NHS Lothian and NHS Borders (Finances)

General Question Time – in the Scottish Parliament at on 13 June 2024.

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Photo of Craig Hoy Craig Hoy Conservative

To ask the Scottish Government what discussions it has had with NHS Lothian and NHS Borders regarding financial stability in the 2024-25 financial year. (S6O-03575)

Photo of Neil Gray Neil Gray Scottish National Party

Despite our significant investment in 2024-25, with an increase of over half a billion pounds, which presents a real-terms uplift to front-line boards, the system remains under extreme pressure as a result of the on-going impacts of Covid, Brexit, inflation and United Kingdom Government spending decisions.

The Scottish Government’s financial delivery unit works closely with all boards, including NHS Lothian and NHS Borders, as part of the financial planning process. The Scottish Government has met NHS Lothian and NHS Borders on multiple occasions to develop and implement 2024-25 financial plans this year. Quarter 1 reviews will be held in the coming months to assess their current financial performance.

Photo of Craig Hoy Craig Hoy Conservative

Mr Gray is aware that both health boards face a bleak financial future as a result of the Scottish National Party’s misplaced financial priorities. The decisions that they are now taking are causing real concerns to national health service staff and worried patients. In the Scottish Borders, 92 essential community hospital beds, including in Kelso, Hawick, Duns and Peebles, are at risk. In East Lothian, the Edington and Belhaven hospitals, the Abbey residential care home and Blossom house residential care home have been summarily closed without any consultation. To top it all, general practitioners in East Lothian face massive increases in facilities management fees.

Despite the Scottish Government being the root cause of those problems, it is passing the buck. Michael Taylor of the primary care directorate recently wrote to me to say that, although the Scottish Government had a national approach to the issue of facilities management fees, it was for boards to agree

“any fair and equitable approach”.

Is it not time for the Scottish Government to step in, properly fund boards, and halt those damaging charges and closures?

Photo of Neil Gray Neil Gray Scottish National Party

There is, of course, a hint of irony in Craig Hoy’s question about the financial stability of our health boards, because our decisions to have a more progressive form of taxation, which means that we have raised £1.5 billion more for public services here in Scotland, were opposed by the Scottish Conservatives.

The allocation to the national health service of the Barnett consequentials that came from the spring budget was also opposed by the Scottish Conservatives. They wanted us to divert that money to business tax relief and are well entitled to do so, but if they had had their way, it would have led to an even worse situation for our health boards because of the financial challenges that they face.

Regarding the situation that is faced by general practices, I, of course, greatly value the work that they do, but it is for boards to come forward and resolve the situation. We invested more than £1.2 billion in general medical services in 2023-24 and are fully committed to increasing the number of GPs in Scotland to ensure that more people get the right care in the right place at the right time. We have a record number of GPs in training and have a head count that includes 271 more GPs in Scotland as a result of our actions. We will keep supporting their work in primary care, which is the bedrock of our health service.

Photo of Alison Johnstone Alison Johnstone Green

I am going to call Sarah Boyack for a brief supplementary question. Before I do so, I remind all members that the length of questions and responses in this session means that it will be impossible for me to get in all members who wish to contribute.

Photo of Sarah Boyack Sarah Boyack Labour

With 84 per cent of Scotland’s future population growth expected to be in the Lothians, NHS Lothian is in desperate need of investment, but our health board is already having to make a 6 per cent saving by cutting vital services, including diabetes technology. Yesterday, in a meeting with the cabinet secretary, the campaign group KEEP—keep Edinburgh eye pavilion—reinforced the urgent need for investment in a new eye pavilion. What will the Scottish Government do now to ensure that our health board has the funding to cope with substantial increases in our population now and in the future?

Photo of Neil Gray Neil Gray Scottish National Party

As I outlined to Craig Hoy, we have passed on a real-terms increase to our front-line boards so that they can respond to the challenges that they face following Covid, Brexit, inflation and the UK cost of living crisis. I recognise that there are challenges despite the 3 per cent real-terms increase, which we have delivered in the face of a falling block grant from Westminster. We have increased the budget for Lothian by £82.2 million this year, but I recognise the challenges that persist.

Sarah Boyack asked about the eye pavilion, but we are in an even more acute situation with capital because of the £1.3 billion cut by the UK Government to our capital budget. It is incumbent on colleagues across the chamber to ensure that they lobby the UK Government—of whichever colour comes next—to invest properly in the health service, rather than continuing the austerity that is currently on offer from both parties.