Interview: Michael Matheson

“I don’t know if the press office has any plans to have me hanging off mountains,” laughs newly appointed Public Health Minister Michael Matheson as he glances nervously but gamely at the Scottish Government press officer at the end of the table.

I’ve asked Matheson, a keen mountaineer, about his love of the hills and whether we should prepare ourselves for an onslaught of press calls inviting us to observe him promoting the health benefits of enjoying the great outdoors.

Matheson has been involved in mountaineering since he was 12 and says it is an activity he “thoroughly enjoys,” having had the opportunity to climb in the Himalayas and the Alps, as well as extensively in Scotland. He has also been a member of the Ochil mountains’ rescue team for some 16 years.

“I try to keep my involvement with the team as much as I can, largely to be a focus to get out on the hills. The great thing I enjoy about mountain rescue is you go along and you are just one of the guys, it doesn’t matter what your job is. So it is a very worthwhile activity but it is also very good fun to be a member of the team,” he says, adding:
“I’m going to try and keep it going as much as I can and whether the Government’s communications team manage to get me involved in some mountain activities, we’ll have to wait and see!”

Regardless, Matheson has a metaphorical mountain to climb as he inherits responsibility for addressing Scotland’s public health record from his colleague Shona Robison, who has moved sideways to take up the position as Minister for Commonwealth Games and Sport.

We have to make sure we are giving people an opportunity to lead as healthy a life as possible

However, he appears unfazed by the challenge ahead and confesses in his first interview since his appointment to being “delighted” with being selected for this particular brief, having formed a “longstanding interest” in public health during both his pre-parliament life as a community occupational therapist and his 12 years on the back benches, including the four he spent serving on the Health and Sport Committee in the last session.

These experiences will no doubt stand him in good stead as he focuses on his new role. His previous career working as a health professional in a social care setting, for example, has given him a “unique insight” into the current debate around integrating health and social care, he says, and has convinced him that some of the barriers are “not as insurmountable as at times people would lead you to believe they are.”

He continues: “There is a tremendous amount of good will and good practice that is exercised by both social care and by healthcare staff. Many of the barriers that have developed over the years are largely artificial. Through good partnerships, I saw first hand how health and social work staff can work very well together. I think it is having that insight into that particular field, and also being able to recognise that some of those barriers are readily, I think, resolved.”

Recently the Cabinet Secretary for Health, Nicola Sturgeon announced she is taking on direct responsibility for older people’s care – a role that previously rested with the Minister for Public Health – and said that improving care for older people will be a “personal priority.” However, having seen the demographic forecasts and knowing how people depend on health and social care services and what pressures already exist in terms of resourcing them, it is surely an issue that weighs heavily on the whole ministerial team.

“I think the reshaping of our health and social care services are extremely important and reshaping them in a way that means they are much more focused on the needs of an individual elderly person, rather than on what necessarily has traditionally been provided. Part of the Cabinet Secretary making it clear that she sees improving standards within these areas as being a priority is entirely correct and it is also about remodelling them in a way that is reflective of people’s needs and also an ageing population.”

One area Matheson says he is particularly keen to see further progress being made is increasing opportunities for individuals to take-up self-directed support, adding that he is “very committed to the idea of giving people much greater control over the care that they receive.”

He adds: “I think with the demographics we have, it is absolutely essential that we give people the opportunity, and that local authorities and other partners within the third sector recognise this, is that we must be much more flexible in the type of provisions that are provided within a local community and how you deliver that type of change as well. So it is about being much more flexible and much more open to what people want to have as opposed to what the council traditionally provide.”

However, Matheson is hopeful that individuals can be given the opportunity to improve their health and wellbeing at all stages of the life cycle. In stepping up to the challenge of improving Scotland’s health record, Matheson says his membership of the Health Committee also proved instructive as he recalls an inspiring presentation given to the committee four years ago by Scotland’s Chief Medical Officer, now Sir Harry Burns.

“He gave us a presentation on his annual report and the line he said was, ‘The real public health challenge is to provide people with hope.’ I think that remains true today. We have to make sure we are giving people an opportunity to lead as healthy a life as possible, and to reach as much of their potential as possible.”

While, he adds that he is “realistic” that there are “no quick solutions” to dealing with many of the health challenges that have become embedded in our society over decades, nevertheless, he asserts his commitment to the long haul.

“It will take governments – that’s plural – years to effectively eradicate many of these problems. But what we are very clear about is that we wish to do that.”
As a member of the committee Matheson had a ringside seat to its scrutiny of the most contentious piece of legislation from the last session, the SNP’s failed attempt to introduce minimum pricing as part of its Alcohol Etc. (Scotland) Bill. It made for uncomfortable viewing.

“If there was a word to describe how I felt at the end of the committee’s proceedings on the last Alcohol Bill it was ‘frustrated’,” owns Matheson.

“Frustrated that, in my view, minimum pricing was clearly an important public health measure that we should have taken and I regret the way in which it became so polarised politically and was often presented as though this was the SNP Government’s silver bullet to deal with Scotland’s alcohol problem. It never has been and never will be. It is part of an overall package of measures and when it is considered in that context, all of the expert opinion in the public health field is saying this is the right thing to do and this will make a real difference.”

During his time in parliament, he says he has never seen an issue “become so polarised so early”. While he says this was “unfortunate”, nevertheless, he takes heart from the fact that they did collectively, and explicitly, agree as a parliament that Scotland’s relationship with alcohol needs to change.

“I said several times during the course of the debate in the Health Committee around alcohol that I think changing Scotland’s relationship with alcohol is potentially one of the biggest public health challenges we’ve faced in a generation.”

He was “encouraged” to hear this acknowledged in Parliament, he says.

“Although many people recognised that in the past I don’t think we’ve ever had a national debate where it was broadly accepted that this is a problem that does require a national approach to tackling the problem. I say that as someone who has now been in the Parliament for 12 years, I don’t think we’ve got to that point with the alcohol debate before.”
And yet, disputes around the mechanisms deployed to tackle that problem remain unresolved. The SNP continues to be steadfast in its support of minimum pricing, having committed itself in its manifesto to bringing forward a Minimum Pricing Bill before the election results revealed the party’s emphatic win and resulting parliamentary majority that now renders the objections of the opposition, which successfully blocked the legislation in its first outing, hollow second time around.
While not the whole answer; Matheson is clear that action on price is an important part of the equation.

“All the international evidence clearly demonstrates there are three key areas that drive alcohol consumption: advertising, availability and affordability,” he states.
While some measures around advertising remain reserved to Westminster, Matheson says that where it has been able, the Scottish Government, in partnership with the alcohol industry, has developed measures to promote “more responsible” advertising. Additionally, he says the issue of availability is being effectively addressed through the Scottish Parliament’s Licensing Act. However, he adds that we can’t afford to ignore that price is a key factor.

“Much of the evidence I saw as a committee member led me to believe that we can put a whole range of measures in place, and of course, we have put a whole range of measures in place to tackle this problem, but if you are trying to change our cultural attitude with alcohol then doing it without addressing what is one of the most major components that drives alcohol consumption, and that is affordability, then effectively it is a bit like trying to push water up hill.”

Despite recognition of this in the chamber, Matheson insists he has not seen “one single serious alternative” to minimum pricing proposed by the opposition. However,
while the make-up of the fourth parliament determines that his party no longer needs to kowtow to the opposition; nevertheless he says he remains “open” to suggestions and hopes the parties can work together “constructively” on this, and other issues.

“I hope that when we start to look at any legislation around minimum pricing that all the parties in Parliament will look to play a constructive role within that and I’m sure they will look to do that. As a government, we are very committed to continuing to look for ideas and mechanisms that can help to improve Scotland’s public health record and if other political parties have ideas around how we can improve Scotland’s public health record, whether it be alcohol or anything else, then my door is certainly open to them and I hope while I am in this position I will certainly work with them as constructively as possible,” he says.

“But that also means being honest about what the potential options are and recognising that where there are measures that can make a real difference that as a government we are committed to improving Scotland’s public health record and we will look to take forward serious bold measures that can make a difference.”