Extra NHS funding from Spring Budget should be spent on Scotland's frontline staff, unions warn

Neil Gray, Scotland’s new health secretary, might find himself very grateful for the UK government’s Spring Budget as he attempts to ward of strike action within NHS Scotland, writes The Scotsman’s health correspondent Joseph Anderson

The Scottish Government has been warned it must spend the Barnett consequentials from the UK government’s Spring Budget on the NHS’s workforce – as it may be the only thing that averts strike action.

Unions have frequently warned that NHS Scotland’s recruitment and retention crisis is spiralling out of control – and better pay and conditions would go a long way to both attracting new students to medicine and convincing older healthcare professionals to work longer hours as they near retirement.

Scotland’s NHS is experiencing an intense amount of pressure due to staffing. Firstly, there is an immense Covid backlog to work through, which requires serious resources to tackle.

Scottish Health Secretary Neil Gray (left) meets staff working in the Major Trauma Centre, during a visit to Queen Elizabeth University Hospital in Glasgow. Jane Barlow/PA Wire

Secondly, a lack of staff is causing congestion at each stage of a patient’s journey through Scotland’s hospitals. There are limited care placements due to staffing shortages, so vulnerable patients cannot be discharged from wards. Care workers can earn more, and work in a much less demanding environment, such as in supermarkets, and are leaving in their droves.

The hospital wards themselves are staffed by a minimal number of exhausted, overworked and, in their opinion, underpaid staff. There are around 5,000 nursing vacancies in Scotland. The vulnerable patients who are fit enough to leave have nowhere to go.

The pressure in hospital wards is in turn causing congestion in accident-and-emergency (A&E) departments, where patients cannot be admitted to hospital beds that do not exist. Here too, staff are burned out and looking for the exit.

With this in mind, healthcare unions are eyeing up the £2.5 billion that Chancellor Jeremy Hunt has just pledged for England’s NHS.

Mr Hunt pledged to increase public sector productivity, including a package of NHS reforms which will “slash the 13 million hours lost by doctors and nurses every year” as a result of obsolete IT systems with a £3.4bn investment.

The Scottish Government will receive a sum equal to a proportion of this figure, as dictated by the Barnett formula, which if spent on frontline staff could go a long way to allaying the fears of healthcare unions, and even avert the threat of strike action.

Reacting to Mr Hunt’s announcement, the Royal College of Physicians of Edinburgh (RCPE) welcomed the extra funding, but warned it “must be spent effectively”.

"While we welcome investment in IT infrastructure, the workforce needs of the NHS must not be forgotten,” said RCPE president Professor Andrew Elder.

"People need to see a qualified medical professional. The NHS is under immense strain throughout the UK and this situation is no different in Scotland.

“Any consequentials from today’s announcement must be passed onto frontline services in Scotland. It is essential that healthcare colleagues are given the support that they need to address backlogs in treatment and elective surgery. It is essential that healthcare colleagues are given the support that they need to address backlogs in treatment and elective surgery.”

Just this week, the British Medical Association (BMA) warned the Scottish Government it would consider strike action, after it said ministers “ignored their pleas for positive engagement” during negotiations over consultant pay.

The BMA has secured an improved pay offer from the UK government for consultants in England, leading the union to call for a similar pay offer from the Scottish Government.

“It sadly and frustratingly seems increasingly clear that the only way we will get the attention, action and improvements necessary for the hugely valuable resource that is our consultant workforce, is to pursue a course of threatening to enter dispute and then undertake the kind of industrial action seen elsewhere in the UK,” said Dr Alan Robertson, chair of BMA Scotland’s consultant committee.

Chair of BMA’s Scottish Council, Dr Iain Kennedy, said the Scottish Government relied to a large extent on the block grant, stressing “arguments around where funding is coming from make little difference to those struggling to provide care in crumbling buildings as waiting lists spiral”.

"The priority must be to invest in the NHS in Scotland, making it a genuinely attractive place to work,” he said. “There simply isn’t a more ‘frontline’ investment than focusing spending on the people who deliver care, day in, day out.”

Neil Gray, new to the role of health secretary, might find himself very grateful for Mr Hunt’s Spring Budget. However, Deputy First Minister and finance secretary Shona Robison said the Spring Budget had provided less in Barnett consequentials from health than in-year health consequentials of 2023/24, and failed to deliver more capital funding for infrastructure.

“Today’s statement provides not a single penny more for capital funding,” she said. "And the Barnett consequentials from health that were signalled by the Chancellor are actually less than the in-year health consequentials of 2023/24 and less than what is needed to address the pressures we face.

"I can guarantee that this Scottish Government will not be passing on this UK government cut to our NHS.”

Meanwhile, healthcare workers in the care sector say they have been forgotten about by the UK government.

The Carers Poverty Coalition described the Budget as “incredibly disappointing” and said unpaid carers on low incomes “will be devastated to see that they have, once again, been forgotten”.

The body said: “The government must recognise the link between caring and poverty by putting robust measures in place for proper support. A review of carers’ allowance, the lowest benefit of its kind at only £76.75 per week, is long overdue and must be a key priority for the next government.”

Without any Barnett consequentials making their way to Holyrood’s coffers due to spend on English carers, it is unlikely the sector can expect any sort of funding injection from the Scottish Government.