ONGOING and sustained attacks against the National Health Service are nothing new. Cuts, closures, long waits and poor services have become the daily reality for workers in Lanarkshire and across Scotland and the UK.

The devolution of health to the Scottish Parliament should in theory allow for us to better organise resources and attend to the needs of every Scottish health board with the interest of communities at their heart, as well as protect NHS Scotland from harsh Tory cuts and privatisation — as the idiom goes, “at least its not as bad as down south.”

In reality the opposite has been seen. The SNP continues to push forward with a failed policy of the centralisation of services, depriving both working-class and rural Highland communities of much-needed services. Be it GPs, radiography or cancer services, workers have been left with a postcode lottery of health services.

NHS Lanarkshire represents one of Scotland’s largest health boards by population as well as one of our largest health and social care services. At the start of this year all staff side representatives were informed of the impending financial outlook for the year starting April 2024. It was announced that the board will be £112.5 million in arrears if current spending continues, due to the SNP’s refusal to increase the budget from March 31 2024.

For 2024/25 no Scottish health board is projecting financial balance. Already for last financial year over half of boards have had to borrow to fulfil their service needs, to the tune of £360m.

If we break down the £112.5m figure it represents 60 per cent of an acute hospital’s annual budget, of which Lanarkshire has three. It represents 75 times the annual cost of nursing and supplies for one ward and 1.5 times the three acute hospitals drug spend per annum. Overall this budget shortfall comes out at the total running cost for 24 days for the board.

The drastic increase in costs has been a key player in need to constantly increase budgets. Energy costs are up 103 per cent, drug costs up 46 per cent and, most disturbingly, acute nurse agency costs are up 782 per cent.

The devastating reality of this is that we are now facing cuts on a par with what we have seen recently in local councils, cuts which the North Lanarkshire Trades Council has organised tirelessly against. Budgeting proposals have been put to departments but little to no guidance is being given to managers and staff, leaving a knowledge gap between the workers and directors. 

What we do know is that “reform” and “transformation” are the words of the day at the higher levels. So far highlighted services for the new Transformation programme are: unscheduled care, planned care, mental health care, primary care and supporting corporate services.

There is a plan for a 5 per cent cut to all departments’ budgets, which is to be expected, as savings are trying to be made at all levels. However, even if this scenario succeeds with minimal adverse effects on staff and services, they will only reduce the deficit to £70m, less than half of what the Scottish government is demanding be saved.

Staff find themselves stuck between a rock and a hard place. They need to provide care to an increasing number of patients and Lanarkshire has a growing crisis in mental health which feeds into the drug-related death figures, the worst in Europe, and with worsening housing and job opportunities, poverty is on the rise and so follows diseases and illnesses that the NHS had at one point eradicated. 

This creates a situation that is only fuelled by shortages. Shortages in staff, drugs, equipment and crumbling infrastructure.

The people’s NHS has been neglected and abused to the point that we once again find ourselves in the midst of a public health emergency of the government’s creation.

Trade unions, as the organisations of staff, must make clear what their visions for the NHS is — and that can only be a fully publicly owned service, universal and comprehensive at the point of use — alongside the political argument of how politicians and capitalists have lobbied governments for the interests of private organisations.

The social, political and industrial struggles must be linked with a singular vision for us to succeed in saving the NHS.

Drew Gilchrist is chair of Unite Scotland’s youth committee.