Reacting to the recent Scottish budget announcement, Dr Iain Kennedy, chair of BMA Scotland, said: “All budgets take time to analyse and understand their full impact – and we’ll need to look at this in some detail to understand fully how it will help Scotland’s NHS. At best I would initially call it a very mixed picture.

“In terms of overall investment in Scotland’s NHS additional funding is, of course, welcome – but it remains a moot point whether this increase of £550m specifically for NHS boards will be sufficient. In this context it is worth remembering that the Scottish Government suggests the consolidated position for all NHS Boards at month six of 2023-24 is a forecast deficit of £395 million. And similar funding increases in previous years have still left Audit Scotland warning about the financial sustainability of the NHS. Finally, the position for primary care remains unclear – and given recent funding cuts that will be a massive concern. We look forward to hearing more details from the Cabinet Secretary on that.

“On the positive side, BMA Scotland has been calling for a National Conversation to help shape the future of Scotland’s NHS for some time, and so it is welcome to hear a solid commitment to this taking place in the next financial year – the Scottish Government must ensure it is an open, honest and transparent conversation that includes cross party and public input, as well as the views of the NHS workforce. By doing so – we can finally start establishing what ultimately we are asking of our NHS and whether funding is indeed sufficient.

“While we appreciate the tough fiscal position, BMA Scotland does have concerns around the impact the new tax band for higher earners could have on senior doctors, who have already suffered years and years of pay erosion and punitive pension taxation. Vacancies among consultants have already soared by 11% over the last year – and are actually likely to be double official statistics when all posts are considered. One of the unintended consequences of this measure may push more of these doctors out of the NHS, to jobs elsewhere or retirement – or force them to cut overtime. In particular, that may force boards to spend more on locums to cover growing gaps, which is far more expensive than permanent staff – and hence would be very much a false economy. By seriously limiting incentives to complete overtime, there is also a good chance it will seriously hinder efforts to cut waiting lists – again impacting quality of care, and a priority set out by the Government.”

Notes to editors

The BMA is a professional association and trade union representing and negotiating on behalf of all doctors in the UK. A leading voice advocating for outstanding health care and a healthy population. An association providing members with excellent individual services and support throughout their lives.