In a move that will surely put anxious minds at ease, First Minister John Swinney has suggested that Scots won't have to travel further for healthcare under his government's ambitious plan to slash the number of health boards from 14 to a mere two. Because nothing says 'we've got this' like a vague promise wrapped in a restructuring.
When the BBC asked about the impact on those intrepid souls already trekking vast distances - like women in the far north who brave 100 miles down the A9 to give birth in Inverness - Swinney assured us it would 'not be my intention' for people to travel further. Initial modelling, he revealed, shows the country divided into two east and west health boards, which sounds simple enough until you consider the geography.
He also couldn't put a 'specific figure' on NHS job losses, though he was admirably 'open about the fact that public sector employment will fall.' Because who needs specifics when you have vibes?
Speaking to BBC Scotland's The Sunday Show, Swinney expressed a desire to maximise local healthcare delivery, provided it's safe. The goal is 'equity of access' regardless of where you live - a noble sentiment, albeit one that might require a map and a compass to implement.
On the Caithness maternity services issue, Swinney clarified it's not about efficiencies or costs, but 'patient safety.' He mused, 'What I want to make sure is that by removing health board boundaries we can maximise the number of local services that can be provided as close to home as possible for individuals in different parts of the country.' Translation: We'll try to keep services local, but no promises, and definitely no details.
Patients and healthcare professionals have raised concerns about paediatric and maternity care, and a nine-month review of maternity services is set to begin this autumn after a BBC Disclosure investigation highlighted poor and sometimes deadly care. Meanwhile, all planned paediatric surgery at Dr Gray's Hospital in Elgin was suspended last month due to safety concerns - a situation that might persist until December, according to NHS Grampian's chief executive.
The grand plan to reduce health boards from 14 to two was announced in Swinney's programme for government, hailed as the 'most significant structural reform in the NHS in the era of devolution.' But questions linger about how these two boards will function in practice, especially for island dwellers. Work began last November, with maps dividing the country into east and west, and the chief executives of NHS Greater Glasgow and Clyde and NHS Lothian taking the lead. There's also talk of absorbing island healthcare into local authorities, though no decisions have been made - because why rush into things?
It's unclear whether this new structure will save money by cutting senior roles or streamlining departments. Unite, the trade union, has branded the plan a 'slash and burn programme for the NHS,' which sounds rather dramatic, but maybe they're onto something.
When pressed on job losses, Swinney said, 'I can't put a specific figure on that today and I simply wouldn't be giving a comprehensive answer if that was the case.' He added that they're working through a reform programme to put people 'right at the very centre of the delivery of public services.' Because that's where they've always been, right?
The first minister also dodged questions about how to cover a potential £5bn shortfall in public finances by the end of the decade, citing 'lots of variables' and the SNP's track record of balancing budgets through Brexit, Covid, and the financial crash. Because past performance guarantees future results, obviously.
Opponents have piled on, with Scottish Labour's acting leader Jackie Baillie saying, 'It's hard to tell whether John Swinney is being evasive or simply has no idea what he is going to do, but either way it's not good enough.' She called for the SNP to 'come clean' about job risks and public service impacts.
Scottish Conservative finance spokesman Craig Hoy accused Swinney of refusing to answer basic questions, adding, 'He cannot say how many NHS jobs could be lost yet expects Scots to believe he has a grip on the SNP's £5bn budget black hole.' He described the first minister as 'completely out of his depth.'
Reform UK Scotland leader Malcolm Offord criticised Swinney's 'word salad' responses, noting, 'What I'm surprised to hear is that a government that has been in situ for 19 years still cannot put names and numbers around the reorganisation.' Indeed, 19 years and still winging it - truly impressive.