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NHS Scotland ‘needs radical surgery’ after being overwhelmed by pandemic


The NHS in Scotland needs “radical surgery” in order to meet the problems posed by the pandemic as well as future challenges, according to a former chief executive.

Paul Gray, who was the top civil servant for healthcare in Scotland between 2013 and 2018, said the NHS was always going to be overwhelmed and the coronavirus pandemic has only made things worse.

In a blog post for the think tank Reform Scotland, he said a combination of demographic changes, funding and the availability of skills were all putting pressure on the NHS before the pandemic.

He said Scotland should learn from healthcare systems abroad which have less central control, such as those in the Netherlands, Sweden and Alaska.

Mr Gray said: “This is not 2019 and it is certainly not 1948.

“Previous models of care are increasingly lost in the mists of time and demographics and public expectation, and the more quickly we grasp that, the sooner we will deliver the reforms that are needed.

“The people currently delivering health and care services have responded brilliantly to the current challenges – we need to hear their voices and the voices of citizens in relation to the reforms that are needed as well.

“I hope that my blog helps to bring about a fresh conversation. I believe in a public health and care system, but we need a new collective version of what that is.”

He continued: “NHS Scotland requires radical surgery.

“It is time for us to look to Sweden, the Netherlands, Alaska, and other international examples, to embrace local decision-making, to promote the contribution of the voluntary sector, to recognise where the private sector adds value, and to create a health and care service for the future, with access, quality, and sustainability at its core.”

Responding to Mr Gray’s comments, a spokesman for the Scottish Government said: “The pandemic has been the most significant challenge the NHS has ever faced in its 73-year history.

“We know that the pandemic is not over, and that Covid-19 and other pressures will continue to impact the NHS for some time.

“Our NHS Recovery Plan sets out commitments over the next five years, backed by over £1 billion of funding, to support an increase in inpatient, daycase, and outpatient activity to address backlogs, which will be supported by the implementation of sustainable improvements and new models of care.

“This includes our commitment to deliver a National Care Service by the end of this parliament in order to help improve the provision and consistency of care services across Scotland.”




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