MCKIRDY REPORT – “CHANGE IN DIRECTION AND LEADERSHIP” NEEDED TO SAVE SCOTLAND’S NHS

heaneymedia

5 months ago

by Democrat reporter

A new independent investigation into the state of Scotland’s NHS has warned that “more of the same will not be enough” to save the NHS for future generations.

The independent investigation, published today (MON) was carried out by Mike McKirdy, pictured right, a retired Consultant Surgeon from NHS Greater Glasgow and Clyde and the former president of the Royal College of Physicians and Surgeons of Glasgow, based on the approach taken by Lord Ara Darzi in his similar piece of work investigating the NHS in England.

This report comes as the BMA has warned that the NHS is ‘dying before our eyes’.

Mr McKirdy sets out in detail the scale of the challenges facing Scotland’s NHS and exposes long-term failures to modernise our NHS.

The report warns that the founding principles of our NHS “are becoming strained and frayed” and current trends risk “entrenching a two tier system where access depends increasingly on ability to pay rather than clinical need”.

Scottish Labour leader Anas Sarwar and his deputy Dame Jackie Baillie, Dumbarton MSP.

The report reveals:

Since 2007, more than 130 major health strategies have been published — the equivalent of one every seven weeks.
The median wait time for an NHS 24 call to be answered had increased from 9 seconds in 2014/15 to over 5 minutes in 2019/20. In 2024/25 it was 22.5 minutes.
Diagnostic waiting times continue to climb: by December 2024, the radiology waiting list was 88% higher than in December 2017, while the endoscopy waiting list had grown by 36%.
As pressures intensify, more patients are turning to private healthcare — since 2019/20, private admissions have increased by 55%, effectively creating a two-tier healthcare system.
NHS staff are around 50% more likely than the general population to experience chronic stress, linked to staff shortages, high workload, and pressure to maintain quality care.

Analysis in the report shows performance in Scotland’s NHS was declining on key measures prior to the pandemic and “the challenges in the NHS were not caused by the Covid-19 pandemic” – rather, Covid “exposed and enhanced” existing weaknesses.

NHS staff are highlighted as a key strength of our health services throughout, however the report recognises that they are “at risk of burnout” and at times dealing with “problematic cultures that actively discourage the raising of issues or shut down concerns even when regarding patient safety”.

Mr McKirdy concludes that “the current challenges are not insurmountable, but they do require a fundamentally new approach” and that “serious change is needed in the direction and leadership of the health service”.

Speaking ahead of the report launch Mike McKirdy said: “The NHS is a treasured institution. Its founding principle – that care should be free at the point of need – remains deeply valued in Scotland.

“That it should be there for us at the start of life, all the way to the end, is a unifying and equalising concept.

“Its staff are proud of the work they do and the care they give is valued and respected by the public.

“Yet, as the service comes under increasing pressure, these principles are becoming strained and frayed.

“As confidence in the NHS to be available declines, so too the commitment to the sharing of the risk of ill health and the common good of our shared life is in danger of becoming lost.

“But, before remedy is possible, diagnosis is required. Therefore, this report considers many aspects of the NHS in Scotland, from patient access to the quality of services, the governance arrangements and productivity.

“It considers hospital activity, emergency and repeat admissions, delayed discharges, patient safety, avoidable mortality, preventive health measures, and inequalities in outcomes.

“The health system must operate within its own specific context, so the report also considers the wider health and inequalities within Scotland and the role of prevention.

“To deliver the outcomes needed, serious changes are needed in the direction and leadership of the health service.”

Scottish Labour Leader Anas Sarwar said: “Our NHS is our most precious public service, but as doctors themselves have warned the very existence of the service is in danger.

“The situation uncovered by the McKirdy Report is one of governmental failure with Scots paying the price

“This landmark report shows the SNP’s utter failure to recover from the impact of the pandemic is because of their inability to modernise our NHS for the future.

“Enough is enough – we don’t need more undelivered strategies, we need bold and meaningful change to fix our NHS and to tackle the waiting list crisis.

“That’s why a Scottish Labour government will declare a waiting times emergency, cut NHS red tape and empower Scotland’s doctors and nurses.”

Scottish Labour Deputy Leader Jackie Baillie said: “The McKirdy Report is a vital intervention and a major piece of work in uncovering the crisis in our NHS.

“The NHS is Labour’s greatest achievement but the simple fact is that over 18 years of SNP Government failure has pushed the service to breaking point.

“We cannot allow the people of Scotland and those who work in our NHS to continue to pay the price of SNP failure.

“This is why the analysis provided by this vital report will play a major role in informing the policy and direction of Scottish Labour’s plan to fix our NHS.”

A summary of some of the statistics showcasing the challenges facing the NHS below as is a fully copy of the McKirdy report.

· A&E departments have not met the 95% standard for patients to be seen within four hours since August 2017.
· The proportion of patients waiting more than an hour to be triaged in A&E has increased from 2.1% in 2017/18 to 5.7% in 2024/25
· From July 2024 to June 2025, around 24% of individuals attending A&E had multiple attendances within the 12-month period, with 8% having three or more.
· The median wait time for an NHS 24 call to be answered had increased from 9 seconds in 2014/15 to over 5 minutes in 2019/20. In 2024/25 it was 22.5 minutes.
· By 2019/20, only 67% of ambulance call outs to potentially life-threatening cases arrived within 10 minutes, down from 85% in 2012/13. In 2024/25 it had fallen as low as 61%
· In 2013 almost all patients were treated within the 12-week Treatment Time Guarantee, but by December 2019 less than 72% were meeting the target. Since December 2022 it has been around only 57%
· Since 2019/20, private admissions have risen by 55% and stats last week showed a record number of private admissions.
· The number of occupied beds due to delay has risen from 1,400 in 2019 to about 2,000 in late 2024, representing one in nine (10.8%) acute beds in 2023/24. Most recent stats showed delayed discharge remains around 1,900 bed every day.
· Prior to the pandemic, the median length of delay was around 15 days. In 2024/25 it averaged closer to 20 days
· Potentially preventable admissions have risen from 6.3% of all admissions in 2014/15 to 7.3% in 2023/24.
· Scotland has historically spent more per head on health, though the gap has narrowed in recent years, from around 17% in 2006/07, to just 2% by 2023/24.
· Around half of the consultants (43%) and nurses (54%) who left the NHS between April 2024 and March 2025 were under the age of 55.
· Sickness absence has risen from 5% in 2015 to 6.4% in 2025, with mental ill health a leading cause.
· NHS staff are around 50% more likely than the general population to experience chronic stress, linked to staff shortages, high workload, and pressure to maintain quality care.
· Reliance on temporary staff has escalated, with nearly 10% of nursing expenditure now spent on bank or agency contracts.
· In the early 2000s, about 1 in 5 people in Scotland reported believing that the standard of healthcare had improved – this fell to 1 in 10 in the years leading up to the pandemic. More recently only around one in 20 believe the health system’s standard has increased.
· There is a rising backlog of estate repairs, which reached £1.5 billion in 2025/26. Of this, 7% (almost £106 million) is classed as high-risk.
· Between 2010/11 and 2019/20, capital expenditure averaged 3.8% of the budget; by 2023/24, this had dropped to 2.6%.
· 28% of MRIs are more than 10 years old, with 9% exceeding 15 years, while 17% of CT scanners are over 10 years old, with 4% beyond 15

NHS Scotland Photo library Picture by John Young / YoungMedia 2010

Royal Children’s Hospital, Queen Elizabeth University Hospital and Vale of Leven Hospital. Top of page Royal Alexandra Hospital, Paisley.

Meanwhile, the Scottish Conservatives have today launched a ‘Fast Track to Care’ policy to tackle delayed discharge in Scotland’s hospitals, which are at the highest levels on record.

Under the party’s plans, patients in eligible areas with care home capacity, boosted by additional funding, would be placed temporarily in a care home within 48 hours of being declared fit for discharge.

The scheme would only be piloted in council areas where local authorities have proactively opted in.

The proposal would secure up to 600 short-term care home beds in pilot areas by providing funding to Health and Social Care Partnerships in the local council areas that have chosen to take part.

It’s not yet known where West Dunbartonshire Council stands on this issue, but it is bound to be contested in the local community.

Scottish Conservative shadow health secretary Dr Sandesh Gulhane MSP said: “SNP ministers promised to eradicate delayed discharge a decade ago, but on their watch it’s at a record high – with 720,000 bed-days lost last year alone.

Conservative spokesperson Dr Sandesh Gulhane and First Minister John Swinney

“John Swinney should be throwing the kitchen at sink at this crisis. Instead of focusing on our overstretched health service, he’s once again talking up his independence obsession. It’s not just a distraction — it’s a dereliction of duty.

“While he fixates over the constitution, we’re putting forward a bold, practical plan to cut delayed discharge, free up desperately needed hospital capacity and bring down waiting times.

“Our Fast Track to Care proposal would ensure patients are moved into care homes within 48 hours of being declared fit for discharge — by securing up to 600 short-term care home beds in pilot areas and boosting funding for councils that opt in.

“We can’t ignore this crisis any longer. Bold action is needed to reduce the pressure of our NHS and save taxpayers’ money. We’ll keep offering the common-sense solutions Scotland desperately needs.”

by Democrat reporter

The report reveals:

A summary of some of the statistics showcasing the challenges facing the NHS below as is a fully copy of the McKirdy report.

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