John Swinney to cut health boards in major realignment of NHS

The number of health boards in mainland Scotland will be cut to two as part of a “radical reshaping of public services,” John Swinney has announced.

Delivering his Programme for Government in Holyrood this afternoon, the first minister outlined an overhaul of the 14 territorial health boards, with different arrangements to be put in place for island health boards.

The changes are part of a wider public service reform agenda, with the first minister describing it as the “most radical reshaping of public services since the establishment of the Scottish Parliament”.

The first minister said: “We will undertake radical and widespread public service reform, putting the individual at the heart of the changes that we make. We will require all public services to make a decisive shift to prevention and early intervention. We will simplify government, remove barriers to progress, and make sure every pound of investment is focused on frontline service delivery.”

This aim is to make public services more affordable and efficient, though concerns have been expressed about job losses and ensuring services have the resources to deliver.

Other early reforms include the merger of four environmental organisations into one, and the establishment of one ferries body covering the Clyde and Western Isles routes.

Swinney also confirmed there will be a three-month “intense” engagement about the future and shape of local government.

He said: “Some of our councils are too small to be strategic, and some are too big to be local.

The government believes that should change – what we propose is a rebalancing of power within Scotland, with our regions strengthened and our communities empowered to bring new life, new opportunities, into the places that they love.”

However, he said he was not “prescriptive” about what that change would look like and would seek to engage with partners. He said any reform must not “create another layer of administration or a new group of politicians”.

Plans for social care are also to be revisited. This follows the failure to pass the National Care Service Bill in the last parliament after it met significant opposition over concerns it would lead to over-centralisation.

He said reforms would be part of the wider engagement with local government, including other political parts and trade unions.

“Again, I do not seek to be prescriptive – but I cannot see us resolving the fundamental challenges facing social care without a single line of decision-making, accountability and funding, with the NHS taking the lead,” he added.

Nine bills are set to be introduced this parliamentary year, it was also confirmed.

That includes one covering the decarbonisation of heating in buildings and a misogyny bill, both of which were delayed from being introduced in the previous parliament.

Other bills will look to reform council taxes, establish a food price cap, and give statutory backing to the public service reform strategy.

Swinney also confirmed bills to be introduced later in the parliament include a Rural Renewal Bill and a Human Rights Bill.

He also announced a £2 cap on bus fares will be introduced in Glasgow and the west of Scotland from this coming Monday, adding to the one already in place in the Highlands.

The legislative programme has been described as “thin gruel” by Reform UK.

Scotland leader Malcolm Offord said people were “fed up with performative politics” and called for measures that would result in “more jobs”, such as support for small businesses.

“Same old empty promises, just rebranded, but still a medley of sticking plasters and gimmicks instead of practical, long-term solutions for the benefit of the Scottish people. Re-arranging the deck chairs on the Titanic,” he said.

Scottish Labour’s Jackie Baillie, meanwhile, welcomed much of the contents of the programme – arguing that many of them were policies long advocated by her own party.

But she added: “Warm words are no substitute for action and that is what needs to change in this government. We need real action to improve our NHS, make life more affordable and help our communities and our economy flourish.

“Scottish Labour will work with the Scottish Government to deliver for Scotland – but we will also hold John Swinney to account on his promises and his failures.”

The Scottish Greens have warned the health board announcement would just result in “full centralisation of services”, with the party calling for more detail to “to reassure NHS staff that there will be no roll back on the Scottish Government policy of no compulsory redundancies”.

The party also slammed ministers for failing to include a commitment to ban conversion therapy. Equalities spokesperson Kate Nevens said: “A comprehensive, watertight ban has been promised again and again, and rather than following through on the promises the Scottish Government made, today’s programme for government has delayed it further.”

Trade unions have reacted furiously to some of the announcements.

Unite has labelled the NHS reform plans a “slash and burn programme”, with general secretary Sharon Graham adding: “The proposals will inevitably result in swingeing cuts and thousands of job losses across the public sector. Our members will not be the collateral damage for the Scottish government’s failings.”

And general secretary of the STUC Roz Foyer warned it was a “misleading choice of cuts packaged as public service reform”.

She added: “This is not the way to do public sector reform. Before the axe is swung on any public service, whether health, council or social care, Scottish Government ministers would do well to engage meaningfully and purposefully with the workers who deliver on the ground.  This cannot be done in the timescales outlined.”