We’ve spent much of the week worrying about the state of our National Health Service and wondering if The Scottish Government’s budget would do anything to help.
It did, slightly, though other “priorities” also got a mention – child poverty, local council services, the arts and the environment.
A report from the auditor general Stephen Boyle warned that without “urgent fundamental change, the NHS would not be able to meet growing demand.” For months we’ve been watching waiting times and waiting lists getting longer, ambulances stacked up outside hospitals, nearly 2,000 hospital beds taken up by patients who are waiting for a care plan, and doctors and nurses warning of staff shortages and burn-out. Last week Aberdeen Royal Infirmary declared a “critical incident” and had to send patients to hospitals in Inverness and Dundee.
So the finance secretary Shona Robison, in her budget statement on Wednesday, gave the NHS a record increase of £2bn, taking health spending to £21bn a year, a third of the entire Scottish budget. It included £200m specially to reduce waiting times. But the auditor general says short term measures are not enough. He complained there was no long-term plan and said the NHS will have to cut services “with limited clinical value” to remain viable.
I wonder what he was thinking of – free prescriptions, cataract surgery, hip and knee operations? Already people are turning to private hospitals to avoid long NHS waiting times. Figures out this week show that 12,600 patients did this in the second quarter of this year, a rise of 7 per cent on the same period last year.
The health secretary Neil Gray insists he has a plan, and that is to move towards preventive medicine, with a larger role for GP surgeries and home care and a smaller role for hospitals. It’s a plan that has been in the air for years but never put into action. The share of GP services in the NHS budget has gone down from 11 per cent in 2006 to 6.5 per cent today. And in this week’s budget we learnt that new building projects are to continue being funded at Monklands and Belford hospitals.
This erratic theme runs through Wednesday’s budget. For example, there is £600m earmarked for various climate change initiatives such as home insulation, woodlands, bus travel, electric charging points, but £1bn is to be spent duelling parts of the A9 road in the Highlands. Economic growth is supposed to be priority but funding for training colleges and universities remains static.
Local councils are being given a record increase of £1bn in their budgets, taking central government’s grants to £15bn for spending on schools, social care, waste collections and those pesky potholes. But the rest of the money will need to come from local council tax. Shona Robison has ditched the SNP’s long insistence on a council tax freeze and some councils are now having to consider 10 per cent increases to be able to keep services just as they are.
Then there are politically wise choices in the budget, to stave off widespread criticism, like the £768m to build 8,000 affordable homes and the £34m for the arts and festivals.
All budgets are political but this one is particularly calculated to put the SNP government in a good starting position for the Scottish elections in May 2026. There is no increase in income tax, in fact the lower bands will begin at a slightly higher level, allowing Shona Robison to claim that half of taxpayers in Scotland will be paying less tax but revenues are still forecast to increase.
She has especially embarrassed the Labour Party by removing the notorious “two-child benefit cap”, compensating families with more than two children for the Child Benefit they are not receiving from the UK Labour government. It will cost between £100m and £150m a year and lift some 15,000 children out of poverty. This has grabbed the headlines and will prove awkward for Labour, as the change will come into effect in the run-up to the 2026 election.
All of this budget has yet to be approved by parliament where the SNP do not have a majority. What generally happens in this case is that minor parties like the Greens or the Liberal Democrats are thrown a scrap from their special policies, hopefully costing less than £100m, and that persuades them to lend the government their votes.
It’s all a bit of a parliamentary dance and such antics have resulted in the public losing faith in our current politics. The latest official Household Survey found that only 45 per cent said they trusted the Scottish government. Interestingly, people under the age of 35 trusted the government more (56 per cent) and trust in other institutions was markedly higher than for central government: local councils (53 per cent), the education system (52 per cent), police (73 per cent) and the NHS (78 per cent). So despite its failings, and the questions over the plan for the future, our beloved NHS is still the most respected institution in the land.
