Chamber and committees

On the 1 September, as part of the Programme for Government, the First Minister announced the Scottish Government’s intention to simplify the NHS by replacing the current 14 territorial Health Boards with two Strategic Health Boards and build on planned reforms to further reduce the number of special Health Boards.

The Scottish Government will engage first and foremost with the workforce and we will set out and agree a process with trade unions to ensure the workforce is able to help to shape these plans. We are currently in the design phase of the work, which includes developing the business case. The work will be developed in partnership with staff, staff representatives, trade unions, stakeholders and the public, with a strong focus on the needs of rural and island communities.

Robust local, regional and national governance arrangements will be established to support both the transition and the longer-term model. We will ensure detailed impact assessments will be undertaken as part of the programme's next phase. Equality, fairness and reducing health inequalities will be fundamental considerations in the design of the reforms. The intention is that structural reform will align organisational arrangements with the way many services, staff and patients are already working across East and West Scotland, as a result of the sub-national planning structures.

It is important to highlight that NHS restructuring and Public Service Reform is about improving services for people, not about structures. The intention is to simplify how people access care, reducing 14 different approaches to one joined-up system delivered through 2 strategic boards. The plans are about reducing the variation in how services are currently delivered across Scotland and the specific needs of rural and island communities will be taken into account.

While structural change will support long-term financial sustainability, the greatest benefits will come from service redesign, better planning and reducing variation in health care and outcomes across Scotland. The costs and benefits of reform will be set out through the programme's business case and developed in partnership with NHS Boards.

This work will complement existing plans to improve financial sustainability and support Boards in returning to financial balance. The programme will be supported by a clear benefits framework and ongoing monitoring to assess whether it delivers improved outcomes and value for money. Decisions on final service structure models and their locations will be worked through during this design phase.

The Scottish Government notes the Report. We recognise that it is very important that the prescription and administration of Electroconvulsive Therapy is subject to the highest possible standards.

Through the national audit process all NHS Boards have been informed of their status against key indicators as well as issues with compliance of national audit standards. NHS Boards are required to submit investigative reports and action plans to consider any relevant factors and actions that will improve compliance with national standards. Mandatory training has also taken place for all NHS Board data leads to support understanding and compliance.

The Scottish Government regularly engages with NHS Boards on matters relating to mental health services.

Across Scotland Electroconvulsive Therapy has been subject to national audit standards. NHS Boards have all been informed of their status against key indicators as well as issues with compliance of national audit standards. In April 2026 the Scottish Government was informed about NHS Ayrshire and Arran, Borders, Fife and Tayside’s level of compliance with the indicators. These NHS Boards have submitted the requested investigation reports and action plans which were assessed by the national steering group and are monitored via agreed processes.

It is estimated that reimbursements made to operators participating in the £2 bus fare cap within Highlands and Islands area, will cost between £23 to £26 million for the 2026-27 financial year. All cost estimates remain subject to change due to the demand-led nature of the scheme

The Regulation of Legal Services (Scotland) Act 2025 (“the 2025 Act”) represents the most significant reform of legal services regulation in Scotland for a generation. It will strengthen consumer protections, improve transparency and accountability, support innovation in the delivery of legal services and modernise the complaints framework.

The Scottish Government recognises that implementation is a substantial programme of work and is therefore taking a phased approach, working closely with the Lord President and key stakeholders to ensure the reforms are implemented in a way that is effective, proportionate and supports access to justice.

The 2025 Act gives the Lord President important new statutory functions. The Scottish Government recognises that appropriate resourcing will be required to support delivery of those responsibilities

Funding for 2026-27 has been agreed in principle with the Lord President’s Office to support implementation of the 2025 Act, with the current estimated requirement being approximately £116,000. Officials are finalising the funding requirement ahead of a budget transfer through the Spring Budget Revision process.

The Scottish Government continues to work with the Lord President's Office, the Judicial Office and the Scottish Courts and Tribunals Service to understand the longer-term resource implications of the Act. Future implementation costs, including recurring costs associated with the Lord President's new functions, will be considered through future budget-setting and Spending Review processes.

I am committed to ensuring that people with respiratory conditions receive timely access to high-quality care and treatment to enable them to live longer, healthier, and more independent lives.

The Respiratory Specialty Delivery Group, within the Centre for Sustainable Delivery is developing a number of national pathways for conditions including COPD, severe asthma, bronchiectasis and sleep apnoea. This work aims to improve referral processes, support earlier intervention and ensure that patients receive the right care, in the right place and at the right time.

We are also improving access to respiratory services, including pulmonary rehabilitation through digital, community and specialist provision to increase capacity and reduce variation across Scotland. This includes work with Chest Heart and Stroke Scotland to develop pulmonary rehabilitation resources and a digital-first offer through their My Lungs, My Life platform, and setting up pulmonary rehabilitation pilots in central and rural areas, helping to ensure people can access consistent support regardless of where they live.

In addition, recommendations from the Long Term Conditions Advisory Group on Respiratory Conditions which will inform the Long-Term Conditions Strategy, due to be published in March 27. This will help inform future action to support equitable and sustainable access to services, including respiratory care.

More broadly, the commitments set out in the 2026-27 Budget will deliver record investment of £22.5 billion for health and social care, supporting delivery of planned care and increasing capacity across NHS Scotland. We have invested an additional £100 million this year to build on progress made through the NHS Operational Improvement Plan and have announced a further £90 million to support those waiting longest for treatment and create additional capacity across the healthcare system.

The Scottish Government recognises the valuable contribution that Scotland’s civil nuclear workforce has made and continues to make. The figure cited is published by the Nuclear Industry Association (NIA) and the Scottish Government has not made a separate assessment of it.

Decommissioning at Dounreay, Hunterston and Chapelcross is expected to continue for decades and will follow at Torness.

The Scottish Government is not involved in the contractual arrangements between Liberty Steel Dalzell and Navantia.

The Scottish Government recognises the challenges that can sometimes affect access to healthcare in rural areas. All territorial NHS Boards, including NHS Dumfries and Galloway, are expected to offer services in ways that best suit the needs of their communities, using a patient-centred approach. We continue to work with Boards to support flexible and easily-accessible services, including for screening programmes and preventative services such as vaccination.

NHS Dumfries and Galloway has among the highest uptake rates for men in Scotland. Most screening programmes can offer appointments locally to participants, including those in rural and remote communities. Most NHS Boards, especially those serving large geographical areas, offer diabetic eye screening (DES) appointments at mobile locations, increasing accessibility. In NHS Dumfries and Galloway, the mobile service can additionally provide optical coherence tomography (OCT) scans where required.

Where it is not possible for screening programmes to be delivered locally, other methods are in place to ensure they are as accessible as possible. Abdominal aortic aneurysm (AAA) is delivered through eight designated centres located across Scotland, including a centre in NHS Dumfries and Galloway. All men are invited for a one-off AAA screening appointment at age 65, and in the year ending 31 March 2025, 85.8% of eligible men participated in AAA screening in NHS Dumfries and Galloway, exceeding the desirable uptake threshold for the programme. Bowel cancer screening uses home testing kits, making the service particularly accessible for people who live in remote and rural areas.

Vaccination is a key preventative health intervention and NHS Boards provide vaccination services at local venues such as GP practices, community pharmacies and other community settings, while eligible housebound individuals can receive vaccinations at home. Mobile units, provided by the Scottish Ambulance Service, are also used to deliver vaccination programmes in underserved communities, including rural and remote areas.

The Scottish Government continues to work closely with territorial Health Boards, Public Health Scotland (PHS) and Screening Oversight and Assurance Scotland (SOAS) to ensure these services are delivered in the most accessible way, including taking account of specific issues posed by rural geography.