Health chiefs in the Highlands have admitted they are facing “unprecedented” cuts of £100million over the next three years.
The shock savings plan prompted the local health board to warn that the entire care model in the region “needs to be changed”.
In a new report, NHS Highland estimates that it faces a “daunting” budget shortfall of £50million in the coming financial year alone – more than double previous projections.
And the total funding gap is expected to be £100million over the three years to 2020.
Opposition politicians claimed last night that the “grim” prospect would have a “very negative impact on staff and patients”.
The gloomy picture emerged amid public anger in the north at a series of controversial reforms being carried out by the health board.
Protests and campaigns have been launched in the wake of moves to downgrade hospital services in Wick and Portree, as well as plans to cut the number of communities which receive emergency cover from a nearby GP from 22 to 17.
In September, NHS Highland said it expected to make £29million of planned “efficiency savings” in 2016-17, followed by £20million for 2017-18 and a further £18million for each remaining year until 2021.
Now it has emerged that while there will be the planned £28.8million of cuts this year, next year’s target has more than doubled to £50million, while the same amount will have to be raised in over the following two years as well.
In a report to next week’s meeting of the NHS Highland board, Finance Director Nick Kenton said: “This is an unprecedented scale of savings requirement and it is clear that a ‘more of the same’ approach is not going to deliver a balanced plan and therefore the model of care needs to be changed.
“There needs to be a mindset that focuses on delivering maximum value within our total £800million resources rather than focussing on savings at the margin.”
However, he added that “although the scale of the challenge is daunting”, there were “significant opportunities” offered by the Scottish Government’s recently published Health and Social Care Delivery Plan.
The revised projection for the coming year has been made following a lower than expected budget uplift from the Scottish Government, as well as a greater than expected contribution to ring-fenced projects.
On top of that, the health board faces £23.1million of “cost pressures” on various spending plans, including care packages, prescriptions, rates re-evaluation, an apprenticeship levy, living wage commitments, and development of urology services.
Another £19.5million is needed to fund a 1% staff pay rise, energy inflation, drugs costs and other contracts, while £11.6million of savings are to be carried forward from the current financial year.
Last night, Scottish Conservative Shadow Health Secretary Donald Cameron said: “This grim projection could have a very negative impact on staff and patients.
“I can understand organisations like NHS Highland being asked to find more efficiencies. But it’s hard to see how these significant cutbacks will be made without even more pressure being put on staff, and a reduction in patient care.
“The Scottish Government’s budget has increased in recent years, and it has received plenty more to spend on health thanks to UK Government decisions and the Barnett Formula.
“As such, it would be reasonable to give health boards like NHS Highland something of a break.”
NHS Highland previously hit the headlines in 2013-14 when it was forced to seek a £2.5million loan from the Scottish Government to break even.
Highlands and Islands Labour MSP David Stewart said: “Although the health board has previously stressed that front-line services will not be affected, relentless cutbacks are bound to affect patient care.
“Budget cuts will also pile on the pressure for our hard working and dedicated NHS staff. The next five years are going to be difficult and patients should prepare themselves.”
Health Secretary Shona Robison said: “For our NHS to provide the services that people need, we must deliver the twin approaches of investment and reform.
“We have set out in our Health and Social Care Delivery Plan a range of actions to ensure that our services are sustainable, and this is backed up by our commitment to increase the NHS revenue budget by £500million more than inflation by the end of this session of parliament.
“As with all NHS boards, we will work with NHS Highland to deliver efficiency savings to ensure public money is being used effectively and for the benefit of patients, and every penny of these savings will be directly reinvested in the frontline budget.
“This year, NHS Highland’s budget has increased by 5.0% to £577.5 million, an above inflation increase, having previously increased by 4.7% in 2015-16”.
