NHS managers in Scotland are calling for an urgent review of health and social care funding, saying it has grown increasingly difficult to deliver a “first class NHS” within budget.

They have called on Holyrood’s new MSPs to demand an independent review to identify how a “fully funded” health service can be maintained in Scotland.

Managers in Partnership (MiP), a trade union for healthcare managers, sent all candidates in the Scottish Parliament elections an email asking them to sign up to a pledge regarding the future of the health service.

The pledge, which gained support from three SNP candidates, said: “I will demand the expectations of the Scottish public for a fully funded NHS are met and that an urgent independent review of health and social care funding be conducted to identify how this can be maintained in the future.”

It also asked future politicians to commit to support managers when they look at re-organising services, even if the public are uncomfortable with the proposals.

While the Scottish Government has acknowledged the need to change the way services are delivered, MSPs often speak out against plans which change current hospital provision.

The pledge says: “I will provide visible public support for NHS leaders in their essential attempts to deliver healthcare in a safer and more sustainable way and help the public to appreciate the urgent necessity of this even in the face of public unease at NHS change.”

Wayne Gault, Scottish representative on the national MiP committee, said it was difficult for NHS managers to raise issues such as funding concerns “without appearing to be disloyal or upsetting the apple cart”.

He added: “We thought it was really important colleagues had the opportunity to have their views expressed during election time and hopefully someone will listen to them.”

Explaining the thinking behind the pledges, he added: “The Scottish electorate consistently view the NHS as one of the most cherished political issues. 
“Our members have seen the increasing difficulties NHS Scotland has had in meeting the people’s aspirations for a first class NHS given the available budget. 

“With an ageing population, rising drug and technology costs, and the legitimate rise in public expectation of quality care, this cannot and should not continue.”

He added people should be proud of the improved safety record of the Scottish NHS, which has gained international recognition. However, he said, sometimes tricky decisions needed to be made to provide safer, more sustainable services.

When communities were against such changes, he said “too often politicians will be using that as a campaigning tool to get on the bandwagon when, in actual fact, they are doing themselves and their constituents a disservice”. 

Healthcare leaders, he said, could feel very exposed about taking necessary decisions for fear of being castigated by politicians.

Dr Peter Bennie, chairman of the British Medical Association Scotland, said the BMA had repeatedly warned rapidly increasing demands on Scotland’s NHS are outstripping available resources and creating a funding gap that must be addressed. 

He added: “With the election now past, the challenge for politicians – from the Government and opposition – is to find a sustainable way forward for our NHS and set out in greater detail the range and models of services they plan to pursue with the resources they are committing.”

Shona Robison, health secretary in the last Government, responded to the email from MiP but did not commit to the pledge. 

She said in her response the SNP would never waiver in their belief the NHS should be publicly funded. She continued: “The SNP have increased the frontline health budget by £3.3bn since we were first elected to government, in the face of swingeing cuts from Westminster. We’ll not only continue to provide real terms protection, but we’ll increase the NHS revenue budget by £50m more than inflation by the end of the next parliament, an increase of almost £2bn.”


Although a 6.5% increase in the NHS budget was announced for this financial year - it is a complicated settlement with £250m going to health and social care partnerships. These bring community services such as GP surgeries together with local authority social care services - and councils had their budgets cut.