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22 October 2015, 06:00
NHS Scotland will not be able to provide the same level of service in the future unless urgent action is taken to alleviate the pressures it faces, according to a new report.
The health service is struggling with tightening budgets, rising costs, higher demand for services, pressure to meet targets and increased staff vacancies, Audit Scotland said.
It warned the Scottish Government has not made sufficient progress towards its 2020 vision to change the balance of healthcare to more community-based settings.
Doctors said "substantive action'' was needed to address the report's findings while opposition parties called for SNP ministers to "get a grip'' on the NHS.
Audit Scotland found health boards missed seven out of nine key waiting-time targets and standards at March 2015, "reflecting a general decline in performance in recent years''.
Boards spent #284 million on temporary staff in 2014/15, an increase of 15% from the previous financial year.
The number of agency nursing and midwifery staff increased by 53% while spending on locum doctors increased by 22%.
Caroline Gardner, auditor general for Scotland, said: "We all depend on the NHS and its staff who provide high-quality care.
"But it will not be able to provide services as it does at present due to the number of pressures it faces within the current challenging financial environment.
"It is important that the Scottish Government and health boards work closely together to help alleviate these pressures and also increase the pace of change necessary to meet its longer-term ambitions.''
Dr Peter Bennie, chair of BMA Scotland, said: "The overriding message that must get through from this report is that substantive and realistic action is needed if our health service is to cope with the rapidly increasing pressures it is facing.''
Royal College of Nursing Scotland associate director Ellen Hudson said: "If we are to put the NHS on a sustainable footing, then the government needs to take heed of the recommendations in this report and listen to what we and many other organisations have been saying for some time about the pressures on our health services.''
Health boards spent a total of £11.4 billion, ending the year with an underspend of £10 million.
The report said the health budget had decreased by 0.7% in real terms between 2008/09 and 2014/15.
Labour's public services spokeswoman Jackie Baillie said: ``For years the SNP have protested that they were protecting the health budget - today's expert report shows that the health budget decreased on their watch.
"We are seeing an increased use of private staff to cover shifts and vacancies for A&E staff lying unfilled for six months: under the SNP NHS staff are undervalued, under resourced and under intolerable pressure.''
Liberal Democrat health spokesman Jim Hume said: "The findings of this latest report are stark: unless SNP ministers get a grip, the 2020 vision will not be achieved.
"NHS boards have been forced to scramble to address staff shortages and short-term arrangements have replaced long-term planning. This is clearly not sustainable.''