Scottish health services face serious funding pressures

15 Dec 11
Scottish health services face serious funding pressures despite generally sound financial management, according to a report today from Audit Scotland.

By Keith Aitken in Edinburgh | 15 December 2011

Scottish health services face serious funding pressures despite generally sound financial management, according to a report today from Audit Scotland.

A combination of demographic change, rising treatment costs, tougher health care quality targets and real-term funding reductions mean that ‘current ways of delivering services are not sustainable’, the report says.

It notes that financial performance, while variable, has generally been good. Efficiency savings have been achieved, along with a pay freeze. Staff numbers are also continuing to fall, which might damage morale, the report warns.

The auditors call for improved partnership working and greater consistency in the assumptions underpinning financial plans. It says that the NHS has a continuing difficulty in measuring productivity, but notes a number of outcome improvements, although Scotland’s public health record continues to lag behind the rest of the UK.

Auditor general Robert Black said: ‘At a national level, we are seeing a good picture of the performance of the National Health Service in Scotland. In 2010/11, all NHS boards met their financial targets for the third year in a row, and there is continued progress against the “big three” diseases of coronary heart disease, stroke and cancer.

‘However, it is clear that there are building pressures in the system from increased costs and rising expectations and demand.’

Labour’s shadow health secretary, Jackie Baillie, said the report showed Scotland facing a ‘demographic time-bomb’ which could require up to 6,000 more beds for elderly patients. Her Conservative counterpart, Jackson Carlaw, said the Scottish National Party government should not have ‘wasted’ £50m of the health budget on free prescriptions.

The report is certain to fuel exchanges later today when MSPs debate both the government’s plans to integrate social care with health provision, and the £60bn capital spending plans to 2030 set out last week by Infrastructure Secretary Alex Neil.

A study of the Neil proposals published yesterday by Glasgow University’s Centre for Public Policy for Regions casts doubt on the Scottish Government’s ability to raise the private sector funds it needs while keeping within new fiscal rules on capital spending.

However, it welcomes Neil’s long-term approach and says it is possible the plans can be achieved in that timescale. But CPPR director Richard Harris commented: ‘Greater levels of detail and transparency are still required. It’s not just semantics.  It’s about the credibility and sustainability of such plans.’

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