Intended for healthcare professionals


Scottish NHS faces uncertain future as demand outstrips activity

BMJ 2024; 384 doi: (Published 22 February 2024) Cite this as: BMJ 2024;384:q476
  1. Bryan Christie
  1. Edinburgh

Questions have been raised about the future of a free NHS in Scotland as a major review paints a picture of a struggling service that is failing patients.

Andrew Elder, president of the Royal College of Physicians of Edinburgh, responded to a report from Audit Scotland by saying it is now legitimate to ask if Scotland “can afford to provide every treatment available, free of charge and at the point of access. If we cannot—which is plausible given the huge increases in medical treatments available—how should we decide what we can provide?”

He called for a national conversation to be held in which the public would be asked to decide on the future direction of the service, a move backed by BMA Scotland.

The call follows publication of Audit Scotland’s annual review of the service1 which says that it is failing to keep pace with demand, resulting …

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