Healthcare spending, staffing and activity

Health is the largest single area of Scottish Government spending, making up 35% of the Scottish Government's total discretionary budget in 2024-25 and 39% of its non-benefit budget.2 Its share of spending has grown significantly over time, driven by large increases in health spending in the 2000s and cutbacks to other areas of spending in the 2010s. This trend is set to continue with the Scottish Fiscal Commission (SFC) projecting that to keep up with the demands of an ageing, less healthy population, and medical advancements, Scottish health spending would need to grow by around 3% in real terms per year in the late 2020s and 2030s, compared with around 2% for all Scottish Government spending. More urgently, there is clear evidence that the NHS in Scotland, as in the rest of the UK, is struggling to recover from the COVID-19 pandemic, despite record levels of spending and staffing. In this chapter of our second Scottish Budget Report, we therefore look at long-run trends in healthcare spending in Scotland and how these compare with trends in England and Wales, before examining recent trends in NHS staffing, activity, productivity and performance in Scotland. We conclude with a discussion about future funding and staffing.