a release of resources to support them. That's a very good example of that. Another one would be that one of the programmes that we host within Health Scotland is Community Food and Health Scotland, which supports local community groups across Scotland around the importance of food in local community life, both access to affordable food and the importance of food in social cohesion. A number of those local groups are heavily involved in their local community councils and local community planning arrangements. In terms of my line of questioning, it was more around the reform of health services. For example, here in Edinburgh, the Scottish Government is centralising a gender of health services. Edinburgh cleft palate and lip surgery for children being centralised through to Glasgow. For me, on a daily basis, I'm finding people who are complaining about the centralisation of our health service. I was more wondering in terms of your organisation how you are making a voice heard on that. I will attempt to add something that is perhaps at the limits of where we are in Health Scotland, but it may also be contentious. Four jobs ago, I did a job with the National Services Division about highly specialist services. We have got to take courageous decisions about interventions on rare diseases for which there is a need for expertise. The expertise is gained largely through seeing a lot of the same sort of condition and driving up expertise. Unless we take those decisions and have fewer centres doing better, the outcomes will not improve and the resources will not be freed up to do other things that we would like to see done in tackling health inequalities. We in Scotland have to make some very difficult choices. We will always have limits on the amount of resources that are available, unless we do that. Patients do largely accept that they have to travel for highly specialist treatment. You heard last week that even non-specialist treatments such as cataracts are a necessity to journey to the west of Scotland from the east of Scotland. I think that, largely, patients will accept that if we put the case clearly about the consequences. The consequences are outcomes and resources are freed up to do other things. Can I maybe mention about the local aspects of public health? I think that this is an important part of the development of the health and social care delivery plan. The Government's announcement so far has been simply to reform the national landscape. I recently embarked on the first stage of ensuring that we see the positioning of public health in a very different space between local government and the NHS. I was invited to an event where senior local government leaders were involved in helping to shape what those public health priorities for Scotland would be. I wonder whether that might bring some more of a local dimension into shaping those national priorities. The extent to which I expect to see a shift is that we have seen the public health resources relocate in many cases to within health and social care partnerships, but the relationship between the national priorities for public health and the local delivery landscape is a crucial issue. What do you think is key to people not feeling that they are empowered when it comes to those decisions? It is quite clear that people do not feel that their views are taken into account. Frankly, I am not going to bring very much new thinking to this. I think that I would just go back and read the Christy commission about what he said. In moving towards having specialist centres and centres of excellence, which I think is commonly accepted, if we are going to be able to deliver the kind of care and the health technology that is now available, it will require reconfiguration. What role do you think politicians have in being able to communicate that to their constituents? Do you think that that further action collectively has to be taken to communicate the benefits that will follow such changes of service? I will attempt to answer that. I will try to fold it back into our area of focus. Quite a lot of our recommendations, where the evidence is about tackling inequalities, is very plain and simple, and it sounds very straightforward to implement such as legislation and regulation. At local level or the effect on the individual or the way that they see the world, that is much, much more contentious. In the clinical side, you have a grateful patient and also a very skilled doctor and their medical team around them. They do not like to see change unless it is explained in their case one over. There are stakeholders and players, and I think that the role of MSPs is to understand what all the dynamics are and to represent their constituents. However, there is a bigger picture here about the future of Scotland and its public services and its health service. One of the justifications that I would make for staying as a national public health agency is that we can do once and well what other people could do 14, 22, 31 times with less skill or less expertise. I think that there is an efficiency, effectiveness and a better outcome from some functions taking place at national level or regional level. It depends on the intervention and the type of thing that we are looking at. For a highly specialist evidence, such as the health effects of welfare, such as refining the evidence on interventions to tackle inequalities, such as cleft lip and palette interventions, those things need to be held at national level so that we get the best out of the public pound. Several times, local issues are there. What impact has the budgetary decisions made here then passed on to local government having on health inequality? Local government has historically been in the very front line in addressing poverty and health inequality. I can only take my own local authorities example in West Lothian. We have had £90 million removed from the budget, so what impact is that having on the ability of local government to address local health inequality? I do not have to hand detailed information on that. Clearly and empirically, less resource available means that they can do less to alleviate the effects of inequalities. The things that local authorities do, apart from their role in integrated bodies, let us say in transport, in planning or in schools in education, are fundamental to alleviating or mitigating the worst effects of inequalities. How can they prevent them? There are roles, certainly in the targeted social work, for instance, and the population wide housing and planning side, where they can take evidence-based measures to prevent inequalities getting worse. We have a growing relationship with COSLA as the national representative agency in local authorities and local public health colleagues to try to get that message across. I believe that the closer links with the integrated authorities and some joint appointments between local authorities and health boards will bring those groups closer. The review took on board and paid particular attention to local authorities' concerns over the influence of public health expertise on what they did. That is a particular area where we want to see improvement once things settle down after the review and the implementation of the review is under way. Obviously, it is recognised that if the Government is going to play a role in tackling health inequalities, that needs a cross-departmental approach, but there is still that perception that the Government policy on health all too often focuses on what the national health service can do rather than what the Government can do. A recent example is probably the mental health strategy, which I think was widely criticised for not being as transformative as it could have been. Do you think that there is enough cross-departmental work when it comes to tackling health inequalities in Scotland at the moment? The short answer is no, but I see a number of policy areas in which there is real room for encouragement. The current policy focus around educational attainment has broadened the discussion quite significantly from what happens specifically in the classroom. Indeed, we have been invited into a number of related areas of work in understanding the impact of family income, as I mentioned earlier on, but also in the way in which other important dimensions—for example, earlier childcare—can impact on future educational attainment. I think that that would be examples that are at least encouraging signs. I do not think that people do not get that intellectually, but they do. It is sometimes just very hard, especially in the way that we allocate resources, which are often very much within particular channels. At a time, particularly when those resources have been reducing, it can be quite difficult to get those resources freed up to focus on that joint effort. Since we started on our work on health inequalities, we have said from the start that this is not a job that we can do alone. It is collaborative. Again, an area of encouragement is the extent to which, particularly local government—I think that local elected members, for example, often have a very acute sense of the health in their local communities. Local government has been hungry for the kind of evidence that allows them to promote different decision-making. That is a range of functions. I think that there is also a role for other public services beyond that—anything from environmental protection to transport planning. If, for example, we want to have a more active population, simply telling people to be more active—we actually know from the social attitude study that people know that they need to be more active, but simply telling them to do that is not going to be what will achieve that. The people that we need to get to most are the least active. Therefore, one of the things that we need to do is think about how we design a different approach, including our public transport policy, our travel policies, but also the environment in which we are building new communities. How do we do that in a way that will make people more active? I am encouraged by, at least hearing from those organisations and across Government about the willingness to consider that. It is often much more difficult to deliver in the reality. How do we break down barriers to making sure that it becomes a reality? For example, one of your resources is a health and equality impact assessment. How widespread is that used by people other than, frankly, health policy? Does that use right across Government? How do you break down barriers that has every department of Government putting health and equality at the top of their agenda? I think slowly, gradually, perpetually trying to gain influence in places where we have not been before. Two jobs in 18 years ago, I was in the Government as a health policy adviser, and we started to break out of the old mould about health policy being about health services and little else. I think that comparing where we are now with where we were then, we are a lot further forward, but there is lots, lots more to do. Internationally, Scotland is seen as way ahead on integrating children's policy. Health interests have a real influence on what happens in schools, for instance. It is more than many other countries. However, we are talking to the energy officials and the energy minister about efficiency there. We have heard before about housing. We want to have more influence over climate and sustainability, and we are being heard. We are largely welcome because people accept that if there is a health case, there is more power to the case that they can produce as a global reason to do things and change things. Those are areas where we are just getting into it, but 18 years ago, I do not think that I would have ever dreamt to have had such an influence over planning policy makers as we have over the place standard. There are cold areas, but we have warmed up a lot of areas. Health in all policies is a slogan, but we would like to be the embodiment of that. We would like to be everywhere and doing anything, but to come back to a point that Jerry made earlier, we need to look at our priorities and where we can get the most influence. Part of that is strategic, part of that is tactical and opportunistic. Where we are heard goes back to the other point of welfare and devolved powers and non-devolved powers. We have things to say whether we listen to or not and whether that ground is fertile. What our job is is to create the conditions in which health can improve and we can effectively tackle health inequalities. Those include the political, as well as the public and media tenor of debate. We are there trying to get into other areas with policy makers and local authorities, just as much as we are trying to influence other audiences. Maybe one of those other audiences is, for example, employers. I mentioned the healthy working lives programme. We were in touch with 7,000 employers last year who were seeking advice on how they create a healthier and support a healthier workforce, not least because that will make them a more productive workforce. We also host the healthy living award, which supports retailers in promoting better choices in retail food outlets, particularly in the fast food sector. We are working across a whole range of public services. Third sector organisations have worked very significantly with Shelter Scotland, with the Poverty Alliance and others, in order to bring evidence to them to help to support them in pushing for particular changes. We are first and foremost a public services organisation, but we are supporting other aspects of civic life in Scotland. You are a public service organisation, but is it not a bit strange that you have to lobby public service to tackle health inequalities? You are a lobbying organisation by the sounds of it rather than a Government organisation, because you haven't to lobby the Government to carry out, frankly, the reason you were set up. I have worked for a lobbying organisation in the past, and I am very clear that we are a public service organisation. However, we have the resources that help to examine the evidence of what makes a difference and where that is not happening. It is an asset for Scotland's public sector to have organisations like ours, which, with a very small fraction of the total budget that is being spent, points out and identifies, perhaps, unintended consequences of particular decisions that are made or where we can make a difference, for example, in access to public services and then in the quality of service that some of our communities experience. Dr Fraser, you said just a moment ago that help policies impact what happens in schools perhaps more so in Scotland than elsewhere. I note that, from your delivery plan, number two is children, young people and families. You will both also be aware of the Government's priority at the moment in terms of closing the poverty-related attainment gap. I wonder if you could give us some concrete examples of where the work that you have done has impacted upon healthcare within education. There is a good deal of work going on, not really closely associated with what we have done, but on school nursing and schools generally. One specific is on the HPV vaccine, where there has been a joint enterprise between public health and, particularly public health, health services and education, and that is a great success. The data is very encouraging on that. We are increasingly in close cooperation. I think that we could go further with Education Scotland about curriculum and integration of curriculum with health topics. We are also doing work around childcare and the quality of childcare and influencing policy around that. So, it is working progress. You are asking for specific instances. I think that it is almost, it sounds negative, but it sounds almost as if we are invisible, but we would like to move things and change things and not even be found out for being health reasons why curriculums change or why the content of school activities change. It would not necessarily be for health reasons if other good reasons exist and are more attractive to decision makers. Closing the attainment gap, it is not just about schools. It is not just about what happens in schools. It is what happens outside. Certainly children coming to school in primary 1 are ready to learn. That is not a function of the education system as we have it. In many ways, I have to say that there is mitigation to be done when children arrive aged 4 or 5 at the gates of the school and they are already behind. We have to understand that but also see what more we can do in schools, primary and secondary, to help people to catch up and not to widen further attainment. However, those are functions not just of the education sector. I could add to that because we host Scotland's public health network and it produced a very influential report last year in May last year addressing childhood experiences in Scotland and talking about the impact of adverse childhood experiences on learning and a number of other factors. That brought forward recommendations about ways of focusing and introducing other different actions that helped to mitigate some of the impact of those adverse experiences that many of our children have in their early years. I think that my own personal experience in dealing with your organisation is that the professionals that you have working for you have produced some terrific pieces of research and I can only compliment them on that. However, I have a great sense of frustration that some of the stuff that you are doing is not developing into policy and having an impact on the deep city to health inequalities that we have in this country. I think that you summed that up when you said that we have an opinion and we just wonder whether anyone is listening. I think that sums it up. Thanks for your evidence and could we suspend briefly? The agenda item 2 is subordinate legislation. We have one affirmative instrument, as usual affirmative instruments. We have an evidence taken session with the minister and officials on the instrument and then we will have a formal debate on the motion. The instrument that we are looking at today is the public body's joint work in prescribed local authority functions etc. Scotland amendment regulations 2017 draft. I welcome to the meeting Shona Robison, Cabinet Secretary for Health and Sport. Peter Stapleton, carers act implementation manager and Kate Walker, principal legal officer all Scottish Government. Could I invite a brief opening statement from the cabinet secretary? Thank you convener. Thanks for the opportunity to speak briefly to the committee about these amending regulations. You will all be aware that when this parliament passed the carers Scotland act 2016 last February, the integration of health and social care was already under way across Scotland. As the committee will recall, the purpose of the existing public bodies joint working prescribed local authority functions regulations 2014 is to prescribe the mandatory delegation of adult social care functions to integration authorities so that these functions must form part of their strategic commissioning plan for delivering health and social care services locally. We have put forward this instrument to amend the existing regulations so that they take account of the provisions in the carers act in the same way. If approved, it will specify that the function of preparing local eligibility criteria under section 21 of the carers act is one that must be delegated by local authorities to integration authorities. The committee will be aware that the purpose of setting local eligibility criteria is to determine whether a local authority is required to provide support to individual carers to meet their identified needs. As you know, the carers act will commence in full on 1 April 2018. Most of the provisions in the act are already capable of being delegated to integration authorities. Indeed, carers support services are already part of the integrated arrangements across Scotland under the existing regulations. Mandatory delegation of this function to local integration authorities will help to ensure that the synergy between the strategic planning and commissioning priorities that integration authorities are setting and the legislative requirements to improve outcomes for carers that we, as a Parliament, supported during the passage of the 2016 act. We are happy to take questions on the regulations. Questions from members? No questions? Okay. If that is the case, can we move on to agenda item 3? This is the formal debate on the affirmative SSI on which we are just taking evidence. Can I remind the committee and others that should not put questions to the cabinet secretary during formal debates and that officials may not speak in the debate? Can I invite the minister to move motion S5M-05457? I move that the Health and Sport Committee recommends that the public body's joint working prescribed local authority functions etc. Scotland amendment regulations 2017 draft be approved. Okay. Thank you. Any contributions from members? No. The question is that motion S5M-05457 be approved. Are we agreed? That's agreed. Thank you very much. As agreed previously, we'll go into private session.


to members' statements. I recognize the member from St. Catharine's. Thank you, Madam Speaker. I rise to react to recent government announcement about Ontario Electricity Support Program, OESP, that bring warmth to some, yet it leaves a chilling gap in our fight for energy affordability. Last year I called for urgent action against soaring gas bills, expanding this program to include other energy sources, a call that remains unanswered. Our government prefers corporations over people. Last week the government announced they would reverse the OESP's decision, their own regulatory board decision that would lower heating costs for families across Ontario. Instead, this government would subsidize Enbridge the same corporation that doubled heating bills for their customers in 2022. When criticized, this conservative government's response was very predictable, pointing fingers at the federal policy that they cannot influence. Finger wagging at provincial solutions that put affordability before rich corporations. Sitting on their hands will family shiver. This isn't just about electricity, it is about gas, about warmth that every Ontario home deserves but many cannot afford. Today I stand before you, urging an extension of the OESP to include gas bill relief. This is not a political issue, it is a matter of addressing affordability. Whether you use electricity or gas to heat your home, no one in the prosperous province should have to choose between heating their home and essential of life. Thank you. Member Statement. Member for Canada, Mrs. Sava Erin Mills. Thank you, Madame Speaker. I was happy to announce last month with my Peel colleagues that the Ontario government's reviving Peel regional police was over 3 million and Peel joined Fire Communication Center with 1.8 million for the transition to the next generation 911. Madam Speaker, next generation 911 is a new system that will allow 911 dispatchers to receive text messages, data and GBS coordinates from the public. This will allow for a better and faster emergency responses when people need it most. And the last months, we heard the big news. On February 21, at 3.30 a.m., Peel Regional Police became the first large communication centre in Canada to successfully finish the transition to new Generation 911. Speaker, this is a huge milestone for emergency services here in Canada. With this new technology, we will finally be brought into the 21st century. I am very excited for this new technology and want to thank everyone who played the role in making this happen. And a special thanks to the heroes of Peel Police working every day to keep us safe. Thank you, Madam Speaker. Thank you. Next Member's Statement. The Member from Glengarry Prescott Russell. Thank you very much as the representative of Glengarry Prescott Russell. I want to underline that we are beginning the month of March, which is for Francophonie. We need to celebrate the French language everywhere in the world, and its diversity. There are five continents involved. The celebrations that take place on the 20th of March will be good for even more dialogue. So there are almost 700,000 Francophones in Ontario, from one end of the country to the other. This is French expression, be it your own language or a language you have learned. And this is immigration also allows us to learn French even if this is not our mother tongue. So we are going to be presenting these people who represent Francophonie. And so on the 20th we will be able to celebrate together all of these countries and people who ensure that Francophonie will continue. So thank you for entrusting me with this mission, and I would like to wish you a happy month of March, consecrated to Francophonie. Thank you Speaker. Speaker, as you would be well aware, last year 2023 was the hottest year on record, and the expectation is that this year will be even hotter. We are really starting to push the limits on what is happening globally in terms of heating. We are setting ourselves up for dramatic changes in the world around us that we will not want to have to encounter. We're all well aware of the smokehouse fire in Texas and the fact that the smoke from that conflagration is visible here in Canada. The consequences of global heating, drought, wildfires, flooding are visible around the world. Speaker, to even stabilize the global climate, to even stabilize it, not to pull back on the damage that's happened, but to even stabilize it, we need to reduce our missions in Ontario by 50% by 2030. As people are well aware, this government has set an irresponsible target of 30%. It will not do what is needed to be done. It will not show the leadership that as an advanced industrial society, Ontario should be setting. Speaker, we need this government to change course. It needs to set a target of 50% reduction of emissions by 2030. It needs to put in place the investments, the policies, the programs to actually deliver on that. Failure to do that will cause damage that all of us will regret for the rest of our lives. Thank you. Thank you. Next member's statement. The member from Bruce, from Simcoe Gray. Thank you very much, Madam Speaker, and it's a pleasure to rise this morning to talk about a topic that's close to my heart and very closely connected to my riding of Simcoe Gray. Currently, the 2024 Canada Special Olympics National Winter Games are taking place in Calgary, Alberta. And recently, the town of Blue Mountains celebrated the 25th anniversary of hosting the sixth Special Olympics World Winter Games in 1997, only the second time it was held outside the U.S., when 2,000 athletes representing 73 countries descended on the town of Blue Mountains to celebrate their sports. The town of Blue Mountains established a strong relationship with the Special Olympics movement and has been home to the Alpine Ski Program since that time. Speaker, eight of the 12 members of the Ontario Alpine Ski Team are from the riding of Simcoe Gray, and I want to recognize each of them. Robin Shooter, Aaron Wright, Matthew Fields, Eddie Bunkowski, Kevin LaChance, Jamie Hall, Julian Hudson, Angela Blaney, all from the riding of Simcoe Gray, and they are joined by their teammates Cameron Oliver, Carter Simpson, Ryan Soarley, and Ben So. And I've recently learned that they are coming home with at least three medals after spectacular performances, and I want to congratulate all of them. They've done a great job representing Ontario, and their motto, Madam Speaker, is let me win, but if I cannot, let me be brave in the attempt. And they have certainly been brave, and they've represented us well, and many of them will go on next year to turn to represent Canada. Thank you very much. Thank you. Next member's statement. The member from Hamilton Mountain. Thank you, Speaker. Yesterday I spoke with individuals who are currently living in tents outside of Hamilton City Hall in solidarity for the almost 2,000 unhoused citizens across our city. They're calling for solutions to the lack of housing options, both temporary and permanent, including wraparound services to support their health and safety. Many of our homeless are facing other multiple challenges and crises at the same time, some in the form of addictions like opioids or other street drugs. This polycrisis is amplified by now another provincial decision in healthcare, the distribution of naloxalone kits. On February 9th, an executive order was issued without notice or consultation, changing our local community agencies' access to these life-saving kits. In Hamilton, overdoses don't always happen within walking distance to a pharmacy, within their operating hours or within sight of someone carrying a life-saving Narcan. It is often organisations and outreach groups who are on the streets, in our shelter systems or part of our health teams, who are handing out these kits 24-7. We need to support those who are doing this important work and call to action when decisions are made that cause harm rather than good. This is an epidemic. We need solutions, not barriers. All levels of government need to ensure there is immediate access to life-saving tools, affordable housing and wraparound supports that will save lives. Member statements? Member for Oakville North, Burlington. Speaker, I rise today to recognise the National Association of Women in the Law, which celebrated its 50th anniversary at an event I had the honour of attending in Ottawa last week. The founders of Null were not only visionaries, but also dear friends from the University of Ottawa Law School. Since 1974, Null has been at the forefront of feminist advocacy and law reform in Canada. Through the tireless efforts of founders, Diane Ansell, Shirley Greenberg, Lynn Kay, Maria Lynn Harness de Souza, Peggy Mason and Maureen McTear and many others who followed in their footsteps, Null spearheaded groundbreaking initiatives that have reshaped our legal landscape and advanced the cause of gender equality. Null was the catalyst for change, challenging entrenched societal norms regarding sexual violence, advocating for key amendments to the Criminal Code and the Divorce Act and a new Family Law Reform Act. Its contributions to Sections 15 and 28 of the Canadian Charter of Rights and Freedoms was pivotal in ensuring equality and justice for all Canadians. Women across Canada owe a debt of gratitude to Null for the groundbreaking work they have advanced over the last 50 years forever changing our nation's legal framework. As we look forward, I would like to recognise its achievements and I remain steadfast in our shared goal to end violence against women and children through legal, social and legislative reform. Thank you very much. Member Statements. Member Statements. The Member for Perth Wellington. Thank you Speaker. It is my pleasure to rise in this place today to talk about a small high school sports team with a ton of grit and determination. The Metro District High School Seniors Boys basketball team recently secured the WASA Single A Championship. The Blue Devils beat the Rainian Champions Woodstock Collegiate Institute 62-52 in the semifinals. In the finals against London Christian, the Blue Devils came out strong, but London trailed by just one after the first eight minutes. Alan Chen led the surge in the second quarter, scoring nine of his 15 points. Jared Volsbier, Charlie Geiger and Kale Murray all contributed to the offensive comeback and Blake Redford finished with 27 points for the Blue Devils. Coach Moses utilized all the players in the final. In the end, the Blue Devils beat London Christian School 86-52 in the WASA finals and punched their ticket to the Offset Championships. The boys take the court at Offset today in Welland. Speaker, it was 40 years ago when MDHS Senior Boys basketball team last won the Offset Single A Championship and the boys have high hopes for this year's tournament. The secret to their success, according to Coach Moses, is effort and attitude. To Sam, Jack, Luke, Charlie, Ryan, Will, Jared, Blake, Lincoln, Alan, Kale, Tayden, Brock, Talbot, Elijah, best of luck in Offset, and know the entire community stands behind you. Go Blue Devils! Member Statements, the Member for Cambridge. I would like to rise today in grateful acknowledgement and support of Oak Bridge Academy. Oak Bridge Academy, or OBA, is an independent not-profit school for neurodiverse children in my writing of Cambridge. It is a place where high-needs kids on the artistic spectrum go and learn to live and thrive. And this is important because really there's not that many places in Ontario for these children to go. As an independent school and registered charity, Oak Bridge Academy relies exclusively on small donations and tuition fees to fund its world-class programs. Even so, people, educators from England, are coming over to Cambridge to see how they handle their situations with the students in our country. However, this may soon change. Tomorrow, Oak Bridge Academy will compete in a Waterloo Region competition to determine which non-for-profit organization makes the strongest case for support through social ventures, partners, perfect pitch competition. School representatives who would be in the gallery today if they weren't in dress rehearsal right now would take the stage with other non-for-profit executive leaders to showcase the incredible work being done in our community to support those in needs. Or so, they would speak to the innovative, cost-effective and inspiring programs that make the difference for so many of my people that live in Cambridge. I'd like to thank Oak Bridge Academy for serving not only as an educational path for the last resort of families, living with autism, but also a provider for first-class, neurodiverse programming. I'm so proud to represent you in the house today. Good luck tomorrow, Oak Bridge Academy. Yay! Members' statements? Point of order?


Thanks for checking out this movie review video. This is for the 1983 film Christine Obviously based on a Stephen King novel done by John Carpenter. So This is actually the first time I've seen this film and this one goes out to Long-time subscriber of my channel uncle Pete who had told me a few times, you know, you really need to see Christine He said it's behind the thing remake. It is his second favorite John Carpenter film, which is funny because he he made the thing and then right after that his next film was Christine so it was boom boom for Uncle Pete I still think after watching this the fog is my second favorite after the thing for John Carpenter But Christine is really good and I'm really glad I finally saw this film I think it has done better over time because when it first came out It actually did not do well at the box office. It was not received all that well Just because I mean think about what the premises. It's absurd. It doesn't sound like it would be a good film But I think that the way Carpenter shot it It ends up being good. There are some things that could have been changed here or there to make it even better But yeah, and I will say that after watching this film It really does make me want to read Stephen King's book, which one day I'm not a super fast reader So we'll see Once again directed by John Carpenter. This was after the thing and right before he did Starman that's I don't think I've no I think I have seen Starman I was gonna say I don't think I've seen it, but I think I have but it's been like decades Literally this one was written by Bill Phillips who's also written some screenplays such as fire with fire Physical evidence and there goes the neighborhood and obviously based on Stephen King novel as we know Phillips put profanity in this intentionally apparently So he did the script and then he went back and he injected profanity into it because he And I don't get this He wanted to make sure it would get an R rating Because he thought that with the premise of what it was supposed to be And I think the the studio thought as well that if it didn't get an R rating And then it would have even less of a chance of being financially viable in the theaters Which obviously didn't end up being that in the end, but Why don't you just make the kills more grandiose make the kills gorier? Like that's another thing like don't just put in the profanity to get to an R rating put in the kills Put in at least some blood because it's it's it has a little bit of blood Especially at the end where Arnie dies, but put more blood in it doesn't have to be like over the top So it becomes an unrated film, but just put in more blood like I feel like that's the best way to do it Obviously the cheapest way to do it is put in profanity because you don't need to spend money on The fake blood and everything, but I don't know just for me personally And that's one of my biggest criticisms of the film is that the kills are too Tain, I mean especially for the 80s, you know, this is 1983 in horror films There were so many great kills so many great kills So I feel like this film it's like a missed opportunity with this film And I kind of like to see John Carpenter remake it nowadays. I think that'd be really cool. Just have it gorier Anyway 15% of the budget was actually spent on cars for this because as you can see watching the film They destroyed cars they destroyed plenty of cars and that's one of the other things I really like about this film is whenever they're shooting stuff or when Carpenter shooting stuff in this film Around the cars It looks way better than you would expect it to like he shot it in a way that all the car sequences are actually super engaging Like I said like you would come into this thinking the premise is really stupid and it's probably not going to be that interesting But he managed to shoot them in a really interesting looking way and it's super engaging and I was surprised You know when Uncle Pete was like you got to watch Christine. It's so good I'm like it's about a killer car man. Like how good can that really be pretty good? Keith Gordon who played Arnie actually pretended the car was an actual woman So one of the things he said he's he's done is he would visualize Touching an actual part of a woman whenever he was touching Christine to kind of create that chemistry between him and the sentient Car which I think is a really cool idea and it's really cool Just to know that little bit of information Especially if you do a rewatch on it and you're just like what part of the woman Does he think he's touching right now because I found my myself thinking that when I was watching the film Yeah Kevin Bacon was initially offered the lead role He was supposed to be Arnie Very interesting. He ended up turning that down for Footloose I Don't like Footloose personally. I know by a lot of people do but I'm not a Footloose fan I would rather seen him in this but I do think that Keith Gordon did an excellent job Which by the way, Keith Gordon now is a director and has mainly just been directing TV shows But he did some movies as well, but that's just interesting to know Scott Bayo was considered for the role of Arnie. Brooks Shields was considered for the role of Lee Nicholas Cage auditioned for the role of Buddy And John Cusack auditioned for the role of Arnie A lot of big names right there makes you kind of like start thinking what if What if what if I always like those scenarios? I love finding out who else auditioned and then just play those what if scenarios in my mind So especially when you throw nick cage into the into the buddy role that could have been pretty fun He's not a big role in it, but you know So the backstory of the plant Making the car and it being evil immediately. I don't really think is that great But it does kind of make you wonder until you get further into the film Like what's the car been doing up for decades up until the point that Arnie finds it But you you know slowly end up getting that information and finding out that It's been killing people basically it's been getting very close controlling people and killing people Which tells you exactly what's going to end up happening with Arnie But watching the movie you just have this feeling like Arnie could be the one who breaks that Sequence basically the that breaks the history of what this car does to people But alas in the end it's not meant to be he still dies as well Which is sad Because he wasn't a bad character. It's just the hold of the evil car christine like got a hold of him Now that initial backstory sequence of the car actually being made Apparently is not in the book from what I've read and it was just put in there to kind of have like an origin for it I don't think it's a great origin. Honestly. I obviously sets it up to be a killer car But where did it come from? Like where did this sentience For the car actually come from it makes no sense. It's just like it rolled right off the Uh the plant And it just happened to be evil, but none of the other cars are I don't really get that Was it like a child's play type situation? I don't know like I feel like we needed that a little bit extra or don't have the plant thing Just have the car show up You know when Arnie and Dennis initially see it and just go from there. I just don't think the backstory really worked Honestly, plus it kind of I feel like it kind of takes some of the tension and Discovery of the film away because you already know that the car kills It would have been kind of better impact wise if you didn't know that the car kills up front Because when George the person that they purchased the car from or that Arnie purchases the car from When George says that his brother died in the car or when they find out that his brother died in the car You might think oh, yeah, it was suicide But having seen that opening sequence you think well the car killed him because the cars killed other people Now take that sequence out and you would potentially think okay. Some guy killed his so he killed himself in the car. That is creepy But you don't know the extent of it and then it's more of a surprise when you find out that Christine will kill people So I don't know. I just like it. I would like it better without that that initial scene, honestly The setups are pretty typical horny high school guys setup Um, which is fine. It makes it very relatable for a younger audience Which is obviously what they were going for especially with it not being like super gory and everything So that's fine You get the idea that Arnie can't do anything with Dennis in the very beginning of it because he's constantly kind of looking at Dennis for what should I do here? And it also seems like he doesn't really have any Willingness or ability to stand up to people unless Dennis is there. It's kind of like his backup It's like all of his courage comes from Dennis until obviously further in the film where he starts getting that instead from Christine It's like he has to siphon courage off of other people Because he his self-esteem is so low and you see why obviously because his home situation is terrible The way his parents treat him. They bully him at home. He's bullied at school. It's a lot of bullying in this film and it's At its core a very interesting story for that reason Because it's it's also relatable because I'm sure a lot of people have had a friend or been a been one of the people who You Aren't seen as popular. You aren't seen as desirable Like Arnie and then you get a relationship like Arnie gets with Christine And you all of a sudden have this boost of self-confidence a boost in self-esteem And you feel like you have value then Because someone is feeding that to someone is making you feel like you matter at that point and then there's a tendency that You can kind of go a little bit too far in how your personality changes, which is what happens with Arnie You know most people don't go to the extent that Arnie does because he stops He starts caring about only Christine She has such a hold over him and then doesn't really care about people who end up dying That's you know something else, but I think there's kind of like this this um Uh extra magical Type hold that Christine has on Arnie that it's not all natural part of it is natural I think his his personality changes, but not all of it because they're so severe The first scene with buddy is definitely too long. I really did thought they needed to cut that scene down like you get the point pretty Immediately immediately that Arnie is bullied and downtrodden and he can't stand up for himself They didn't need to you know have it go as long as it did especially with buddy not being such a huge part of the film What does Arnie really see in Christine? Uh, you end up realizing that later he sees himself and her Something that's abandoned and undervalued this kind of goes to what I was talking about about the self-esteem issue That Arnie has he then sees a lot of that in Christine Which is why he initially wants the car you could probably also argue that there's some sort of like magical hold That Christine puts out initially when he first sees her Maybe there's no actual evidence for it, but it it would it would make sense But I think it was more of he saw an undervalued car that is ugly like him I think he even makes a statement kind of like that at some point. And so he wants to Improve that car and through improving that car He's improving himself as well And then you see once the car is actually in working order and looks great He totally changes his look, you know, he loses his glasses. He starts dressing a lot cooler He gets that date with Lee like everything changes So it's a mirror image of what's going on with this car and the work that he's putting into his car It's just like work that he's putting into himself to improve himself along with the car How is Arnie's mom mad at Dennis? It's like she views him as Arnie's babysitter This kind of speaks a little bit more to The bullying issue there and the fact that you know Arnie's parents are so bad that they don't even trust him to like be an adult Even though he seems like he's initially a good student Where he gets the car and then Arnie's mom's like yelling at Dennis saying like Why did you let him and he's like I didn't let him he bought the car Like I told him not to but he bought the car like he's a human being He has his own, you know, will he's gonna do what he's gonna do But that makes it makes you feel like when his parents aren't with him with him That they feel like Dennis should be the one to babysit him and make sure that he doesn't do things that they don't Want him to do which is ridiculous But that shows that level of control issue at home As soon as Darnell Comments that he knew a person with a car like Christine who killed himself in it You know that that was Christine. In fact, I do like that little bit of dialogue there Because it makes the audience member like oh, yeah, it was that guy most likely I guarantee it Notice how people demean Christine just like the bullies do to Arnie a lot of people talk trash about Christine especially initially which I do feel like kind of Helps in creating that initial emotional connection between Arnie and Christine because Arnie Like he's bullied all the time is seeing that Christine is kind of being bullied in the same way So that kind of drives him even further to her Christine playing songs to communicate is a clever way to have her interact with characters I did like that also the the use of the green light that comes on with the radio to kind of Show that Christine is trying to interact with people or going to do something I did like that touch as well. That was really nice And the thing is the song thing could have come off as really weird and and like corny and cheesy But I it doesn't it plays well for some reason You see that Arnie just looks at Lee as an object when he yells at the guys Trying to get trying to give her the Heimlich maneuver when she was choking because Christine made her start choking It's kind of kind of similar to the way Christine is with Arnie like there's a mirroring Factor going on there where you realize that Arnie Wasn't really even in to Lee as a person He was just into her body and started just really viewing her as an object because his actual relationship was with Christine so From a sexual standpoint and a you know appearance standpoint He was just looking at Lee that way and like I said you see that most when she's joking And the the person at the drive-in theater pulls her out and starts trying to give her the Heimlich maneuver Arnie's not concerned at that moment about her choking Or about is she okay or not? He's more concerned about yelling at the guy to get his hands off of her because that's his girl Because that's his property basically and if you think about it, that's what Christine is doing Christine is making Lee choke at that point because that's my guy Arnie is my guy get your hands off my guy It's the same thing And that's why story-wise it's very well executed all this stuff um Great shot of Arnie tending to Christine and Lee standing alone in the background This is when uh, Christine's been smashed up the first time and Arnie finds it when he's with Lee at the time and then the just his great shot of showing Focus on Lee in the background and then Arnie like tending to Christine and it's it's just such a great shot because even though Lee is there with Christine and Arnie It it frames it and makes it look like she's alone because she is like There's so much focus between Christine and Arnie that Even though Lee's there. She is definitely alone You have a hard time believing Christine would allow herself to be destroyed But then when you see her end up rebuilding herself Uh, it indicates that she let it happen in my opinion I think she let that happen in order to draw Arnie closer to her because she was kind of starting to see That Arnie was moving a little bit closer to Lee and I think that Christine believed that if she let those bullies destroy her Then she could pull Arnie closer in to care about her more just like I mean that happens with people in actual relationships You know they act like they have some sort of problem or they need the other person More for some reason to pull them back in to to keep them from wandering away from the relationship Or to refocus them on that person and their needs Christine does exactly that because you find out she could have immediately rebuilt herself or she could have killed the bullies When they were initially smashing her up So it leads me to believe that she did it on purpose She allowed it to happen to pull Arnie further in and I think that's pretty brilliant story wise Arnie reaches a new level when he has the very contentious first Interaction with detective Junkins played by Harry Dean Stanton who I think is awesome by the way And if you have not seen the film Paris, Texas do yourself a favor and see that he's wonderful in it um Yeah That's something that you feel like Arnie would never have done otherwise If he wasn't under the control of Christine because he gets really mouthy with a detective Not a good detective mind you but a detective nonetheless Because he's just like this absurd detective that like it seems like he has kind of an inkling what's going on with the car But at the same time like how would he have that inkling of what's going on? And if he was an actual good detective, he would have been looking at everything points to Arnie So why is he just having like these very casual conversations with Arnie and also allowing Arnie to be like very belligerent And mean to him at the same time and not becoming even more suspicious of Arnie It seems like he's just suspicious of Christine the whole time, which doesn't really make sense in my opinion. It just doesn't The scene of buddy's car getting wrecked and blown up is pretty cool And then buddy getting chased by Christine while Christine is on fire And then run over and he's on fire as well That's even better like the the buddy's car blowing up scene that whole scene is really good in the first place But then it ups itself once again with Christine on fire chasing buddy down the road It looked great carpenter shot it in an excellent way This goes back to what I was saying before about all the car related scenes were shot so well and engaging Everything would point to Arnie being the one killing people. Yeah Just think about that like it really would and Arnie kind of seems to not pick up on that because he's so focused on Christine When Dennis scratches the message in Christine's hood To make you know Arnie show up to the garage Darnell's You really are thinking do not do this pal because that car is going to kill you for that I mean at least I did I did like the twist though. I didn't see it coming of Christine already hiding In the I guess garage at the junk. It was a junkyard. I guess at the garage Um, I didn't see that coming and then I also didn't see it coming that Arnie was actually in Christine I thought it was Christine who was Just doing her own thing like she was like these people are going to try and come between me and Arnie So I have to take them out. No Arnie was actually in her. So at that point Arnie was Willing to kill them or willing to go along with Christine to kill them and that was he he reached this pinnacle So that's the point where really he did have to die story-wise And it's tragic and I do think it was a good impactful death for him, especially when you it comes so Close after you just find out that he was in the car And I think for that reason it's cool that they made The windows like they blacked the windows out so you couldn't really tell if Arnie was in there or not Which I thought was smart Um Nice touch with the little bit of movement of the christine cube at the end. I call it the christine cube how she was like Compacted into that cube. Uh, there's that little bit of like a movement Perfect. So I mean obviously set it up for a sequel. I don't think there was ever a sequel book There was obviously not a sequel movie. I don't think so if i'm wrong. You can tell me in the comments, but Yeah, it was a good ending Um, obviously it shot really well this film because it's john carpenter Um, oh something you need to note the guy who plays george in this the guy they initially buy the car from His name is roberts blossom and when I was watching this watching it for the first time I was like his voice sounds very familiar. He plays marley in home alone the original home alone Just fun little fact there Note how arnie starts looking and acting different once he gets christine It literally is like what happens when someone gets a significant other Because confidence increases and how they mark the passage of time In the film lets you know that arnie's change is actually gradual. That's another great thing that they chose to do They could have just had it all happen within like a week or something, but You're just getting the highlights of how of the points where arnie's Uh, personality is is changing for the worst And they do a good job of marking that by saying, you know, it's october It's december, you know Stuff like that. So you get the idea that more time is passing. You're just not seeing all the boring stuff So they did a good job with it. So overall obviously I quite enjoyed this film I think it's pretty well done. So out of five stars with half stars in play I'm going to give it a very solid four star rating. This is a good film Uh, glad I finally saw it. So thank you uncle pete, but i'm going to remind you because I know you watch this review uncle pete Because I watched christine bump that up my list You have to bump up assassination nation and attack the block Just saying And i'm excited for you to get to those. I already have a review for assassination nation on my channel I need to do a review for attack the block and I will at some point But anyway, thank you so much everyone for checking this out. Put some comments down here What do you think about christine your thoughts and feelings on it? And what you know, what were your thoughts when you first saw it where you did you think it was stupid? And then you thought it was better later. I don't know. I'd be interested to know that Also, do me a quick favor hit that subscribe button because that is the best way to repay me If you like this video or any video I've ever done. I really do appreciate it I'm just trying to build this nerdy horror community and that really does help Um, so yeah, I would appreciate that also hit the notification bell button That way you'll know when I'm putting up more review videos or unboxings or any of that stuff So regardless though, thanks. I really appreciate you taking your time to watch this and until next time keep it brutal