NHS boards have received nearly £60 million in bail-out loans from the Scottish Government in the last four years amid growing concerns about the health service.
Nearly half of the country’s boards relied on these so-called “brokerage” payments as a way of coping with budgetary problems.
Labour MSP Anas Sarwar hit out, saying: “It's time for SNP Health Secretary Shona Robison to get a grip on the crisis in our NHS before it's too late."
Staffing shortages, growing demand for services and tough clinical targets are all contributing to unprecedented pressure on the NHS.
The growing list of problems prompted BMA Scotland chair Peter Bennie to claim recently that the NHS was “stretched pretty much to breaking point”.
Against a backdrop of financial pressure, the Sunday Herald asked the Government to provide a list of brokerage payments made to NHS boards since 2012, as well as the amounts that were repaid.
In the last four years, NHS Tayside was propped up with over £25m in crisis loans from the Government and most of the cash has not been repaid.
A recent Audit Scotland report explained the reason for the sums: “NHS Tayside has needed brokerage from the Scottish Government to break even in each of the last four financial years.”
NHS 24, which is also struggling financially, got over £20m between 2012 and 2014, but the Government response stated that only £400,000 had so far been paid back. According to a board spokesperson, the sums were to help meet “implementation costs” relating to a new “technology platform”.
NHS Lothian, which provides services to around 800,000 people, received £8m in 2012/13 to support delivery of waiting time targets. The full amount has been paid back.
In 2012/13, NHS Fife required £1.4m of brokerage to cover “delays” in receiving income from the sale of St Andrew’s Memorial Hospital, but the sum was repaid in the following year.
NHS Highlands, the largest health board in terms of land mass, had to be given a loan of £2.5m in 2013/14 in order to achieve financial break even. A spokesperson said the sum has now been repaid in full.
The health board in Ayrshire and Arran, which serves a population of around 400,000, received £387,000 extra in 2014/15 to pay for the demolition costs of Healthfield Clinic. The sum was repaid to the Government.
And NHS Orkney needed a £1m injection in 2013/14 to support a “transforming clinical services programme”. The board has since repaid all brokerage in full and is in “recurring financial balance”.
The total amount in brokerage came to around £58.5m during the four-year period.
Sarwar said: "This is yet another example of the impact of a decade of SNP mismanagement of our NHS. Staff are being over-worked, undervalued and under resourced by the SNP. The failure of Nationalist ministers to plan effectively has led to this problem."
Scottish Conservative shadow health secretary Donald Cameron said: “The issuing of these loans shows the sheer desperation that can set in at cash-strapped health boards north of the border. It’s extremely worrying that these have been used so often.
“If the SNP had planned properly when it came to power 10 years ago, not just for an ageing population but for other challenges it knew was coming, perhaps these loans wouldn’t have been required.”
A Scottish Government spokesman said: “Brokerage allows the Scottish Government to work with boards to support their medium to long term financial planning by providing additional in-year funding that is recovered in future years. Decisions are made on a case-by-case basis.
“In the four year period in question, the brokerage amount of £55 million represents 0.12% of the cumulative health resource budget of £46 billion, so these amounts can be comfortably managed. The Scottish Government has received over £30 million in brokerage repayments to date, so the net position is closer to £25 million.”
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