In response to Audit Scotland’s report, NHS in Scotland 2023, Dr Iain Kennedy, Chair of BMA Scotland, said:

“Over recent years Audit Scotland’s annual reports have consistently raised concerns about the sustainability of NHS Scotland, but this year’s forensic and detailed assessment of our health service is staggeringly bleak and paints a picture of a health service in crisis, without a plan to address it.

 

“As BMA Scotland has warned for years, the report confirms the NHS in Scotland, and its workforce, is simply unable to meet the growing demand for health services of our population. The service is not financially sustainable and NHS boards face a blackhole in excess of £0.5 billion by 2025/26.  Staffing – and workforce planning - is woefully inadequate, with increasing vacancies and spending on agency workers – leaving healthcare professionals feeling exhausted and unable to provide safe or effective care – which our members have confirmed in surveys for some time.  At the same time, doctors and their colleagues are struggling to provide the best care they can in, not fit-for-purpose, crumbling buildings with a maintenance backlog nearly three times the future budgets available to address it.

 

“And the problems go on. Healthcare staff are still not working in a culture where they feel confident to raise concerns. Waiting lists are growing, which will only further embed the two-tier system we have seen developing, where ability to access timely care is based solely on whether you can afford it. The Scottish Government’s recovery plan – which we did warn at the time was inadequate - has failed to effectively address even the longest waits for treatment.

 

“If this report isn’t an urgent call to action, then it’s hard to imagine what might be. Frustratingly, previous Audit Scotland reports have generated some heated political debate – but still we await the development of a concerted, focussed overall health and social care plan that moves us away from the kind of piecemeal, politically expedient kind of action we see at the moment. That cannot happen this time around, otherwise we will just be repeating the same mistakes already made and putting the whole future of our NHS, providing healthcare free at the point of need, at massive risk. We have consistently called for an honest, open national conversation on the future of the NHS in Scotland to finally build consensus on how we tackle these problems in the long term. We agree with Audit Scotland that the Scottish Government should now work with NHS boards, their healthcare workers, partners, and the public to develop a long-term strategy for health and social care and support the movement from recovery to reform. The urgency and importance of this work must not be underestimated, and to protect Scotland’s NHS for generations to come it must start now.”