Efforts to reform the NHS are being hampered by soaring costs, staffing pressures and unprecedented savings targets, Scotland’s public services watchdog has warned.
Audit Scotland said that “major challenges lie ahead” for the health service, as the Scottish Government’s flagship attempts to deliver more care at home have floundered due to a failure to switch funding away from hospitals.
In a critical report published today, the watchdog warned that NHS funding was not keeping pace with demand and health boards were using short-term measures to break even, such as loans, one-off payments and reduced use of the private sector.
Staffing issues are so acute that £135 million was spent on temporary nurses and midwives last year, while a small number of consultants were being paid more than £400,000 to provide cover for less than a year.
Labour accused the government of “utterly staggering” mismanagement of the NHS and called for health secretary Shona Robison to make an emergency statement about the report’s findings.
It comes just weeks after Auditor General Caroline Gardner alerted the Scottish Parliament over significant issues at NHS Tayside and NHS 24, which face a combined overrun of more than £140m.
Ms Gardner said: “Major challenges lie ahead for the NHS in Scotland.
“There are growing pressures on health boards which are struggling to juggle service delivery and progressing major reform whilst also managing considerable financial challenges.
“The Scottish Government has had a policy to shift the balance of care for over a decade but despite multiple strategies for reform, NHS funding has not changed course.
“Before that shift can occur, there needs to be a clear and detailed plan for change, setting out what the future of the NHS looks like, what it will cost to deliver and the workforce numbers and skills needed to make it a reality.”
The report, entitled NHS in Scotland 2016, highlighted how deep-rooted financial and staffing pressures made it difficult for NHS boards to meet performance targets.
Health boards failed to meet seven out of eight key national targets, reporting lengthy waits for emergency treatment, inpatient and outpatient appointments, cancer treatment and mental health care for children.
Only drug and alcohol treatment times were in line with national targets.
Labour health spokesperson Anas Sarwar said: “The scale of mismanagement in our health service revealed by this report is utterly staggering. On every key test the SNP is failing.”
The NHS budget grew by 2.7 per cent from last year to £12 billion but spending on drugs has shot up by 10 per cent, use of costly agency staff is on the rise and the number of emergency admissions rose by 6 per cent, the report found.
Some health boards are missing out on funding they should be entitled to due to problems with how the money is allocated, leaving boards such as NHS Lothian more than £12m short.
On top of this, hospitals were ordered to save more than £290m this year but failed to meet the target.
Royal College of Nursing (RCN) Scotland director Theresa Fyffe said: “How many more reports will be published by Audit Scotland before action is taken? Patients, staff and families deserve a decisive response from the health secretary.
“We will only be able to meet the growing demand on our health and care services if brave decisions are taken now on how services are to be delivered in the future.”
Ms Robison acknowledged the challenging situation but said that the health budget had reached record levels with major investment in social care and primary care.
She said: “Under this government there have been significant improvements in the performance of the NHS, the safety of patients, overall life expectancy and survival rates for conditions such as heart disease supported by a real terms increase in spending on our NHS.
“These are changes that will help to equip our health service to continue to deliver excellent and safe care for the people of Scotland in the years ahead.”