Reform Scotland

NHS 2048: Future-proofing Scotland’s Health and Social Care

NHS 2048: Future-proofing Scotland’s Health and Social Care

  • New Reform Scotland research on orthopaedic waiting lists and times
  • BMA Chair says workforce “running on empty”
  • Reform Scotland announces major debate on improvements needed to NHS ahead of 2048 centenary

Reform Scotland today releases research that reveals sharply rising waiting lists and times for orthopaedic procedures in Scotland’s hospitals. Freedom of Information requests to health boards obtained comparable figures on waiting lists and times in orthopaedics, and the specific data for hip operations. The paper also marks the launch of a major Reform Scotland research programme that will explore the changes required if the struggling NHS is to reach its 2048 centenary in better health. 

Dr Iain Kennedy, chair of BMA Scotland, said: “It is a system bursting at the seams, with a workforce running on empty – there are not enough of us to give our patients the time and care they need and deserve. The time for platitudes has long passed – we need action, and we need it now.” 

The full paper – NHS 2048: Future-proofing Scotland’s health and social care – can be read below. It reveals that:

  • 11 health boards have seen at least a doubling in the wait time for a hip operation from point of decision. This includes an increase from 163 days to 386 in Greater Glasgow & Clyde, and an increase from 114 days to 360 in Lothian.
  • The waiting list for a hip operation has more than tripled since 2019 in Ayrshire & Arran, Dumfries & Galloway, Fife, Grampian, Lothian and Tayside
  • Well over 10,000 people are on the waiting list for a hip operation, up from just over 3,000 in 2019

While the increase in waiting times is deeply worrying, waiting times data only covers the point from when a decision to treat was made. As a result, patients will in reality be waiting far longer. There is further data on orthopaedic operations in general, showing around 45,000 on a waiting list. 

Reform Scotland, a non-partisan think tank, is calling for an open, constructive and mature conversation about improving the NHS in time for its centenary, and has been joined in that call by Dr Iain Kennedy.

“The figures in this report from Reform Scotland are shocking, yet not surprising. BMA Scotland has been warning for some time that the NHS in Scotland simply cannot deliver what is expected of it under its current limitation. It is a system bursting at the seams, with a workforce running on empty – there are not enough of us to give our patients the time and care they need and deserve.

“The time for platitudes has long passed – we need action, and we need it now. We are in a year-round crisis with our NHS and workforce planning is abysmal. The Scottish Government must move forward with their commitment to have a cross-party national conversation on the future of our health service – an open and honest discussion that also involves the profession and the public.

“Enough is enough, we cannot continue on this path if we want to futureproof our NHS for generations to come.”

“Reform Scotland’s report is a stark warning of how bad things have become. As an orthopaedic surgeon I am working as hard as ever, and yet my waiting list seems to be growing longer. Seeing my patients in pain and knowing how long they are likely going to have to wait for their operation breaks my heart. Having to tell patients they could be waiting for more than a year for an operation they need in order to get through a day without pain is really difficult.”

“We need a mature, constructive debate to identify and build consensus around specific measures that will help our health and care services in both the short and long term.

“The electorate can cope with this discussion. They know that the health service is ill - they live with the consequences every day. Are the politicians up to it, though? Can they set aside petty party differences and work together to save this vital public service?

“If we are to maintain a taxpayer-funded, free-at-the-point-of-need system up to the NHS’s centenary in 2048, reform is required in order to make the best use of the resources we have.

“Reform Scotland will provide a platform for that discussion to take place.”