Cuts and PFI are creating a crisis for the NHS in Scotland
By a Scottish NHS worker and Unison member
The NHS in Scotland is under financial strain. The demand for year on year savings coupled with the imposition of extensive treatment time targets is leading to colossal financial pressures. Every health authority is being told to make savings over and above the 3% expected, as a matter of routine.
In my health board we have experienced a cut in our budget every year for the last three years. On an estimated annual budget in excess of £700m, over £70m has had to be saved. There is evidence that beds have been cut, especially in psychiatry, all over Scotland.
We are facing a major staffing crisis which means health boards resort to agencies for nurses, doctors and even support staff. This spending is often essential to meet safe staffing limits in clinical services. In some areas the use of so-called locum doctors on temporary contracts are the only way in which services can operate. This is a semi- permanent feature of the NHS in Scotland, and it shows no sign of ending.
Under the Private Finance Initiative (PFI) New Labour used private finance to build public services. In my health authority four hospitals were renovated by private companies who then charged the health board an annual mortgage for the course of the contract.
PFI costs
The cost of these facilities is currently over £14m (2% of the annual budget) per year until 2026, £12m to 2030 and finally £9.5m until 2042. The overall cost of these contracts exceeds £400m.
These costs represent a loss of spending on clinical services and redirects money away from patient care to private companies. Adding these costs to the rigid saving targets means a permanent financial crisis. By no means is NHS Tayside the only Scottish Health Board managing long term debt because of PFI. It represents a significant burden across NHS Scotland.
At no time have the governments of Scotland sought to alleviate this financial cost to the NHS. If we are to take seriously the idea that the SNP are anti austerity they need to do more in protecting the NHS from financial crisis.
A proper review of PFI should take place and the facilities built returned to public ownership rather than remain as a source of profit for private business overcharging the NHS.
