Chamber and committees

Budget scrutiny 2024-25

Background

The Health, Social Care and Sport Committee is undertaking budget scrutiny for 2024-25.

In recent years, in line with the recommendations of the Budget Process Review Group (BPRG) report, Scottish Parliament subject committees have undertaken pre-budget scrutiny, in advance of the publication of the Scottish budget. The intention is that committees will use pre-budget reports to influence the formulation of spending proposals while they are still in development.

In order to facilitate this, committees are required to publish pre-budget reports (or letters) at least six weeks prior to the Scottish budget. The date of the Scottish budget has not yet been confirmed but is normally in December following an Autumn UK budget. Timings, however, have sometimes been different in recent years due to the timing of UK elections and the Covid-19 pandemic. For now, the working assumption is that pre-budget reports/letters will be required to be published by the end of October.

The Committee sought stakeholders' views on the following topics and questions:

Budget context

The Scottish Government’s Medium-Term Financial Strategy identifies planned increases of 4% per year in real terms for health and social care over the next four years:

How would you see these planned budget increases meeting the various challenges facing health and social care over the next four years, including: 

• Addressing the treatment backlog
• The planned creation of a National Care Service
• Cost and demand pressures in areas such as NHS pay, drug costs and demographic pressures?

Longer-term outlook

Challenging decisions lie ahead in relation to health and social care spending.  Pressures result from demographics, pay, technology and drugs, but opportunities also exist through use of artificial intelligence and service re-design.

• Given the short-term and immediate pressures on the health and social care system, how can the Scottish Government take the more radical decisions required around service redesign, or reducing/stopping existing services?
• Is there any evidence of longer-term thinking in budgeting for health and social care, either in Scotland or elsewhere in the UK or abroad?

Financial Sustainability

The Scottish Government expects NHS Boards to reach a break-even position within three years, although a number of boards are still requiring additional support in order to achieve this.  Despite increasing budgets, there is general agreement that service redesign will be required in order to deliver services effectively.

• Is the achievement of financial sustainability a realistic prospect in the face of continuing pressures around pay costs, treatment costs and rising demand?
• How can or should any additional health and social care funding be directed to support alternative models of service delivery?

Health and social care outcomes

In relation to health and social care, a range of different performance frameworks and targets exist, including the National Performance Framework, Local Delivery Plan (LDP) standards, the ‘National health and wellbeing outcomes’ and the Wellbeing Economy Monitor.

How should health and social care budgets be prioritised in this landscape of multiple frameworks and targets and which targets or outcomes should take precedence?

Your views

The call for views closed on 25 August 2023.

Read the responses

Report