The Scottish National Party's (SNP) proposed reforms to the National Health Service (NHS), which aim to reduce the number of health boards from 14 to two, have been met with criticism from the Scottish Parliament's health committee.
The cross-party committee stated that the government has provided "scant details" regarding the plan, highlighting a lack of clear evidence, costings, and an assessment of the potential impacts on patients and staff. The committee expressed concern that decisions may have been made without a developed business case or comprehensive consultation.
Health Secretary Angela Constance, who believes reducing the health boards to two is the correct approach, stated that the reforms are intended to simplify care access and eliminate existing geographical and bureaucratic barriers that lead to variation and duplication across the 14 current health boards.
The reforms were announced in September as part of broader efforts to reform the public sector and reduce backroom costs. According to Scottish Government figures, the cost of "corporate" functions within Scotland's NHS reached £1.1 billion in 2024-25, an increase of £58 million. This amount, the report notes, could fund approximately 33,000 new nurses.
While the Scottish Government has assured staff that compulsory redundancies are not anticipated, employees may be offered retraining, redeployment, or voluntary redundancy. Public Service Reform Secretary Ivan McKee indicated that specific budget allocations for upfront costs associated with potential job cuts resulting from these reforms are unlikely.
The health committee's pre-Budget scrutiny report also noted confusion surrounding the scope and implications of the reforms. It called for a full and proper consultation process, emphasizing the need for greater clarity on the process, timescales, and opportunities for public input. The committee referenced the failed National Care Service proposal, which incurred nearly £30 million in costs before being dropped, as a lesson that structural reforms can sometimes overlook leadership, culture, and practice.
Scottish Labour health spokesman Dame Jackie Baillie described the plans as "rushed, wholly lacking in detail, and risk making it harder for patients to access care." Scottish Conservative health and care spokesman Miles Briggs characterized the proposals as a "devastating verdict on John Swinney’s back-of-a-fag packet plans for Scotland’s NHS."
Ms Constance stated that the government welcomes the committee's recognition of the need for reform and emphasized that detailed proposals will be supported by a business case. She added that engagement with NHS boards, staff representatives, trade unions, local government, integration authorities, social care partners, and the public will be part of the process. She also committed to keeping the Scottish Parliament informed as a more detailed transition and implementation timeline is developed.