Why SNP's failure to take hard decisions is turning NHS 'triumph' into 'disaster'

After tomorrow’s Budget, we will know whether John Swinney’s pledge that it will have “improving the NHS at its heart” was the usual PR spin or a genuine break from years of failure.

That failure can be seen in the record number of private in-patient and day-care hospital admissions, for procedures like cataract surgery and hip replacements. It’s also evident in record-high figures for ‘delayed discharge', showing people well enough to leave hospital but stuck there because of a lack of social care.

A problem for years, it’s been getting worse, not better. As of September, there were 1,951 people delayed in hospital, a 9 per cent increase on September 2023. The effects are so serious that the queue of patients waiting for a bed can stretch through the hospital, via A&E, to a line of ambulances parked outside.

The NHS has enabled people to live much longer lives than before. The failure of government to deal with the consequences of a large elderly population risks creating a 'disaster' (Picture: Tom Stoddart) | Getty Images

NHS productivity drive

The situation prompted the Royal College of Physicians of Edinburgh to make the latest of many pleas for action with its president, Professor Andrew Elder, saying: “The ageing of our population is a triumph [of the NHS] and the lack of effective ‘social care’ in Scotland risks turning that triumph into a disaster.”

This is far from the NHS’s only serious problem. According to new research by Audit Scotland, in addition to record delayed discharge levels, commitments to reduce waiting lists have not been met and NHS initiatives to improve productivity and patient outcomes have “yet to have an impact”.

Stephen Boyle, Scotland’s Auditor General, made a stark suggestion: “To safeguard the NHS, a fundamental change in how services are provided remains urgent... Difficult decisions are needed about making services more efficient or, potentially, withdrawing those services with more limited clinical value to allow funding to be re-directed”.

Hard realities

The problem is the SNP has a poor track record on tackling ‘difficult decisions’. They shy away from anything that might knock faith in their government and the independence project, so Scotland retains politically valuable universal benefits like free prescriptions while frontline services crumble.

Scotland desperately needs tomorrow’s Budget to finally face up to hard realities that the SNP has ignored for far too long.