John Swinney warns of medicine rationing if Scottish Budget voted down

Medicines may have to be rationed and operations cancelled if MSPs vote down the Scottish Budget, John Swinney has warned.

The First Minister said “real damage" would be done to the NHS if the Scottish Government’s spending plans are not passed in Holyrood.

The SNP operates as a minority government so John Swinney needs the support of MSPs from another political party to get his spending plans through Holyrood (Picture: Jeff J Mitchell/Getty Images)

He said £2 billion of additional investment would be put at risk, causing a "catastrophic reduction" in service delivery.

“Operations would likely have to be cancelled, nurses’ and doctors’ pay rises would be under threat, medicines might have to be rationed," he said.

Opposition politicians accused him of desperation and using “threatening language”.

Mr Swinney made the comments in his first major speech of the year in Edinburgh on Monday, where he also took aim at Elon Musk, the tech billionaire, who has made several inflammatory interventions in UK politics in recent days.

The First Minister said his speech was about addressing the issues relevant to people and providing solutions. "Those solutions are not always straightforward," he told reporters. "And they are certainly not as glib as populists like Elon Musk would suggest they are.”

Mr Swinney said voting down the Budget would play “right into the hands of Elon Musk and other populists” because it would demonstrate the political system could not address people’s concerns.

The SNP operates as a minority government and so needs the support of MSPs from another political party to get its spending plans through Holyrood. A deal with the Liberal Democrats or the Greens is thought to be the most likely option. If an agreement cannot be reached, this could ultimately lead to a snap election, but this is considered very unlikely.

Mr Swinney said he was “confident” the Budget would pass, but added voters would be “unforgiving of any politicians who would rather play political games”.

He said “strict” emergency spending limits would have to introduced if the Budget falls, with “severe consequences”. Government departments would not be able to increase spending from 2024/25 levels, or spend money on new areas, he said.

Spending would also be limited to month by month, Mr Swinney added, saying: “As an example it might mean we cannot spend any more money on health and social care in April 2025 than we did in April 2024.”

He questioned how pay rises and rising energy bills could be met in such a scenario, adding: “If the electricity or gas bill in a public building rises next year – and we know it is going to – how can the lights be kept on when the budget is frozen every month?”

On the impact elsewhere, he said: “It would mean no universal heating payments for pensioners; the record increase in arts and culture funding halted; fewer teachers and no new money for additional support needs; increased funding for affordable housing lost. Real damage to the very fabric of our public services, real damage inflicted on some of the most vulnerable in our land. For the good of Scotland, I want to make sure that none of this comes to pass.”

Mr Swinney described the NHS as “bruised” and said action needed to be taken on issues such as waiting times. He said passing the Budget would deliver more funding for health care.

“Thwarting a Budget may make some politicians feel good, but it will be at the expense of Scotland’s NHS,” he said. “It will be at the expense of Scotland’s pensioners. It will keep more children in poverty. It will be a wrecking political ball, when what Scotland needs is recovery. It’s as simple as that.”

The draft Budget, which was published last month, includes a record £21 billion for health and social care, with an increase of £2bn for frontline NHS boards.

Scottish Labour leader Anas Sarwar called on Mr Swinney to “stop the shadow boxing”.

He said: “John Swinney wants to pretend that somehow the Budget's on a knife edge. Let's be really honest - he knows he's got the votes to pass the Budget and he knows the Budget's going to pass. All he is trying to do is play the politics of the Budget to look away from the decline.”

Scottish Conservative leader Russell Findlay accused the First Minister of “getting desperate in his bid to pass another SNP Budget that raises taxes on working people without improving public services one bit”.

He said: “If he wants a Budget to pass, there’s a simple common-sense solution – bring forward a better one that reduces tax on workers and businesses, changes public services for the better, reduces bureaucracy, and gives people more power over their own lives and what happens in their own communities.

"He talks of this Budget being a 'turning point', but it's 18 years of SNP rule that has got Scotland in this state and driven people to lose hope in Holyrood’s ability to get anything done.”

The Greens criticised Mr Swinney’s “hugely overblown language”. The party’s Ross Greer said: “Other parties in Parliament have a responsibility to carefully scrutinise the SNP’s draft Budget and to push for inclusion of our own priorities.

“It is frankly daft and divisive for the Scottish Government to claim that such an important feature of our democracy is somehow fuelling dangerous political forces.

“John Swinney is right to say that the Budget is an opportunity to bring people together, but not with the kind of threatening language he is now using.

“To defeat the dangerous, billionaire-led forces of the radical right, we need to build a fairer, greener Scotland for everyone and tackle the very real public frustrations which the far right feed on, not fall in line behind a tepid SNP status quo.

“If the First Minister is prepared to be bolder, then he will have the Scottish Greens’ support.”