Scotland’s government has set out proposals to shrink the current network of 14 health boards to just two and says the changes should not force people to travel further for treatment. First Minister John Swinney told BBC Scotland that early modelling splits the country into an east and west region and that the objective is to keep services as local as safety and quality allow.
Plans aim to protect local services where possible
Swinney said it was not his intention for patients to face longer journeys for routine and urgent care, using the example of women in remote parts of the far north who currently travel long distances to give birth. He emphasised that the redesign is driven by a desire to deliver care safely and equitably rather than by cost-cutting alone.
"It would not be my intention" for people to travel further, Swinney said, adding the focus is on maximising services provided close to home where it can be done safely.
The announcement comes amid wider concerns about the state of some services. A planned, nine-month review of maternity services is due to start this autumn following calls from staff and experts for improvements after previous investigative reporting highlighted shortcomings. Separately, elective paediatric surgery at Dr Gray's Hospital in Elgin was suspended last month over safety worries.
Workforce and safety considerations at the fore
Swinney acknowledged that public sector employment will decline but stopped short of giving a precise figure for potential job losses in the health service, saying only that he has been open about the likelihood of reductions. The government says the redesign is intended to create a framework that supports safe service delivery across Scotland, including in island and remote communities.
He also spoke about the intention to increase the number of services that can be delivered locally by removing some administrative boundaries between boards, with the aim of improving equity of access regardless of where people live.
- Current structure: 14 health boards cover Scotland.
- Proposed change: Reduce to two boards, modelled as east and west regions.
- Key aims: Improve safety, sustain local services where possible and promote equitable access.
Health workers, patients and campaigners have raised concerns about paediatric and maternity services across the country. Those concerns have informed the government’s review and the proposed restructuring, officials say.
| Aspect | Current | Proposed |
|---|---|---|
| Number of health boards | 14 | 2 |
| Regional model | Multiple local and regional boards | East / West split (initial modelling) |
What this means for patients
The government’s position is that any consolidation should not reduce proximity to essential care, but campaigners and clinicians will be watching closely. For people in remote areas who already face long journeys for services such as maternity care, the practical impact will depend on how responsibilities are redistributed and whether staffing and infrastructure can be maintained or improved under the new arrangements.
Officials have said the change is intended to make it easier to co-ordinate services across larger regions, which could in theory help smaller hospitals access specialist support. Critics worry that larger administrative units might distance decision-making from local communities and that transitional disruption could temporarily affect access.
As the nine-month review of maternity services gets under way, the government will need to show how safety recommendations and workforce planning are being incorporated into the new board design. For now, the pledge that travel burdens should not increase will remain a central test of whether the plans deliver on their stated aims.
Readers who travel for care or who work in Scotland’s health services may see changes in how services are organised over the coming months. The government has signalled that change is coming; the detail and the outcomes will determine whether the reforms ease pressures on staff and patients or add new challenges.
