How underfunded NHS Lothian is paying a £124m penalty

The "chronic underfunding" of the health board has cost it the price of a new hospital

Emergency situation: Pic: NHS Lothian

Lothian’s health service is suffering from a chronic illness that is threatening to turn terminal – rooted in national funding decisions which whittle away at its ability to plan for the challenges rushing towards us.

The symptoms are - sadly - increasingly familiar: staff shortages; lengthy waiting times across the board, including for cancer treatment; inability to invest in infrastructure; key targets not only unmet, but seemingly disappearing over the horizon.

In their most recent annual report, NHS Lothian’s risk register – compiled to identify and report on operational jeopardies - officially designated the situation around a number of issues as “extreme.” These include the repeated failure to hit national targets on 4-hour access to emergency treatment, hospital bed occupancy, access to treatment and – notably – finance.

In recent weeks we have seen the Scottish Government announce a pause for all NHS capital projects which will have a significant impact in our region. That means the postponement of a new eye hospital, first agreed five years ago; the planned new cancer treatment centre at the Western General; and the new National Treatment Centre at St John’s Hospital in Livingston, part of a planned network of ten centres designed to deliver more elective surgeries and treatments.

No-one can deny that the Scottish Government has a difficult task in balancing its budget, but the evidence points to health services in the Lothians - supporting the fastest growing population in the country - being squeezed harder than its counterparts.

The Scottish Government has a formula for distributing funds to regional health boards which is designed to ensure those areas with the greatest need - those with the biggest health problems and most deprived neighbourhoods - get the most help. That means the Lothians get less than most other parts of the country. Fair enough.

However, the reality is that NHS Lothian does not receive the full funding that it should under this, the Scottish Government’s own funding model. In fact, over the past eight years it has never received its full allocation, with the total of revenue funding “lost” over that period hitting £124 million. For illustrative purposes, that equates almost exactly to the estimated cost of the new eye hospital (£123 million) which the health board cannot build.

In the course of investigating the issue of health service funding, the Inquirer has spoken at length with one senior local NHS executive who told us that the cumulative impact of years of under-funding was to make forward planning of services “impossible”.