A new First Minister has taken office, inheriting the same old challenges. Our NHS faces deep-rooted structural issues, and if John Swinney is serious about improving Scotland’s health system, he must solve them instead of delivering short-term relief.

Without changing the way the NHS operates and adequate, sustained funding to local government, physical activity programmes and active travel, Scotland’s ability to address growing health inequalities is at risk. A systems-based approach, with physical activity at its heart, is required.

Movement for Health, a coalition of Scotland’s leading charities, has called for a significant shift towards preventative healthcare and social prescribing, without which our NHS will fail to meet societal needs.

The figures are staggering. A Reform Scotland report, NHS 2048 , showed that less than two-thirds of new outpatient appointments were being met within the 12-week treatment guarantee. Waiting lists for elective surgery are of critical concern. The number of people waiting for hip or knee operations has significantly increased across practically all health boards since Covid. Thousands are having to wait for over a year, often in severe pain.

New funding will undoubtedly help, including prehab and waiting well services. But significant constraints within the NHS remain. Strikingly, there are simply not enough surgeons and nurses to go round. So, we need to consider new ways to address shortages. Moreover, these constraints are not felt just across the NHS. Major funding and capital reductions in local government are affecting the provision of critical leisure facilities.

Preventative health, physical activity and social prescribing are not new ideas. Bu there is a growing need to address how we are funding prevention, as is evidence about how physical activity affects people’s lives and delivers positive outcomes for patients.

Regular movement makes vital contributions to good physical and mental health. Critically, up to 40% of long-term conditions, including type 2 diabetes, cardiovascular diseases and some cancers, could be prevented if everyone met the UK Chief Medical Officer’s physical activity recommendations.

Supporting people to move in ways that help them and their conditions matters. Movement for Health champions best practice and the provision of clear information about how existing guidelines can be implemented.

It needn’t cost a lot. Good signposting and training for GPs and other health and allied professionals would provide a pathway for patient referrals to appropriate facilities and support. However, ongoing investment in the infrastructure and personnel to support these pathways is also required: yet our leisure services are in danger with risks felt by many members of Community Leisure UK, part of Movement for Health.

Such an approach needs to start early in life. Schools play an important role, ensuring that children develop good habits and that preventable health conditions are spotted early.

Throwing money at the problem will only get us so far. Instead, we need to reframe the funding landscape and implement preventative healthcare jointly across local authorities and the NHS. Physical activity plays a fundamental role, enabling us to live healthier lives to the full.

Kirsty Cumming is CEO of Community Leisure UK

Agenda is a column for outside contributors. Contact: agenda@theherald.co.uk