Scotland’s NHS ‘not financially sustainable’
Scotland’s National Health Service is under severe pressure, is “not financially sustainable” and needs reform, the Auditor General has said.
A review of the NHS by Audit Scotland warned of an “ever-increasing backlog of patients waiting to be seen” and that rising spending on the health service was “unsustainable”.
The spending watchdog said that the Scottish Government has ambitious plans to redesign NHS services but stressed they “will be challenging and take a long time to realise”.
Its report said the Government “struggles to recruit enough people with the right skills” into the health service and increasing staffing in the NHS must be a priority.
Plans for a National Care Service could also hinder the recovery of the health service as Scotland emerges from the coronavirus pandemic, according to the auditor general, Stephen Boyle.
Mr Boyle said: “Reforming the NHS is key to the Scottish Government’s pandemic recovery plan and needs to remain a priority. Putting Covid costs to one side, health spending is rising every year, meaning less money for other public services.
“There’s now a clear opportunity to do things differently by building on the innovation and collaboration we’ve seen across the NHS in the last few years.
“For that to happen, our leaders must take the public with them and involve them in the shift from care being delivered in hospitals to much closer to people’s homes.
“But better-informed policy decisions and services won’t be possible without better collection and use of data.”
He added: “The need for reform of the NHS is as strong as ever.
“Health spending continues to grow every year and it’s unsustainable.”
Assessing the NHS’s finances, Audit Scotland found that an additional £2.9 billion of funding was allocated in 2020-21 across health and social care, including £1.7 billion for health boards.
In 2020-21, the health budget was £18 billion – accounting for 35% of the total Scottish Budget.
Of this, the NHS funding allocation was £16.3 billion, an increase of 19% in cash terms on the £13.7 billion the previous year.
Suggesting there is significant uncertainty about coronavirus-related funding and spending, the report added: “The NHS was not financially sustainable before the Covid-19 pandemic, with boards relying on additional financial support from Government or non-recurring savings to break even.
“The scale of the financial challenge has been exacerbated by the pandemic.
“The cost of delivering services has risen and additional spending commitments made by the Scottish Government add to NHS boards’ financial pressures.”
A total of 14 of the 22 NHS boards required additional Scottish Government funding to achieve financial balance in 2020-21, with six boards facing a “particularly challenging financial position”.
Those boards: NHS Ayrshire and Arran; NHS Borders; NHS Dumfries and Galloway; NHS Fife; NHS Highland; and NHS Orkney, have been submitting monthly plans to the Scottish Government since Autumn last year about how they plan to achieve savings to improve their financial position by the start of the 2022-23 financial year.