Swinney pledges action to bring down NHS waits

First Minister John Swinney had pledged his government will bring down NHS waiting lists and make it easier to get GP appointments.

The SNP leader announced measures he said would put the health service "on a path of modernisation and renewal".

Opposition leaders accused the SNP of mismanaging the NHS, which has seen record waiting times and delayed discharge figures in recent months.

Medical unions welcomed parts of the announcement, but said it lacked detail.

At a speech in Edinburgh, Swinney set out three priorities: to reduce immediate pressures in the NHS, shift the balance from acute services to the community and to use innovation to improve access to care.

He acknowledged patients were not getting "the right care in the right place at the right time", warning that waiting times and delayed discharge figures were the "canary in the coal mine".

The first minister said the health service would carry out an extra 150,000 appointments and procedures in the coming year.

That is to include 10,000 through "smarter working" at national treatment centres.

Swinney said hospitals would also do an extra 9,500 cataract procedures, as well as 2,500 extra orthopaedic appointments and procedures, such as hip or knee replacements.

"In this way, we will create centres of excellence, places of expertise and specialisation, where we will be better placed to capitalise on the technological innovation and the potential of AI," the SNP leader told an audience at Heriot-Watt University.

According to Public Health Scotland (PHS), in the year to June 2024 there were 1.26m outpatient attendances at consultant-led clinics and 250,880 inpatient or day case admissions across the country. This is down from 1.43m and 279,937 respectively in the last full year before the pandemic.

PHS also recorded just over a million hospital procedures performed in 2023-24, a 3% increase on the year before but a 11% drop compared to four years ago.

Although these figures have increased steadily in recent years, they will have to be ramped up above 2019 levels to clear the NHS backlog.

Swinney said ministers had listened to GPs and that a greater proportion of new NHS funding would go to primary and community care.

"As much as possible, people who do not need to be in hospital will not go to hospital, protecting those acute services for those who absolutely need them," the first minister said.

He pledged £10.5m to improve GP capacity and "intervene earlier" in preventing illness.

Swinney told the audience that specialist "frailty" staff wold be stationed in accident and emergency departments from the summer.

"This will mean that frail patients, often older patients with complex needs, will bypass our busy A&Es, in order to receive the specialist care and support they need, whether in hospital or back at home," he said.

The government's Hospital at Home scheme is also to be expanded to at least 2,000 beds by the end of 2026.

"Without the need for any new bricks and mortar, the effective capacity of every single hospital in Scotland will be expanded," the SNP leader said.

Swinney said NHS Scotland's Pharmacy First Service would be expanded "so that community pharmacies can treat a greater number of clinical conditions and prevent the need for a GP visit in the first place".

He also promised that better use of data would improve efficiency in operating theatres and cut waiting times, while innovations in genetic testing would be used to deliver "smarter, better care".

And he said a digital dermatology service was being rolled out, while the NHS Digital Front Door app would be launched by the end of the year. The app will allow patients to manage and contribute to their own health and care information online and interact with health and social care services.

The Scottish government has made a series of commitments to tackle NHS backlogs since the pandemic.

However, targets to "eradicate" long waits have been missed, with NHS waiting lists and delayed discharge figures hitting record highs.

Audit Scotland said last month that "difficult decisions" might have to be made about whether the NHS can continue to provide some services. It called for urgent reform to cope with growing demand.

The British Medical Association also warned the NHS would struggle to make it through another year without immediate action.

Scottish Conservative health spokesperson Sandesh Gulhane said: "John Swinney has been at the heart of the SNP government for 18 years and it's his own mess he's looking to fix.

"And quite frankly he has just given us empty rhetoric. There is nothing here that is going to solve the crisis."

Scottish Labour accused the SNP of a series of failures, including wasted funding, workforce shortfalls and A&E waiting times.

The party's deputy leader Jackie Baillie told BBC Scotland News the speech included "recycled announcements", describing it as "too little too late".

Dr Iain Morrison, chair of the BMA's Scottish GP committee, welcomed a focus on general practice to solve a "perpetual NHS crisis". However, he called on the government to provide more detail on its plans.

Unison co-lead for health Matt McLaughlin told BBC Scotland News that much of the speech appeared to be "reannouncements" of previous pledges.

While the union chief welcomed aspects of Swinney's statement, he said the first minister "completely missed the key issue, which was how do we improve social care to make sure that the delayed discharge problem is tackled once and for all".

The government abandoned plans to set up an NHS-style National Care Service last week. Ministers insist they remain committed to improving the care system.

The proposals lost the support of opposition MSPs, councils and trade unions due to concerns about costs and a lack of detail.

Former health secretary Jeane Freeman, who was involved in formulating the plan, was critical of the government over the weekend.

She told BBC Scotland's Sunday Show: "I feel angry, I feel dispirited, because it is beyond my understanding how all of that support has been lost."

The government has been here before.

Ten years ago it announced plans to build a series of specialist hospitals called National Treatment Centres that would focus on non-urgent care.

Despite making that a central commitment of the Covid Recovery Plan – funding for new buildings was pulled with fewer than half opened.

In 2017 there were promises to employ 800 new GPs. But Scotland now has fewer GPs than a decade ago, with more patients needing care.

And more recently, in 2022, the government said that by September last year, nobody would have to wait longer than a year to start treatment. Yet the latest figures show over 90,000 waits were over 52 weeks.

Speaking to doctors, pharmacists and others who attended today's event, they welcome the plans to create more capacity and shift resources to the community, but they question the lack of detail from the first minister on exactly how it will be achieved.