The leader of Scotland’s doctors has warned the Scottish Government’s flagship policy of moving more care out of hospitals is at risk because of a growing resource gap.
Speaking as Audit Scotland published its latest overview of NHS finance and performance, BMA Scotland chair Peter Bennie said that ‘substantive action’ was needed to close the gap.
The overview shows that the NHS in Scotland had to make unprecedented savings of £390m to break even in 2016-17 – even though the health budget, at £12.9bn, accounted for 43 per cent of the total Scottish Government budget.
It said that while staff were committed, and overall patient satisfaction was high, there were signs that the NHS was struggling to maintain quality of care amid increasing cost and rising demand for services.
Auditor general Caroline Gardner said there was widespread agreement that healthcare must be delivered differently if it is to withstand growing pressure on services.
‘There is no simple solution, but these fundamental areas must be addressed if reform is to deliver the scale of transformation that's needed across the NHS. Involving staff, the public and bodies across the public sector will also be crucial for success.
‘Substantive action on the increasing gap between resources and demand is needed if Scotland’s NHS is to be able to cope with the challenges it faces.’
More to do
Health secretary Shona Robison said there had been ‘clear improvements’ in Scotland’s health system under the SNP but acknowledged that more needed to be done.
‘We have long been realistic about the challenges for the NHS and the need for change. Alongside record investment of over £13bn, including almost half a billion pounds of NHS spending being invested in social care services alone, we are looking at new ways of delivering services that meet the changing needs of people across Scotland.’
She singled out efforts to negotiate a new Scottish GP contract, with a ‘strengthened and clarified role for GPs’; rising staffing levels, and steps to improve the nation’s health.
She added that the Government would shortly give greater clarity on the future direction of the NHS.
‘We’re working to develop a medium term financial framework, within the context of the budget settlement that the Scottish Government receives. This will be to outline the broad direction for the NHS and care services to meet the changing needs of the people of Scotland, including shifting the balance of care towards community health services,' she said.
BMA Scotland council chair Peter Bennie said the report made it clear that it was getting harder and harder for the NHS in Scotland to cope with continued austerity.
‘Demands on the NHS are increasing rapidly every year and sufficient resources are simply not being made available to meet the needs of patients,’ he said.
‘The report also raises serious questions about how the aim of moving more care into community settings will be funded and achieved against a backdrop of continuing financial pressures.’
He said that demographic change meant that aging population meant that pressures on the health service were set to increase further.
Challenges outlined in the report
- More people are waiting longer to be seen
- The majority of national performance targets were not met
- Scotland's health is not improving, and significant inequalities remain
- General practice is under pressure, including recruiting and retaining GPs and low morale.
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