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by Ruaraidh Gilmour
22 February 2024
Scottish Government must develop a clear national strategy for health and social care, says Audit Scotland

Activity in healthcare settings increased the last year | Alamy

Scottish Government must develop a clear national strategy for health and social care, says Audit Scotland

The Scottish Government must develop a clear national strategy for health and social care if it is to address the pressures currently facing the services, Auditor General Stephen Boyle has said.  

A new report from Audit Scotland warns that “significant changes” must be made to ensure the financial sustainability of Scotland’s health service.  

It cites growing demand, operational challenges, and increasing costs that have added to already mounting financial pressures facing the NHS and says without reform long-term affordability is at risk.  

Hospitals and other secondary care setting are being outpaced by demand, as activity in healthcare setting increased the last year, the report says, which has led to increased pressure on health and social care services. However, it adds activity in those settings remains below pre-pandemic levels. 

While Audit Scotland acknowledges the Scottish Government has a range of strategies, plans, and policies in place, it says there is no overall vision. And without a shared national vision and a clear strategy to deliver it, it will be more difficult for health boards to plan for change, the public body says. 

However, the report has been criticised by the Royal College of Physicians of Edinburgh. It accepts the need for reform set out by Audit Scotland, but argues that reform alone “will not save our NHS” and that increased funding must be made available.  

Stephen Boyle, Auditor General for Scotland, said: “Without change, there is a risk Scotland’s NHS will take up an ever-growing chunk of the Scottish budget. And that means less money for other vital public services.  

“To deliver effective reform the Scottish Government needs to lead on the development of a clear national strategy for health and social care.    

“It should include investment in measures that address the causes of ill-health, reducing long-term demand on the NHS. And it should put patients at the centre of future services.”  

Responding to the report, Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh, said: “We recognise the challenges highlighted in Audit Scotland’s report, and their call for reform of the NHS. But reform alone, in the absence of increased funding, will not save our NHS.  

“At the same time, it is legitimate to ask whether we can afford to provide every treatment available, free of charge and at the point of access. If we cannot – which is plausible given the huge increases in medical treatments available – how should we decide what we can provide?  

“In order to address these questions, the college believes that a national conversation is required in Scotland, during which the public should have its say on deciding the NHS’ priorities and whether they think more public funds should be diverted to the NHS.  

“While politicians will have their views, and doctors can and will wish to advise, the NHS belongs to the public and they must have the main say in its future direction.” 

Scottish Labour health spokesperson Jackie Baillie said: “This report lays bare the SNP government’s catastrophic failure to re-mobilise our NHS following the pandemic – with patients paying the price.

“Audit Scotland reveals this government’s lack of ‘overall vision’ for the future delivery of healthcare in Scotland.

“Without a proper plan to support primary and social care, the situation in our NHS will only deteriorate.

“As our A&E departments overheat and almost 1 in 6 Scots languish on waiting lists, the cancellation of all infrastructure projects threatens to fan the flames of the NHS crisis.

“The fact is that the very existence of our NHS is at risk under the SNP.

“Only Scottish Labour has a plan to slash waiting lists by delivering 160,000 more appointments every year, empower clinicians and to put modern technology at the heart of our NHS."

Leader of the Scottish Liberal Democrats Alex Cole-Hamilton said: "Every day I hear from constituents who are waiting in pain for an NHS appointment.

"I am yet to meet a doctor or nurse who thinks Humza Yousaf's so-called NHS Recovery Plan is up to scratch. The Scottish Government have not delivered the vision or the resources required to tackle the strain our NHS is under. It is no wonder health board deficits are growing.

"The nationalists cannot be trusted to cut waits, expand appointments and deliver care close to home.

"There needs to be urgent investment in clearing waiting lists and delivering preventative care so that small problems don't spiral."

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