Neil Gray: Every working parent always has dad-guilt or mum-guilt – I am no different

Oasis is clearly on Neil Gray’s mind. Or, more specifically, reports he was trying to buy tickets for one of the band’s reunion gigs while chairing a panel on dementia at the SNP conference.

Before I’ve even taken a seat in his office in the parliament, where I’ve come to talk to him about his plans as health secretary, he dubs it a “non-story”. He genuinely seems quite bemused that the incident is still in the headlines five days later. Part of the reason it is, though, is that he initially labelled the Sunday Mail splash “total nonsense”. He was, he admitted, in the queue to buy tickets, but later told LBC his phone was in his pocket for the duration of the meeting and he was “fully focused” on the discussion.

I wonder if the whole affair has given him pause for thought, and whether in the future he might have to think a bit more carefully before making wisecracks about being “Half The World Away” given his is one of the most important roles in government.

I’m fortunate to have one of the most important jobs around the cabinet table

“I will always be me, I’ll always stay true to who I am,” Gray says, before adding: “But politicians do have to be careful what they say. Every word that we say is pored over, and rightly so because we’re giving direction and leadership to the country on really important and serious issues. So of course I’m careful with what I say, and it’s important that I am.”

Gray is still fairly new into the role, having taken over from Michael Matheson in February. As economy and energy secretary, he’d made good headway in rebuilding the Scottish Government’s relationship with business and as a result was largely regarded as a positive addition to the cabinet. He was even pegged as a future leader of the SNP and, indeed, had seriously considered throwing his hat in the ring when Nicola Sturgeon stood down, but instead chose to back Humza Yousaf.

But with a new portfolio comes new challenges, and health in particular is a difficult one to get right. Regular reports on missed waiting time targets, drug and alcohol deaths, persistent health inequalities and a system under pressure mean Gray has had to endure a rather different narrative in recent months – the Oasis story being just one example of that extra scrutiny. I ask if it’s bothered him.

“I’m not in politics or ministerial office for plaudits, though of course it’s nice when you’re recognised if there is the feeling you’ve done something well,” he says. “Like I said, I accept the fact that there’s going to be criticism, that there is going to be scrutiny. Of course there’s going to be. I’m fortunate to have one of the most important jobs around the cabinet table, the most important job in government in terms of making sure we’ve got a health service that is meeting the needs of the people of Scotland. I will always accept reasonable critiquing of the work that I’m doing. I’ll learn from what people have to say around whether we’re doing the right things, and I will listen.”

Still, that criticism is not without cost, and that personal toll is something the health secretary is all too aware of. “The job that I’m privileged to have carries massive responsibility,” he says. “We’re talking about people’s lives and their experience with the most treasured institution in public life in Scotland, I believe. The health service touches everyone literally from birth to beyond – and in fact pre-birth, given the work that we’re doing on family nurse partnerships and ensuring we have that early intervention on maternal health, recognising the impact that good maternal health has on not just a baby’s health, but that baby’s chances in life.

“So I bear a huge responsibility; I feel it and it is high pressured, but it’s a privilege to do the job that I do. I’m incredibly passionate about serving such an important institution and coming forward with improvements to ensure that everybody gets the best from our health service, that we reduce health inequalities, that we tackle the impact that poverty has on the health of our nation. Those are all things that drove me into politics in the first place – an anti-poverty agenda, looking to make sure that we get the best public services for people, that’s what I’m in politics for.”

If I’m at home, I’m feeling guilty that I’m not at work. If I’m at work, I’m feeling guilty I’m not home

Gray’s first foray into elected politics was as part of the cohort of SNP MPs elected in 2015, and he held onto his Airdrie and Shotts seats in 2017 and again in 2019. But with a young family at home – Gray has four children, two of whom were born while he was an MP – he took the decision to quit the Commons and seek election to Holyrood in 2021. He says he’s glad that “gamble” paid off, because even as health secretary, “I’m still able to see more of my kids than I did when I was in London half the week”.

He was invited into government in 2022 as a junior minister, then promoted to cabinet when Yousaf took over just over a year later. He did not at any point consider turning down those jobs because of his family. He was confident about being able to balance home life with work life, something he is still managing today.

“I think every working parent always has dad-guilt or mum-guilt – I am no different, you know? If I’m at home, I’m feeling guilty that I’m not at work. If I’m at work, I’m feeling guilty I’m not home. If I’m on government business, I’m feeling guilty I’m not in the constituency. If I’m in the constituency, I’m feeling guilty that I’m not doing government work. So you always have that, where you’re trying to make sure that the different parts of your life are getting sufficient attention.

“I have always tried to make sure that my children aren’t always just seeing me working, and most of the time I’ll get home from parliament, sometimes I’m able to eat with them and put them to bed, and then once they’re in bed, the laptop’s out and my evening is spent doing work.”

Most people get an incredibly good service from caring, dedicated, committed, professional staff

And there is no small amount of work to be getting on with. There are almost daily warnings about the state of health and social care as well as concerns about the creaking NHS. I ask, bluntly, if the NHS is in crisis or at least reaching crisis point.

“No,” Gray replies, equally bluntly. “There are huge areas to celebrate within our health service, of incredible success, incredible stories of staff going above and beyond, providing life-changing, life-saving care, and I want to ensure that I celebrate that.

“Of course, for people that are waiting too long – and I accept readily that there are too many people waiting for too long for treatment – that feeling is going to be there. And for staff that are feeling burnt out or are feeling the frustration of not being able to get their patients treated, of course there is going to be that feeling as well.

“But I want to make sure that there is a realistic balance between the challenges that are there, that are clear, that are also not unique to Scotland, I need to make sure that we’re addressing those, but I also can’t allow a situation where all aspects of the health service are perceived in that way, because as I’ve been going about my business over the summer, touring all around the country, seeing staff and patients, seeing clinicians, hearing from health boards and social care partnerships, I’ve seen incredible work being done. I obviously have to make sure that we balance the narrative that there is around the health service, that most people get an incredibly good service from caring, dedicated, committed, professional staff. They do so on time and they do so in an environment that is conducive to them getting good outcomes.

“Yes, there are challenges, I will be the first to accept that. The reason why I am so committed to seeing reform and improvement is because I recognise those challenges and we accept responsibility. We are taking decisions to raise revenue – the decisions that we’ve taken around taxation are not easy, we’ve received criticism for them, but they’re precisely because we want to see that continued investment in our health service. And so, this isn’t a health secretary that is ignoring challenges or isn’t taking responsibility. This is a health secretary and a government that is facing up to them.”

Those plans for reform are going to be shaped by a national conversation currently being carried out by government, led by Gray. That conversation is considering “what reform looks like, how we can involve clinicians to help lead in designing services, and how we can enable greater innovation at the frontline”, he explains.

When resources are tight, it’s more difficult to invest in areas of improvement and reform

It will also require shifting to a more preventative approach to healthcare. This necessity has been recognised for more than a decade, but while most politicians I’ve spoken to about it have skirted around the issue of how to fund that shift while still delivering frontline services, Gray tackles it head on. He accepts that in the current financial situation, reform will be hard.

“When resources are tight, it’s more difficult to invest in areas of improvement and reform because you’re looking to try to make sure that the current services are able to be maintained. Ordinarily you would wish to provide additional investment that would see service change. The challenge is going to be – and this is the challenge for myself, for government, for the health service, for clinicians and those on the frontline – to work together and collaborate to ensure that we’re able to see that shift in where people interact with the health service, how we deliver services, whilst at the same time continuing to maintain what we’re doing so we’re not seeing investment in primary care at the expense of what goes into our hospitals, for example.”

Pressures on the public purse were brought home by finance secretary Shona Robison two weeks ago. She announced £500m worth of cuts to services to help her balance the books for this financial year. Of that, £115.8m came from Gray’s portfolio.

“I want to give some reassurance to people that some of this, not all of it, but some of this is about marketing spend, some of it is about in-year underspends that we can take back,” Gray tells me. “But these are difficult decisions that we did not want to have to make. When you do not have investment in public services matching inflation, there is an impact in-year because your money does not go as far as it did when you set your budget. That’s why the trajectory of continued austerity from the Labour government is so damaging and why we need to see a continued increase.”

I’m very keen that I’m health secretary for a long time

Budgetary constraints could also impact another major reform being pushed forward by this government: the National Care Service (NCS). Originally envisioned by Derek Feeley, who chaired the review of adult social care, the NCS was to be given “equal footing” to the NHS. But without an equivalent organisation in England, there will be no Barnett consequentials to attach to it – and therefore no extra cash for the Scottish Government. Can it really be delivered?

“Obviously if we’re successful in getting the National Care Service through, then the budget has to follow,” says Gray. “I believe that there are conversations elsewhere in the UK looking at a similar model. I’ve got family members in England, some of whom require social care, so I can say this without it being seen to be a political statement, but we are further down the track in terms of integration. We are further down the track in terms of the recognition of the need for parity between health and social care and the investment that we put in as a result.

“I suspect that there will be a need for others to be following some of the work that we’re doing and so I would expect there to be – I would hope that there is – that consequential impact that would allow for us to see finance come north.”

Gray is the tenth health secretary since devolution. With the notable exception of Sturgeon, who was in the role for more than a parliamentary term, that’s an average tenure of just over two years. That constant change can make reform harder, but Gray is determined to be the right man for the job now and long into the future. “I’m very keen that I’m health secretary for a long time,” he says. “I want to be health secretary beyond 2026.”