Plans to build new hospitals, health facilities and national treatment centres in Scotland have been put on the back burner for potentially up to two years, owing to budget constraints.

The Scottish Government has promised to publish a revised NHS infrastructure plan in the spring, while essential maintenance issues would be prioritised in the interim. Reports of the delays first surfaced last month, with health boards having been instructed by the Scottish Government to halt any building projects.

NHS Lothian finance director Craig Marriott said ministers in Scotland had told local health bosses that they would need to wait “at least” two years for new capital investment, Construction News and other media reported.

The reports prompted Labour MSP Jackie Baillie earlier this month to ask First Minister Humza Yousaf when the Scottish Government expects all national treatment centres to be opened.

Mr Yousaf said the Scottish Government’s ability to fund capital projects had been “detrimentally impacted and affected” by soaring inflation and the UK Government’s decision cut its capital budget.

“Our infrastructure investment plan identified priority health capital projects, including national treatment centres, for funding within that period. As a result of the almost 10-per-cent cut in our capital budget from the UK Government, a revised pipeline of infrastructure investment will be published in the spring this year. All due consideration will be given to what projects can be included and on what timescales.”

That decision will include national treatment centres, said the First Minister, who also confirmed that two national treatment centres – NTC Forth Valley and phase 2 of the Golden Jubilee national hospital – were due to open in the coming months, providing additional orthopaedic, endoscopy and general surgery capacity.

Ms Baillie listed a number of treatment centres impacted by delay or threat of cancellation, including those in Ayrshire and Arran, Lanarkshire, Lothian, Grampian, and Tayside. But she added that these were not the only NHS capital infrastructure projects put at risk.

“The Aberdeen Baird family hospital and ANCHOR – Aberdeen and North Centre for Haematology, Oncology and Radiotherapy – project are delayed,” she said. “The Institute of Neurosciences in Glasgow is delayed. The Monklands Replacement Project in Lanarkshire is delayed. The Edinburgh cancer centre and the eye pavilion are delayed. The Caithness, Raigmore and Belford projects are delayed. Health centres in Kincardine, Lochgelly and East Calder are cancelled. Barra community campus has been cancelled.”

Mr Yousaf reiterated his view that many capital projects were under threat “because of the UK Government’s disastrous mismanagement of the economy, as well as the 10-per-cent cut to our capital budget, which will impact not just health projects but capital projects across the country”. He appealed to the UK Government to use the spring budget to reverse the budget cut “in order to allow those important health capital projects to go ahead”.

Modernisation needed

Commenting on the pause in construction work on the BBC’s ‘Good Morning Scotland’ programme, Dr Iain Kennedy, chair of BMA Scotland, said: “We’ve been saying for some time that the NHS in Scotland does not have the resources to be sustainable in the future.”

He told the programme that the health service should be “free at the point of delivery” but that modernisation was imperative, adding: “We can’t have a free buffet for all, where it is an ‘all you can eat’ buffet. We definitely need to prioritise and say what we will provide and what we won’t provide.”

The Scottish Government is also looking to introduce a whole-system strategic service and infrastructure plan. The aim, it says, is to identify how services and infrastructure can be best configured to support current and future organisational, patient, and community needs. As stated in its Scottish Capital Investment Manual, it anticipates this will result in a “whole-system change plan, with an accompanying prioritised infrastructure investment plan, including a ‘do minimum maintenance only’ option”.

Explaining the reasons for the change, the Manual notes: “Too often in the past, business cases have focused on the need for a new building to replace an older one. Investment decisions have also tended to be prioritised towards projects that are more advanced in their development, rather than on their prioritised need. This has resulted in a pipeline of individual investment proposals that do not necessarily represent a Board’s, community’s, or country’s whole-system priorities.

Under the new approach, health boards will be required to plan for a number of scenarios, including a ‘do minimum maintenance only’ plan. The Manual adds: “These will reflect realistic assumptions around funding availability and are informed by a comprehensive assessment of risk and opportunity to improve.”