The number of people waiting over a year for planned surgery in Scotland has reached a record high as waiting lists continue to grow.

The latest quarterly release from Public Health Scotland reveals that the total number of people on waiting lists for an inpatient or day case procedure was at an all-time high of 151,093 by the end of September this year - nearly twice the level seen in March 2020 when all non-urgent elective work was suspended due to Covid.

Thousands of patients are still facing extremely long waits which were virtually unheard of before the pandemic, despite Scottish Government pledges to "eradicate" them.

The number of people who have been waiting over a year for a procedure stood at 36,993 by the end of September - a record high, and up from 1,297 in December 2019.

Around one in three were orthopaedics patients waiting for operations such as hip and knee replacements.

This figure includes 17,812 people waiting over 18 months; 7,078 people waiting over two years; and 1,432 who have been waiting over three years.



At the beginning of July 2022, First Minister Humza Yousaf - then the Health Secretary - announced targets to "eradicate" waits of more than two years "in most specialties" by the end of September 2022, followed by 18-month waits as of September 2023, and year-long waits by the end of September 2024.

However, the latest figures reveal that there has been virtually no change in the size of the 18-month waiting lists between the target being announced and the deadline being reached, with the number of patients with 18-month waits going from 17,816 in June 2022 to 17,812 in September 2023 - a reduction of just four.

Three year waits have come down from a peak of 1,944 in March this year, while two-year waits peaked at 9,984 in March 2022.

Prior to the pandemic, in December 2019, just 120 patients on inpatient/day case lists in NHS Scotland had been waiting over two years for a procedure - including 15 people who had been waiting over three years.

Public Health Scotland said the "rate of growth in the waiting list size has slowed in recent quarters" but that overall elective activity "remains markedly down" on pre-pandemic levels.

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It comes as the former chief executive of NHS Scotland, Professor Paul Gray, told the BBC that the health service in its current form is not sustainable and called for a "mature debate" on the role that the private sector could play.

He suggested that charging some patients for treatment on the NHS could be considered.

He said: "What we can't afford is just to carry on as we are and hope for the best. The consequence is that everything slowly gets worse.

"The pressure on staff continues to grow. The service that patients and their families receive, despite the best efforts of everyone, continues to reduce."

A record number of Scots have already been turning to the private sector and paying for procedures, such as hip replacements - which cost around £13,000 - in order to avoid NHS delays.

Prof Gray added: "There are certain things even within the overall provision of health and care services that people do pay for. So for example, in some cases, you do pay for your dentistry.

"People choose to pay for some elements of care that they receive, that choice is already open to them. So I think it's about having the conversation.

"I don't have a view about what the conclusion of that conversation should be because we haven't had it yet. So my view is we should have it.

"If we decide that actually, the way we do it is the best way of all the choices we could make, that's okay, we've had the conversation.

"If on the other hand, we decide there's more space for the private sector, perhaps they could do more, then good, that's fine too."

Professor Andrew Elder, president, Royal College of Physicians of Edinburgh (RCPE), said the NHS was under pressure from the growing number of frail and elderly people living with multiple conditions, as well as a retirement timebomb - with 48% of current consultants due to turn 62 over the coming decade.

He said: “The biggest challenge for our NHS can be summed up by the following questions - can we afford to provide every treatment available for the general public, free of charge and at the point of access? If we cannot – which seems probable in the coming years – how should we decide what we can provide?

Scottish Labour deputy leader Dame Jackie Baillie said the NHS was "on the brink of disaster" ahead of the winter period.

She called on Health Secretary Michael Matheson - who is currently embroiled in a row over a near-£11,000 data roaming bill racked up on a holiday in Morocco - to be sacked, adding: "Waiting lists are at an all-time high, with thousands of Scots being left to suffer for over a year waiting for treatment and the SNP seem incapable of doing anything about it."

Dr Sandesh Gulhane, a GP and the Scottish Conservative's health spokesman, said the figures were "utterly disgraceful".

He said: "The discredited and distracted SNP health secretary Michael Matheson is presiding over a scarcely believable backlog in Scotland's NHS."

A spokesman for the Scottish Government acknowledged that there were "unacceptable waits in some specialities", but said it remains "committed to delivering year-on-year reductions" in the NHS waiting lists. 

Two new National Treatment Centres which opened this year in Fife and Highland, plus two further centres opening soon in Forth Valley and the Golden Jubilee, will provide "additional protected capacity for patients across Scotland", he said.

He added: "The First Minister has announced new annual funding of £100 million to help reduce inpatient and day-case waiting lists by an estimated 100,000 patients over the next three years.

"We are working with NHS Boards to reduce long waits, which have been exacerbated by the impacts of the global pandemic.

"This includes targets to address long waits and delivery of the commitments in our £1 billion NHS Recovery Plan to support an increase in inpatient, day-case, and outpatient activity."