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Auditor criticises budgetary short termism

The BMA has backed Audit Scotland’s call for the NHS to take a longer term view of financial planning.

The association has also warned that managers should avoid knee-jerk reactions to falling budgets.

In its annual review of NHS financial performance, the watchdog found that all health boards met their financial targets for 2011/12, but the overall picture did not reflect the pressures boards had faced in achieving this.

Auditor general Caroline Gardner said: ‘Money was moved between boards, several relied on non-recurring savings, and some needed extra help from the Scottish government to break even in 2011/12.

‘The requirement for boards to break even each year encourages a short-term view, and the NHS needs to increase its focus on longer term financial planning.’

BMA Scottish council chair Brian Keighley said tough choices had to be made.

Avoid 'knee-jerk reactions'

He said: ‘It is vital that politicians and managers avoid knee-jerk reactions to falling budgets and instead take a longer term view for the NHS, working with healthcare professionals to identify how services can be made more efficient and where cuts should be made without compromising patient care.

‘Doctors are at the heart of the health service, seeing and treating patients every day. They are best placed to provide strong clinical leadership and indentify waste and inefficiencies in the system.’

The report states that staff costs continue to form a major part of health service expenditure, but says boards have ‘limited flexibility’ to make reductions to employee costs because of a national policy of no compulsory redundancies and fixed requirements for medical training.

‘Boards will need to look at different ways of delivering services in order to make any significant changes to costs,’ the report says.

It also shows that medical directors tend to be the highest earning directors of NHS boards, although directors of public health and chief executives are the highest paid at four boards apiece.