Health cash caution:

Health spending is set for a £729m boost, but as demands on the NHS rise, will it make a difference? HELEN MCARDLE reports

REACTION to the Scottish Budget by health professionals is probably best described as cautious.

Despite a £729 million headline figure unveiled by Derek Mackay, the sense among those at the frontline is that investment in Scotland’s health service is “running just to stand still”.

The 14 so-called “territorial” health boards – that is, NHS Tayside, NHS Lanarkshire, and so on – will share an uplift in funding worth a total of £359.4m, or 3.8 per cent in absolute terms.

Other frontline boards will also see their funding increased in 2019/20. The National Waiting Times Centre – better known as the Golden Jubilee Hospital in Clydebank – is set for a £200,000 boost (up 0.4%); the Scottish Ambulance Service an extra £22m (up 9.2%); the State Hospital at Carstairs, Scotland’s only high-security psychiatric hospital, will receive an additional £500,000 (a 1.4% increase); and NHS 24 an extra £2.3m (up 3.5%).

In total, territorial and national boards combined, including regulatory bodies such as Healthcare Improvement Scotland, will receive a boost in funding worth £413.2m. It may sound generous, but it is actually less than the “unprecedented savings” of £449.1m achieved by NHS Scotland’s health boards in 2017/18. Yet the savings expected in 2019/20 will almost certainly be more demanding.

Dr Lewis Morrison, chairman of BMA Scotland, said the extra health funding announced in Wednesday’s Budget was welcome but “unlikely to make any significant difference” to the widening gap between available resources and demand for NHS services.

He added: “There simply is no clear plan in place to deal with this growing gap, and despite increased funding, substantial efficiency savings are still likely to be demanded of NHS boards.

“These are boards that are already struggling to deal not just with growing demand, but also the requirement to meet a raft of targets that often say little about quality of care.”

The bottom line is health inflation – the rising cost of drugs, staffing, medical devices, and other hospital overheads – are running far beyond investment.

Earlier this year, the Institute for Fiscal Studies estimated health spending for the UK as a whole should rise by 3.3% a year in real terms over the next 15 years simply to maintain the status quo, and by 4% annually in real terms if we wanted to improve the NHS.

In this context, increases of less than 4% in Scotland – not accounting for inflation – are a

Despite increased funding, substantial efficiency savings are still likely

drop in the ocean. Of course, the total amount of public spending available to the Scottish Government is set by Westminster and it is another debate entirely whether an independent Scotland or Brexit-free Britain could or would invest more in the NHS.

Besides the increases in funding for health boards, the Scottish Government is also allocating an extra £149m next year on reforms to improve waiting times, primary care, cancer services and mental health, including child and adolescent mental health, and the continued roll out of Scotland’s new trauma network.

Overall, primary care is set for a £61m uplift (up 7%), but GPS are concerned that it is unclear what proportion of that will be allocated to general practice specifically.

Meanwhile NHS Greater Glasgow and Clyde has recruited 458 newly-qualified nurse graduates from universities, mainly from the west coast of Scotland.

Nurse Director Dr Margaret Mcguire said it was “incredibly encouraging NHSGGC continues to be seen by graduates as a desirable employer where they can grow their careers”.