John Swinney is warned reform package may be ‘more reckless than revolutionary’

Plans to cut the number of regional health boards in Scotland from 14 to just two could be “more reckless than revolutionary”, John Swinney has been warned.Roz Foyer, general secretary of the Scottish Trades Union Congress, issued the warning after the Scottish First Minister announced the move in Tuesday’s Programme for Government at Holyrood.Pledging the “most radical reshaping of public services” since the Scottish Parliament was established, the SNP leader said there would be “significant structural reform” of the NHS, along with plans for a new structure for local government.However Ms Foyer said the First Minister was “presenting the public with a misleading choice of cuts packaged as public service reform”, adding this was “disingenuous at best and a falsehood at worst from the Scottish Government”.She added: “Crushing down Scotland’s health boards into two may seem bold on paper but further centralising power when local communities are crying out for health and social care services tailored to their needs seems more reckless than revolutionary.Read More“This is not the way to do public sector reform.“Before the axe is swung on any public service, whether health, council or social care, Scottish Government ministers would do well to engage meaningfully and purposefully with the workers who deliver on the ground.”Bosses at the trade union Unite meanwhile claimed the proposals for the NHS amounted to an “unacceptable programme of cuts”.Regional co-ordinator James O’Connell said: “Culling health boards does not resolve the need to invest in health and care services.“We have seen a repeated failure to invest in health and social care workers who provide essential services.”He added: “Reducing health boards does not reduce workload or staffing pressures.“Unite will not stand by and allow workers and services to be attacked.“We will be consulting our members on the damaging implications of this announcement, and all options will be on the table to prevent this unacceptable programme of cuts.”The British Medical Association (BMA) said that “disappointingly given the scale of the changes proposed” it had “very little detail” on the Scottish Government’s plans.But BMA Scotland chairman Dr Iain Kennedy insisted that “evidence of how these changes will improve care for patients and not simply be about saving money must be central to what does ultimately come forward”.Adding that the “voice of doctors and NHS staff must be heard and taken into account” by ministers, Dr Kennedy stressed: “Structural reform must not come at the expense of the immediate need to address the challenges the NHS faces.”Colin Poolman, executive director of the Royal College of Nursing (RCN) Scotland, said they had “concerns” that the changes could be “being driven by considerations around savings, rather than improving how services are delivered”.While he said the RCN would “not oppose change in a kneejerk way”, he added: “Structural change alone will not address increasing need and the persistent workforce challenges across health and care.“Long-term workforce planning is key – this must be a priority – and reform must also tackle the persistent culture problems that continue within the NHS.”Also raising concerns about the impact on the NHS was the British Dental Association.Its Scotland director Charlotte Waite said: “It is a truth universally acknowledged that top-down reorganisations of the NHS rarely deliver the goods for taxpayers, patients, or practitioners.”She added: “These plans need to be subjected to forensic scrutiny.“The only thing we can be sure of at this stage is unintended consequences.”Scotland’s councils meanwhile said they would “take time” to consider “carefully” any changes to local government structures.Shona Morrison, president of Cosla, the body which represents all 32 of Scotland’s councils, said: “Today’s Programme for Government is a significant statement of the Scottish Government’s priorities, and we will take time to consider its detail carefully.”She added: “There are important implications for local government and council services, particularly the proposed NHS reforms and what they will mean for the future delivery of social care.“Over the coming days, Cosla will engage closely with our member councils and with Scottish ministers to ensure these proposals are focused on what is best for communities across Scotland and respect the democratic legitimacy of local government.”Ms Morrison said: “Public services work best when decisions are taken as close to communities as possible.“We look forward to meaningful engagement with the Scottish Government and believe that the dialogue on the future of local governance must be carried forward with councils and Cosla as the collective voice of local government.”