Scottish NHS failing to meet demand, ministers warned
HL: Scottish NHS failing to meet demand, ministers warned
SF: Staggeringly bleak report paints a picture of a health service in crisis, without a plan to address it, says BMA
By Simon Johnson Scottish Political Editor
Scotland’s struggling NHS cannot keep up with demand and needs “significant” reform to survive, a “staggeringly bleak” official audit has warned SNP ministers.
Audit Scotland said waiting lists “are still substantially larger, and waiting times substantially longer, than before the pandemic”, with most targets being missed.
Despite a recent increase in “activity” in hospitals and clinics, this also remained below pre-Covid levels and more cases are being added to waiting lists than are being removed.
“This pressure is creating operational challenges throughout the whole system and impacting staff, patient experience and patient safety,” the auditors said.
They found that “significant changes” are required to resolve a shortfall in the NHS’s finances, thanks to a combination of growing demand, operational “challenges” and increased costs.
The health service’s “longer-term affordability is at risk without reform”, they said, warning that the NHS was taking up an “ever-growing chunk” of the Scottish Budget. This means “less money for other vital public services”.
Despite the Scottish Government publishing an abundance of strategies and plans for the future delivery of healthcare, they found there was “no overall vision” and this made it “more difficult for NHS boards to plan for change”.
It emerged earlier this week that at least a dozen NHS construction projects have been postponed thanks to a squeeze in capital funding.
Audit Scotland said it was “not clear” how the cost of a repairs backlog in excess of £1.1 billion would be met, warning this was “almost double” the available capital budget.
The audit was published as it emerged that beds in the main hospital in the new SNP health secretary’s constituency were closed over an infestation of flies, asbestos and a dodgy ceiling.
A leaked report also expressed concerns about fire safety and legionella at Monklands Hospital in Airdrie but funding for a replacement has been postponed by the SNP government.
Neil Gray, the Airdrie and Shotts MSP, replaced the disgraced Michael Matheson as Scottish health secretary earlier this month.
The British Medical Association (BMA) in Scotland said the “forensic” new audit “is staggeringly bleak and paints a picture of a health service in crisis, without a plan to address it”.
Dr Iain Kennedy, its chair, said: “As BMA Scotland has warned for years, the report confirms the NHS in Scotland, and its workforce, is simply unable to meet the growing demand for health services of our population.
“The service is not financially sustainable and NHS boards face a blackhole in excess of £0.5 billion by 2025/26. Staffing – and workforce planning – is woefully inadequate, with increasing vacancies and spending on agency workers, leaving healthcare professionals feeling exhausted and unable to provide safe or effective care.”
He said the report should be a “call to action” and urged ministers to develop a “focused overall health and social care plan that moves us away from the kind of piecemeal, politically expedient kind of action we see at the moment”.
The Scottish Government allocated £17.8 billion for the NHS last year, 39 per cent of its total budget, but the audit found that increases in spending were being swallowed up by surges in inflation, energy prices and pay deals.
With nursing vacancies having risen from 3,024 in 2018 to 5,447 in 2023, the report said spending on expensive agency nurses increased by 79 per cent last year to £169.7 million.
Audit Scotland said the Scottish Government was “unlikely” to meet pledges to reduce both waiting lists and waiting times, while “key targets for eradicating long waits have been missed”.
Dr Sandesh Gulhane, a GP and the Scottish Tories’ shadow health secretary, said: “This utterly damning report exposes the monumental failings of the SNP’s management of Scotland’s NHS.
“As well as having no clear vision for our health service, SNP incompetence has meant there is now no money to progress desperately needed new healthcare facilities across the country.”
Mr Gray said: “The Scottish Government is already taking forward a range of immediate and longer-term reform to our NHS, and I will set out my vision for further reform of the NHS in the coming weeks.
“The fundamentals of Scotland’s NHS will not change; we remain committed to free access to healthcare.”
Colin Lauder, director of planning, property and performance at NHS Lanarkshire, said the board remained “fully committed” to replacing Monklands Hospital and a 2031 opening date had been identified.
