NICOLA Sturgeon has insisted her government’s NHS recovery plan is fit for purpose, but admitted it may have to “develop and evolve” to deliver what it promised.

At FMQs, the First Minister rejected a Tory plea to re-write the plan in light of a “damning” report by spending watchdogs, but added it would need to be “flexible and adaptable”.

Audit Scotland’s annual review of Scotland's NHS warned of an “ever-increasing backlog of patients waiting to be seen” and growing spending that was “unsustainable”.

The watchdog said although the Scottish Government had ambitious plans to redesign NHS services, those would be “challenging and take a long time to realise”.

It said the Government already “struggles to recruit enough people with the right skills” into the health service and said increasing staffing in the NHS must be a priority.

The Scottish Government published its 28-page NHS Recovery Plan 2021-26 last August.

It proposed an extra £1billion investment to help tackle the backlog in care that built up during the Covid pandemic, including £400m for eight new elective surgery hubs.

Audit Scotland said it would be “stretching and difficult to deliver against the competing demands of the pandemic” and new policies such as a National Care Service.

Asked by Scottish Tory leader Douglas Ross if she still had confidence in the plan, Ms Sturgeon replied: “Yes, I do. But the Government will continue to work hard to ensure that the recovery plan continues to develop and evolve and be fit for the purpose of getting the NHS through the remainder of Covid and on to a path, not just of recovery, but of sustainability for the future.”

She said the Audit Scotland report was “challenging” but “also fair and balanced”.

She said: “It recognises that the task that all governments face to recover their health services from Covid is a difficult one and there are no easy answers.”

Mr Ross suggested her confidence in the plan was glib and misplaced.

“Yes I do – three simple words from the First Minister confirming that everything she has put forward in her NHS recovery plan has her backing. It’s what she believes is the way of getting our health service out of the struggles of the pandemic,” he said.

“Yet it’s a very different view from Audit Scotland who have said this morning, quite a damning verdict on the Government’s plan to rebuild Scotland’s NHS.”

He quoted part of the report which said: “There is not enough detail in the plan to determine whether ambitions can be achieved in the timescales set out.”

He urged the First Minister to re-draft the plan, but she refused.

She said: “I do, however, agree that, as the Government, we must ensure the delivery of that recovery plan and we must ensure that recovery plan is flexible and adaptable to make sure that it is fit for the very significant challenge that Scotland faces and, indeed, countries across the world face, in recovering their health services from the pandemic.”

Scottish Labour leader Anas Sarwar said the report painted a “devastating picture” of what the country’s NHS had become under 15 years of SNP rule, and accused the First Minister of pretending its problems had all been created by Covid.

“But that is not true,” he said, quoting from previous Audit Scotland reports. “Scotland’s NHS was in crisis before Covid hit and that’s why we are struggling to recover.

“This Government has been solely responsible for Scotland’s NHS for 15 years. The result? Staff burnt out and wanting to leave and patients failed and languishing on waiting lists.”

Ms Sturgeon replied: “I don’t pretend that all of the challenges facing the NHS and other health services are all down to Covid. The health service has been facing demographic pressures.

“It has faced the pressure of a decade of Tory austerity, started actually under the last Labour Government, in case we forget that point.”

Audit Scotland found the health and care budget was £18bn inr 2020/21 - around 35% of the total Scottish budget.

Of this, the NHS funding allocation was £16.3bn, up 19% in cash terms on the previous year.

Suggesting there was significant uncertainty about coronavirus-related funding and spending, the report added: “The NHS was not financially sustainable before the Covid-19 pandemic, with boards relying on additional financial support from Government or non-recurring savings to break even.

“The scale of the financial challenge has been exacerbated by the pandemic.

“The cost of delivering services has risen and additional spending commitments made by the Scottish Government add to NHS boards’ financial pressures.”