No clear plan to deliver NHS vision for future, states Auditor General

Despite increasing funding and staffing, the NHS in Scotland is still seeing fewer patients than before the Covid-19 pandemic. Auditors found that:

• commitments to reducing waiting lists and times have not been met 

• the number of people remaining in hospital because their discharge has been delayed is the highest on record 

• and NHS initiatives to improve productivity and patient outcomes have yet to have an impact and lack clear progress reporting. 

Health accounts for about 40 per cent of the Scottish budget. Funding grew again in 2023/24 but has mostly been used to cover pay commitments and inflation. Costs are forecast to continue rising and making savings remains challenging. Work to build new healthcare facilities also remains paused.

The Scottish Government’s restated vision for health and social care is not clear on how these operational pressures on the NHS will be addressed or how reform will be prioritised. It needs to work with NHS staff, partners and the public to set out a clear delivery plan and make tough decisions about how it may change or potentially even stop some services.

Stephen Boyle, Auditor General for Scotland, pictured left,  said:  “To safeguard the NHS, a fundamental change in how services are provided remains urgent. The Scottish Government needs to set out clearly to the public and the health service how it will deliver reform, including how progress will be measured and monitored.  

“Difficult decisions are needed about making services more efficient or, potentially, withdrawing those services with more limited clinical value to allow funding to be re-directed. Taking those steps will require greater leadership from Scottish Government and NHS leaders than we’ve seen to date.” 

Responding to the Auditor General’s report which finds the Scottish Government has no clear plan to address the operational pressures on the NHS or reform services, Scottish Liberal Democrat leader Alex Cole-Hamilton MSP, right,  said:  “Under the SNP’s mismanagement, our NHS is on its knees.

“Hundreds of thousands of Scots are trapped on an NHS waiting list, while record numbers are stuck in hospital because they can’t get the care they need at home or in the community.

“With staff overwhelmed and the health and social care system going backwards on so many measures, the SNP Government must now admit that its three-year old NHS Recovery Plan has flopped. It needs rewritten to get people seen quickly and fix care so that patients can leave hospital on time.”

Meanwhile, Scottish Labour has accused the SNP of “systematically dismantling” Scotland’s public services as trust in Scottish institutions collapses.

The new Scottish Household Survey on public trust in institutions has shown trust in the Scottish Government collapsing by 10 percentage points between 2022 to 2023.

The same survey showed a fall in trust across the board, with trust declining in the health system, education system, justice system, police, local government and civil service.

Scottish Labour said this was the result of “17 years of SNP vandalism”.

Scottish Labour Deputy Leader Jackie Baillie, left, said “This damning surveys lays bare the consequences of 17 years of SNP vandalism.

“It’s no surprise trust in the Scottish Government collapsed as the SNP became embroiled in scandal and infighting, but with trust declining across the board it’s clear the SNP’s failure goes well beyond political psychodrama.

“SNP incompetence has left every institution in Scotland weaker and Scots are all paying the price.

“From our NHS to our schools to our justice system, the SNP has systematically dismantled our public services.

“Now the SNP is attempting to dodge scrutiny of their woeful record by dropping these questions from this year’s survey.

“Scotland desperately needs a change in direction and Scottish Labour is ready to deliver it.”

The SNP’s era of high tax and free spending must come to an end, the Scottish Conservatives have said ahead of today’s Scottish Budget. 

Shadow finance secretary Craig Hoy, right, says that for 17 years the nationalists “have failed Scotland by making people pay more while getting less”. 

He added that it is time for a “common sense budget that helps workers and businesses, not another left-wing deal that hammers households.” 

Craig Hoy highlighted the Scottish Conservatives costed tax plans that would deliver a tax cut for workers, businesses and would-be homeowners. 

The Scottish Conservative tax plan would see income tax reduced by £222 for the average earner, as the 19p rate would apply up to £43,662. 

It would mean that everyone earning less than £45,000 – which includes approximately 85 per cent of Scottish taxpayers – would pay less tax than if they lived in the rest of the UK. 

The party are also proposing 100 per cent rates relief for pubs and restaurants next year, meaning they would pay no business rates at all, alongside 40 per cent rates relief for Scottish retail, hospitality and leisure businesses.

The proposals would also see LBTT reduced to zero per cent on all residential properties up to £250,000 which would save the average house buyer approximately £800.

Notes

Trust in Scottish institutions by year:

	2022	2023
Scottish Government	55%	45%
Local Government	59%	53%
Civil Service	62%	56%
Education System	68%	62%
Health System	79%	78%
Police	78%	73%
Justice System	65%	56%

Notes