The Scottish NHS : meeting the financial challenge ahead

Barbour, James and Morton, Alec and Schang, Laura (2014) The Scottish NHS : meeting the financial challenge ahead. Fraser of Allander Economic Commentary, 38 (2). pp. 126-146. ISSN 2046-5378

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The Scottish NHS faces a crisis of affordability in the next couple of decades as the population ages and demands on services intensify. This presents two challenges: the first is how to redesign services to achieve greater efficiencies, and the second is how to engage the public so that there is a realistic public view about what is affordable, against which a mature discussion about the hard choices about funding and provision can take place. We refer to these as the innovation and openness challenges. In the paper we outline the current state of the system and discuss possible policy options. We conclude with some recommendations for next steps.