The Scottish government has now scrapped the system of bailout loans after ruling it had become unsustainable and was unfair on the boards balancing their books – including the biggest authorities NHS Lothian and NHS Greater Glasgow and Clyde.
Instead, struggling boards will be allocated “deficit support funding”, although Audit Scotland notes there is a “lack of clarity and transparency” around this plan.
Returning to its concerns about performance, Audit Scotland has said that the delivery of efficiencies and reform within the health and care system is vital to the financial sustainability of the NHS.
Auditor General Mr Boyle said ministers needed to deliver “detailed, measurable actions that will enable change” in the health service.
He added: “Despite increased spending, the NHS in Scotland remains unsustainable and it will be extremely challenging to eradicate long waits by the spring of 2026.
“The plan and frameworks the Scottish government has put in place for reforming the NHS are welcome.
“But there is still a persistent implementation gap between policy ambitions dating back over a decade and delivery on the ground.”
Health Secretary Neil Gray said: “We are making good progress transforming Scotland’s health services.
“Last year we delivered a record number of hip and knee operations, long waits over 52 weeks have reduced for five consecutive months, and performed operations are at their highest since January 2020.
“To protect the NHS’s long-term future sustainably, we plan to invest in a range of reforms including shifting care from acute to community settings, dedicating £531m to general practice over three years and expanding Hospital at Home capacity to 2,000 beds by the end of 2026.”
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