Analysis: We know what has happened, but not why

THE much-revised workforce job numbers for the Scottish health & social work (H&SW) sector show a substantial fall after peaking in June 2006, despite the fact jobs in this area have risen over this period in England, Wales and Northern Ireland, and NHS spend has been protected in real terms over successive public sector spending rounds.

All three of the main H&SW resource indicators – workforce, output and spending – now tell us the same story: since 2006, Scotland has been lagging behind the increase in resources for England. And this is using prime data sources. For example, the spending data is from PESA, which the UK government uses to compare regional spending and the Scottish Government uses in compiling GERS.

Why has this happened? The answer is not straightforward.

Is the application of the Barnett Formula over time narrowing Scotland’s spending advantage? This does not seem to be the case. While overall identifiable spending per head in Scotland increased by £47, the Scottish H&SW spending per head advantage fell by £95.

Have Barnett consequentials from the increases in English funding not been fully passed on to their Scottish counterparts? This is not easy to discern, due to the breadth of H&SW coverage.

It may be that Scottish H&SW “outcomes” have not been negatively affected by the relatively slower growth in Scottish resources and that the system is being more productive and efficient, which would be a good thing. However, again, difficulty in making such “outcome” comparisons means it is impossible to judge whether this is the case.

Given the importance of this area, in budgetary and political terms, it would be beneficial to gain a far greater understanding as to how Scottish H&SW resources have been shifting in recent years and what impact this has had.

• John McLaren is senior researcher at the Centre for Public Policy for Regions.