By Professor John Robertson
In the Guardian today:
NHS finances so dire that whole service may collapse, says spending watchdog. National Audit Office says NHS in England too cash-strapped to treat patients quickly enough. Years of underfunding have left the NHS in England so cash-strapped that it cannot treat patients quickly enough, and the rising tide of ill-health will make matters worse, the National Audit Office (NAO) said.
On February 22 2024, Audit Scotland reported:
“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.
The health budget has been increasing in real terms since 2013/14. 3. Five health boards needed additional funding from the Scottish Government to break-even in 2022/23.
Even from the famously negative Audit Scotland, there is no suggestion that NHS Scotland may collapse. There is no suggestion nor evidence of years of underfunding here.
BBC Scotland, the following day, read much more into the report, to meet their agenda, with:
Scottish Conservative health spokesman Dr Sandesh Gulhane MSP said the “utterly damning report exposes the monumental failings of the SNP’s management of Scotland’s NHS”.
and
Dr Iain Kennedy, chairman of the British Medical Association Scotland, said the report was “staggeringly bleak and paints a picture of a health service in crisis, without a plan to address it”.
Then in her ‘analysis’ at the end, from the often miserable as, Lisa Summers, she lets slip:
The NHS won’t just keel over.
Where is Sandesh these days?
Talking-up Scotland 'Albatraz' 
As my wife and I are now in our 80s, we have come to depend more and more on the S.N.H.S, along with their partner services, and I can truthfully say they have never let us down. A big thank you to all your staff.
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I am wondering why I can randomly find positive news about NHS Scotland and BBC Scotland cannot?
These press releases for 2024 are from NHS Golden Jubilee in Clydebank.
https://www.nhsgoldenjubilee.co.uk/news/press-releases/press-releases-2024
University of Glasgow and NHS Golden Jubilee strengthen partnership
NHS Golden Jubilee’s heart services to be showcased in new documentary series
New training facility for NHS Scotland workforce
NHS Golden Jubilee named Employer of the Year at the Scottish Veterans Awards 2024
National Hospital rolling out accessibility tool to all clinical services
Scottish Adult Congenital Cardiac Service finalists for national award.
NHS Golden Jubilee Consultant appointed Honorary Professor at top Scottish university
NHD Golden Jubilee research paper exploring 3D bio-printing for bone regeneration gains International recognition
NHS Golden Jubilee awarded Gold for supporting young people
Scotland’s Heart Transplant Unit expands
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The ‘collapse’ of NHS England may have a physical element to it as well. There would appear to be a multi-billion pound backlog of repairs to hospitals ass well.
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£50Billion for Defence and Trident. £30Billion lost to tax evasion. £Billions lost to Brexit.
£125Billion for the NHS. Scottish funds wasted by Westminster.
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It’s all by design of course, reduce EngNHS to a skeleton, people will welcome, and certainly accept privatisation as a cure. Scary.
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” Even from the famously negative Audit Scotland, there is no suggestion that NHS Scotland may collapse. There is no suggestion nor evidence of years of underfunding here ” – I beg to differ John – NHS defunding has been going on since the 1970s, and despite a brief respite in the 2000s when SG became a thing, that reduction has continued to the present day, so there is plenty of evidence.
Never mind the ‘Audit Scotland ” The health budget has been increasing in real terms since 2013/14 “- That’s the same “in real terms” bullshit on which Andrew Neil made his millions and minions supporting him in Chez Moi France – Who knew all it needed was a hairpiece, hypocrisy and selling your own country out to make your ‘money’..
SG has done it’s best to mitigate for sure, but let’s not be under any illusions they are investing anywhere close to the levels required for what NHS was designed for – Not because they wouldn’t like to, but because Wes Streeting et al have been bought out, and will make damned sure it doesn’t happen.
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Well yes and most people in Scotland have no clue whatsoever that when the UKEng gov make cuts to the ENHS, those £’s cuts are mirrored by the UKEng gov, in Scotland.
They have form with that sort of thing.
It’s more than £’s though, looks like hospital buildings are not all in a fit state in England, and of course across the UK, no doubt staffing levels are an issue due to England’s Brexit, one elephant in the room. Labour’s PFI wil; be brought in to er fix that problem.
Many years ago when I had a radio set and listened to the BBC especially in the mornings, I heard a programme investigating the Tory plans for fully privatising the NHS. It had been planned since Thatcher had started the process as PM, and was being taken forward by the ‘neocons’ who had very close ties with private corporate health businesses in the US. The US companies were and are chomping at the bit to get hold of the NHS, first in England and then in Scotland and no doubt Wales. They have their operatives in England/UK like Wes Streeting, and they will make sure he doesn’t fail at selling off the NHS lock stock and barrel, no matter his mealy mouthed faux concerns about the terrible lack of healthcare availability in England.
Scotland, run, secure independence, or start saving every single penny and planning to sell your houses if lucky enough to own one, because your Scottish NHS is a target and it won’t be cheap. Labour will carry the baton of Tory destruction of services especially the NHS where the most profits are to made by US companies and no doubt others elsewhere. Scary.
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As an aside I read that Covid deaths saved the the Health Corps around $80 Billion, ‘ saved ‘. Another article, can’t remember where from, quoted an ‘ entrepreneur ‘ that the future really big bucks for the corps is the hospitals and the drugs which will dwarve income from oil.
Golfnut
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I think you are being unduly pessimistic about what the SG has achieved with the SCottish NHS. It is more than mere mitigation. Just look at the number of new hospitals that have been built the length and breadth of Scotland and the upgrades to existing hospitals.
For example, new Community hospitals in Kirkwall, Aviemore, Broadford, Haddington to name but a few. They provide a better work environment and often increased facilities which mean better outcomes for patients. The new community hospital in Kirkwall won a silver medal in an international competition. Haddington Community Hospital which has only been open for a few years won a gold award for its out-patient endoscopy department and an award for its integration of art into the hospital.
https://tonicarts.nhslothiancharity.org/2024/06/nhs-lothian-charity-tonic-arts-wins-prestigious-gold-design-award-for-pioneering-art-and-design-commission-at-east-lothian-community-hospital/
Other new hospitals include Forth Val0ley Royal Hospital. A PFI hospital signed by Labour in 2007 but built under the SG. Recently its operating suite was extended from 14 to 16 operating theatres plus 2 extra wards to serve the new theatres.
Then there are the specialist hospitals such as QEUH in Glasgow and sick kids in Edinburgh.
There is a lot more to add but you get the picture. Modern facilities and equipment making a positive difference for staff and patients.
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SNHS Scotland is funded £13Billion+. Over a fifth of Scotland budget. Or what is left after Westminster has wasted it.
Funding war and death rather than keeping people alive. Labour illegal wars, redundant weapons and tax evasion.
Thank goodness for the SNHS saving people’s lives.
BBC £6Billion for nonsense. Would be better funding the NHS.
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The recent National Audit Office report entitled ‘NHS Financial Management and Sustainability’ makes substantive comments on the state of NHS England and the challenges it faces due to financial settlements over many years now from Westminster governments. Of course it makes ZERO reference to the knock-on consequences for the size of the Block Grants to devolved administrations and the resourcing of the NHS in NI, Scotland and Wales.
See https://www.nao.org.uk/reports/nhs-financial-management-and-sustainability-2024/
Just a few extracts from the NAO report help to reinforce the point for anyone willing to acknowledge how the Barnet Formula operates:
The NAO explains that ‘over the decade from 2014-15 to 2023-24, the resource expenditure of the NHS in England grew on average by 3.2% a year in real terms, which was less than the long-term average. From 1950-51 to 2013-14, resource expenditure on health grew on average by 3.6% each year in real terms. In the 10 years to 2023-24, expenditure increased by less than this and at markedly different rates at different times.‘ (my emphasis)
The NAO concludes that NHS England’s financial position is worsening because of a combination of long-standing and recent issues:
failure to invest in the estate – ‘The backlog of work needed to improve the NHS estate to an adequate level has increased greatly in recent years because of under-investment, reaching £11.6 billion in 2022-23, of which £2.4 billion (20.3%) related to the highest risk category of work.’ Without further capital investment, NHS England expects the NHS maintenance backlog to exceed £15 billion by 2027-28.
inflationary pressures – including the impact of higher-than-expected inflation which has increased the cost of medicines and other items beyond what the UK government allowed for in NHS England’s budgets. The NAO reports: ‘NHSE estimates that, in 2023-24, non-pay inflation cost an additional £1.4 billion above what was budgeted for. ‘
the cost of post-pandemic recovery – the NHS is still dealing with the pandemic’s legacy, including ongoing enhanced infection controls, operational and capacity constraints, and greater complexity in patient need. The NAO notes: ‘the NHS maintains a policy of leaving beds unoccupied if they are next to patients infected with COVID-19, reducing its efficiency. ‘
This is also noteworthy: ‘Delays in HM Treasury and DHSC’s approval of NHSE’s overall budget and planning guidance have meant NHSE has not agreed NHS systems’ spending plans until after the start of each financial year, making it very difficult for them to plan effectively.’
If NHS England lacks clarity over it annual budget allocation from HM Treasury and the DHSC, what lack of clarity must the administrations in Belfast, Cardiff and Edinburgh face in terms of the size of their Block Grants?
Notwithstanding the authoritative, balanced and reasoned assessment from the NAO about the state of NHS England in the context of Westminster government actions/inactions, the state of the NHS in Scotland – according to the BBC and almost all of the mainstream media that supposedly serve Scotland – is solely down to failures of government in Edinburgh. Knock-on impact on NHS Scotland from anything Westminster does or doesn’t do re -England’s NHS is of course ‘inconceivable’ – not so in Wales though!
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Also more restricted and higher costs for medicines due to Brexit? Not so easy to obtain some medicines?
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Poverty causes higher health costs. Thatcher cut the block grant and took all the Oil revenues and left Scotland in poverty. 15% unemployment, 17% interest rates and 15% inflation. A woman’s health at conception decides the health outcomes for a generation.
The Scottish Gov is trying to eradicate poverty with the child payment. Westminster is doing nothing.
Tories cut NHS funding for years. £125Billion and did not increase it. Cutting it in real terms with an increasingly elderly population. The ones who lost out in birth, especially in Scotland because of Thatcher. The attack on the Scottish economy.
Westminster funded Covid £270Billion over two years. (UK whole Gov accounts). Much of it was wasted in unscrutinised contracts. The Tory unhealthy legacy. The NHS is used by mainly elderly people. 80% used by 20% of the population. Life expectancy falling because of Tory policies.
Labour have now betrayed children to bad health later in life, needing more funding.
Westminster should be introducing more tax measures to instigate better health. Further taxes on sugar and fat etc. Food manufacturers getting away with murder.
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Though the block grant wasn’t introduced until after devolution, but Thatcher no doubt did reduce funding to Scotland as she did in England. She was a disaster capitalist at best, a nasty fascist at worst and the people, the workers, were collateral, fit for the scrap heap. May she be rotting in hell now.
As Scotland was treated as a region of England before devolution, at least economically, councils would have controlled funding. In Glasgow the Labour council during their decades long tenure, certainly did little if anything, to improve the lives of the people there. Labour spent millions of public money taking women workers to court to deny them equal pay. I don’t remember council elections even being a thing back then I was super ignorant, I suspect like most people councils were just out there to collect the rubbish and stuff like that.
I presume now we can examine council spending at the click of a button. The coalition Labour/Tory/Libdem council in Edinburgh are not spending much on rubbish collection these days though!
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‘Interesting’ quote in the BBC News website article today entitled: ‘We owe public apology, says new Welsh Labour leader
The new leader of Labour in Wales – formerly the health minister in the government in. Cardiff – and the likely new FM of Wales is reported as follows:
‘She said people would be brought in “from outside of Wales” to look at the Welsh NHS’s high waiting lists.’ (my emphasis)
That’s a sign of confidence in Labour ministers in Wales, Welsh civil servants, NHS Wales’ professionals, Welsh third sector organisations, Wales’ academic community – is it not?
Wes Streeting to the rescue?
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Private companies, people from outside of Wales? Contracts?
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