Why John Swinney's big gamble on NHS record could define whether SNP keep hold of power

The SNP and Labour are poised for a collision course at next year’s election over the NHS.

John Swinney is putting his neck on the line at next year’s Holyrood election.

The First Minister is brimming with confidence - things are looking much brighter for the SNP in contrast to last year’s dismal general election showing.

First Minister John Swinney delivers a speech focused on the Scottish economy in central Glasgow | National World

With polling consistently indicating the SNP is on course to remain the biggest party at Holyrood at next year’s election, Mr Swinney is leaning into that rosy outlook.

But his insistence that his government will finally deliver on the NHS, and making that record a key part of his pitch to the public next May, could be a huge gamble.

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Scottish Labour insiders will be rubbing their hands with glee at the prospect of the SNP making their NHS record a key election vow.

Sources close to Anas Sarwar have said that by making next year’s election all about the NHS plays into Labour’s hands - partly because they hope it will take focus away from the unpopular decisions being made by the UK government, but largely due to a perception that the SNP has failed to revive the NHS.

Scottish Labour leader Anas Sarwar | PA

The SNP government at Holyrood has burnt through several health secretaries including Humza Yousaf, Michael Matheson and Shona Robison - the gig is a tough one.

But the impacts of the pandemic, many of which are still being felt by frontline NHS services, have made the prospect of resuscitating the health service perceived as an almost-impossible task.

Read more: Inside Anas Sarwar's strategy to 'change the conversation' from UK Labour to rescue Scottish election bid

Since Mr Sarwar took charge of Scottish Labour, he has honed in on the NHS and put the SNP’s record on the health service under the microscope.

But without taking away from the importance of the health service to the public, politically, Mr Sarwar has risked losing impact on his message - due to the repetitive nature of it. In essence, the Scottish public has come to expect NHS waiting times to be missed.

But what if Mr Swinney can finally deliver on the health service? Will it lead to him securing power for another term?

There is still a long way to go before voters go to the polls next year, and Scottish politics has been no stranger to quick, dramatic change since the last election.

Mr Swinney appears to be confident that his government’s record on the NHS will be in such a good state by the time voters go to the polls that his party can use it as an asset on the doorstep.

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To his credit, there is evidence to suggest that NHS waiting times are turning a corner. Mr Swinney was quick to point out that waiting times for diagnostic testing are improving - waiting time targets for child and adolescent mental health services have finally been met, for the first time on record.

But there is a long way to go and a key previously-missed target has been reset by the Scottish Government that by March 2026, no-one waits longer than a year for an outpatient appointment or inpatient procedure.

That vow being hit or missed just before voters head to the polls could set the narrative for whether the NHS is back on track, and crucially whether the SNP’s record on delivery is finally one to shout about.