What are we willing to cut from NHS to keep it alive?

This article appears as part of the Inside the NHS newsletter. Are we really ready to have a "national conversation" on the future of the NHS, even if that means doing less? The BMA has repeatedly called for "an honest, open and transparent" discussion about how to make the health service sustainable long-term, while Professor Andrew Elder – president of the Royal College of Physicians Edinburgh (RCPE) – said in June that it was time for a "debate about whether we increase funding, through direct taxation or some other means, or make reasoned decisions about what we can and cannot provide from the public purse". Scotland's Auditor General, Stephen Boyle, added his voice to the chorus at the weekend when he warned that the current model is "not sustainable" and without reform the spiralling costs of delivering health and social care will undermine other public services.

It comes against a backdrop where NHS Scotland's chief executive, Caroline Lamb, has written to health board leaders urging them to find cost savings amid a predicted £500-600 million overspend in the current financial year. (Image: Newsquest) Budget pressures In a letter dated June 21, Ms Lamb told NHS chief executives that the health service is facing a £500-600m black hole in its finances for 2024/25 unless additional savings are found (on top of the £350m of cuts already identified). This was "not acceptable", she warned.

The Scottish Government is expected to balance its books at the end of each fin.