A report, published today by public spending watchdog Audit Scotland, describes the need to slash spending by April as a “significant challenge for many NHS bodies” and continues “it will be difficult for some to achieve the required level of savings without any negative impact on the services they provide”.
The document also indicates tougher times are ahead. It notes the Scottish health service has received above-inflation increases for eight consecutive years but faces budget cuts in the future.
Staffing levels cannot be exempt from the search to reduce costs as the downturn bites, according to the report.
Robert Black, auditor general for Scotland, said the NHS in Scotland had met all its financial targets last April and finished the financial year with a small underspend.
However, he continued: “The service faces real pressure, from existing cost pressures and the impact of the recession on public sector spending. As the amount of public money available reduces, the NHS will need to ensure that it continues to provide good quality care while becoming more efficient, and it should make sure it is getting the information it needs to achieve this.”
Whether the NHS will be able to reduce spending without affecting patients is causing concern – with opposition politicians warning frontline services are at risk.
Dr Andrew Walker, health economist at Glasgow University, said: “You can only make painless savings tomorrow if there is pointless spending today.
“A lot of the ‘easy’ savings – such as prescribing non-branded medicines – have been made. That leaves tougher choices. One option is trying to do everything with fewer staff and other compromises such as less upgrading of equipment, less staff training and cheaper produce in hospital meals. The alternative scenario is politically very difficult. It raises the question of whether the NHS can continue to try to meet every need. Would we prefer an NHS that tried to do less but to a higher standard?”
Audit Scotland stresses the need for more accurate, up-to-date information showing what the NHS gets for the money it spends to identify where savings can be found.
Jackie Baillie, health spokeswoman for the Scottish Labour party, described the report as “deeply worrying”.
She said: “The health secretary needs to make sure that the NHS has sufficient funding to avoid these swingeing cuts, otherwise vital frontline services will be affected.”
Ross Finnie, LibDem health spokesman, said: “This report is a stark warning that the SNP’s cuts to the NHS budget could start to affect patient care as early as next year. Pressure to deliver more and better services along with a growing elderly population means this budget cut couldn’t come at a worse time.”
Dr Brian Keighley, chairman of the British Medical Association in Scotland, also expressed concern, and said: “We would warn against taking decisions to cut the staff paybill – this would be a short-sighted approach that will have long-term consequences for NHS services in Scotland.”
Health Secretary Nicola Sturgeon said: “There is no doubt that the entire public sector faces a challenging climate ahead, but the Scottish Government’s draft budget for 2010-11 has protected health spending, which is set to rise to £11.347 billion.
“While we cannot predict the public spending environment beyond the next spending review, NHS Scotland is working hard now to become leaner and more efficient so we are prepared to deal with whatever lies ahead.”
