Scotland's NHS 'not financially sustainable' new report states
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 £2.9bn of funding was allocated in 2020-21 across health and social care, including £1.7bn 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 £13.7bn 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.
Commenting on the report, Scottish Labour health spokeswoman, Jackie Baillie, said: "This scathing report is a damning indictment on almost a decade and a half of SNP mismanagement of our NHS and care sectors.
"This is just about the most damning Audit Scotland report in the NHS since devolution.
"The report is explicitly clear - the SNP Government has entirely failed to support the NHS properly for years and as a result the whole system is under exceptional pressure.
"The failure of Humza Yousaf's so-called NHS recovery plan is plain for all to see as one in eight Scots languish on waiting lists, staff are exhausted and the NHS remains on emergency footing.
"Only robust planning will do to get our NHS back on track, but Humza Yousaf's eyes are not on the ball.
"Scottish Labour has repeatedly called on the SNP to back our proposals for an NHS catch-up plan to reduce waiting times and a rise to care workers' pay to £15 an hour.
"It is clear only Scottish Labour has the plan and the ambition to get our NHS back on track and to deliver a National Care Service worthy of the name."
Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh, said: "This report highlights the significant financial impact of the pandemic on our health and care services.
"It points out that workforce planning is vital if we are to clear backlogs and get onto a level footing in our NHS.
"The college believes that quality care should be available for every person who requires it."
Scottish Conservative shadow health secretary Dr Sandesh Gulhane said: "This damning report confirms what we have been saying for some time - that Scotland's NHS is in crisis on the SNP's watch and that Humza Yousaf's flimsy Covid recovery plan will not solve it.
"The report highlights the recruitment problem across the NHS - and that's a product of poor workforce planning by the SNP Government. There are huge vacancies across the health service yet we can't fill them because we don't have enough trained people to do so.
"That's why the Scottish Conservatives have called for the cap to be removed on the number of places at Scottish universities for healthcare-related courses.
"As we emerge from the pandemic, the ever-growing backlog in patients awaiting treatment is a ticking timebomb but, again, we see no strategy from the Health Secretary for getting on top of this."
Scottish Liberal Democrat leader, Alex Cole-Hamilton, said: "The NHS and its staff are on the verge of burnout. They have been let down by 15 years' worth of botched workforce and pandemic planning by the SNP Government which gave them no option but to work flat out.
"There is still no realistic plan to deal with the old problems made worse, from delayed discharges to record staff vacancies and waiting lists lasting years. It is putting lives at risk."
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