Image source, bbc

Emilia Crighton from NHS Greater Glasgow and Clyde says the gap is not being closed but very early education could achieve this.

Ms Crighton says early education can increase mobility in later life.

Committee convener Neil Findlay asks is money was not an object would they carry on screening.

Dr Helen Irvine says make it targeted and for the higher risk women.

Dr Margaret McCartney says you canalways spend money on something better.

However Dr Una MacFadyen says screening in babies works and should be kept, a point echoed by Emilia Crighton. 

Committee convener Neil Findlay says all the issues outside health are the ones that need to be tackled.

Mr Findlay asks if there is evidence that these issues are being tackled.

Public health medicine consultant Dr Helene Irvine says "no" and that she is made to feel odd for raising this but she will continue to do so,

Dr Irvine says the gap must be reduced and commitment must be shown to young people. 

"You have to reduce the gap and that has to be the priority," she says. 

Image source, bbc

Public health medicine consultant Dr Helene Irvine says most people know what they should be doing.

Dr Irvine says healthy food must be made cheaper and the unhealthy food more expensive.

She calls for the taxing of junk food.

General practitioner Dr Margaret McCartney says everything must be driven by evidence. 

Tory MSP Donald Cameron says there are a wide range of communication materials and asks what is being done right and what is being done wrong.

Dr Una MacFadyen from the Royal College of Physicians of Edinburgh says "use the children" and that if children believe a message they will get it to their parents. 

Emilia Crighton from NHS Greater Glasgow and Clyde says the message must be confident in telling people the right things to eat.  

Emilia Crighton from NHS Greater Glasgow and Clyde says the right environment must be in place very, very early.

Ms Crighton says pre-school must be available to all children, particularly those from the least affluent areas.

Image source, bbc

Public health medicine consultant Dr Helene Irvine says there are already pressures on teaching and it is a bit utopian to suggest teaching can be used to solve this problem.

Dr Irvine says people who abuse A&E departments need a redirection policy.

SNP MSP Jenny Gilruth says meaningful employment has been highlighted and the education system has a key role to play.

Ms Gilruth asks if health education needs to be re-configured.

Dr Una MacFadyen from the Royal College of Physicians of Edinburgh says there are opportunities within the curriculum. 

Dr MacFadyen says young people have identified their mental health as a concern and this is people saying "I need help". 

Doctors should spend more time listening to their patients in order to avoid unnecessary treatments, according to Scotland's chief medical officer.

Catherine Calderwood wants doctors and patients to have more open and honest conversations about the benefits and risks of procedures or medication.

She argues that quality rather than quantity of life can be more important.

The British Medical Association Scotland said doctors needed time to "learn, teach and reflect".

But its chairman, Dr Peter Bennie, said it regularly heard from doctors that they did not have the necessary time to do this.

Dr Calderwood names her plan "realistic medicine" in her new annual report.

Read more here., external

Public health medicine consultant Dr Helene Irvine says she has had a cough for eight weeks and she gets it every winter and she certainly does not go to the GP about it.

Dr Irvine says we have encouraged people to be "a little bit health neurotic" and it needs to be "put back in the bottle".

SNP MSP Tom Arthur asks to what extent realistic medicine is being practiced. 

General practitioner Dr Margaret McCartney says the biggest cultural problem is that screening invitations tell the person to come to screening rather than giving the individual information.

Dr Una MacFadyen from the Royal College of Physicians of Edinburgh says there is a potential to lower demand on health services by informing people and making them aware of false screenings.

"Why would anyone understand if you didn't give them the information," she says.

Image source, Thinkstock

SNP MSP Maree Todd goes back to breast feeding and asks what can be done to improve breastfeeding

Dr Una MacFadyen from the Royal College of Physicians of Edinburgh says: "I think there are lots of things we can do."

Dr MacFAdyen calls for "one to one support for mums trying to breastfeed".

She says it is a challenge for the culture to change in Scotland.

Emilia Crighton from NHS Greater Glasgow and Clyde says a balance must be struck to find the right venues for people who need care.

Ms Crighton says targets must be managed. 

Public health medicine consultant Dr Helene Irvine says the target times for A&E brought about a change originally because it encouraged investment in these services.

"We are starting to go back to appalling statistics," she says.

Dr Irvine says this target has outlived its usefulness because problems are being ignored. 

Image source, bbc

Dr Una MacFadyen from the Royal College of Physicians of Edinburgh says the four hour A&E target "seems rather illogical on its own".

Dr MacFadyen says some people need not have been at A&E anyway rendering the four hour target meaningless.

SNP MSP Maree Todd asks how much difference the flu vaccine makes to people's health.

General practitioner Dr Margaret McCartney says there are legitimate questions to be asked about the flu vaccine.

Dr McCartney says she is concerned that GPs get targets for the flu vaccine and that it should be their choice on whether or not to give it. 

"I am worried general practice is being turned into a factory setting," she says.  

Image source, RCPE

In its submission, the Royal College of Physicians, external says: "Preventative spend is relevant to the current Realistic Medicine agenda and its focus on the overuse of investigation, treatment and potentially unnecessary interventions. 

"The evidence base for various universal screening programmes and preventative measures could be scrutinised to assess whether they are effective, both in terms of cost and preventing disease, with consideration given to discontinuing those which fail this test."

Read more here., external

Image source, bbc

Emilia Crighton from NHS Greater Glasgow and Clyde says if you are in the least affluent area as a male you are 16 times more likely to die than those int he most affluent.

Ms Crighton says in Iceland families and children are engaged in alternatives.

She says we need to create an environment people are interested in, food must be the right food and not junk and alcohol must be more expensive.

Dr Una MacFadyen from the Royal College of Physicians of Edinburgh says the risk and benefits of decisions are often missed.

Dr MacFadyen says the Scottish initiative of the Daily Mile has been an enormous success. 

She says programmes like this give children more confidence and promotes a change in attitude.

"A different attitude to preventative health would reap benefits."

Image source, bbc

Public health medicine consultant Dr Helene Irvine says the middle class people also "pig out" and drink to much alcohol, it is not just the poorest.

Dr Irvine says we must find out why a substantial majority is being left behind and address the gap in income and wealth.

Public health medicine consultant Dr Helene Irvine says she would accuse the committee of being obsessed with a data driven process.

"Much of this is common sense," she says.

Dr Irvine says reduce obesity and diabetes will reduce and that data is not required to tell us this. 

Image source, Scottish Parliament

Read more here., external

General practitioner Dr Margaret McCartney says the problem with breast cancer screening is you get over diagnosis.

Dr McCartney says there are a number of areas that have a huge impact on health but GPs cannot address them.

Image source, bbc

Emilia Crighton from NHS Greater Glasgow and Clyde says there must be policies that make the right choices easier.

Ms Crighton says obesity drives breast cancer and breast feeding is preventative.

She points to the link between alcohol and breast cancer.