How Audit Scotland revealed SNP's scandalous misuse of taxpayers' money
The average daily cost of a hospital bed is about £620, compared to just £145 for one in a nursing home, yet legions of people well enough to leave remain stuck on wards
In our troubled world, the question of whether Angela Constance stays or goes as Scotland’s Justice Secretary is unlikely to keep many awake at night. There is actually a case for her staying as walking validation of abysmally low expectations.
I wrote recently: “To be fair to Ms Constance, I seriously doubt if she has the wit to exhume an eight-month-old quote, pluck it out of context and then weaponise it for her own advantage by falsely representing it as the view of a distinguished public servant. That sounds far more like the work of a Special Adviser…”
This is now pretty much confirmed by the “First Minister’s Independent Advisers” whose report states that “the wording came from an additional briefing note prepared for Ms Constance by officials”. Disappointingly, the miscreants are not named and shamed.
It seems odd that reading out the deception which someone wrote for her, without any expectation that she might have questioned its plausibility, has become the case for her defence rather than the prosecution. But I suppose that only reflects the pathetic reality.
SNP concerns about some waiting times
Unusually, Ms Constance caught my attention for another reason this week. Amidst her ministerial travails, she found time to post on social media that “learner drivers in Livingston are being let down, with waiting times stuck at the maximum 24 weeks”.
In a smart response, the former MSP, Neil Findlay, wrote: “I’m sure they are – but what has Angela Constance got to say about West Lothian patients waiting on a GP appointment, waiting on a hospital procedure, waiting on a police officer to call, waiting on a dental appointment, waiting on a social care place, waiting on a CAHMS appointment for their child, waiting on a social house, waiting on a mental health appointment.”
That neatly encapsulated the modus operandi of the SNP government of which, however improbably, Ms Constance remains a senior member. She pontificates about driving tests which are the responsibility of the UK Department of Transport while everything mentioned by Mr Findlay – and unmentioned by Ms Constance – is 100 per cent the responsibility of the Scottish Government.
£440 million cost of unnecessary stays in hospital
One of these issues, social care places, came under the spotlight in a truly shocking report by Audit Scotland which found that “people medically ready to leave spent 720,000 unnecessary days in hospital in 2024-25. Whilst the full financial impact is unknown, the cost to the NHS in hospital days alone is an estimated £440 million a year”.
It is a problem which affects every area of Scotland. In my own part of the world, a recent report to the Health Board said that at one point, 60 per cent of hospital beds were occupied by patients ready for discharge – with nowhere to go.
Even in a society that seems inured to political failure, this report (and thank goodness for Audit Scotland) does seem spectacular. With the Scottish Budget imminent, it underlines the point that the problem is not a shortage of money but the vast amounts which are mis-spent because of policy failures, misguided priorities and sheer incompetence.
The human consequences of bed-blocking confirm that we are as far away as ever from a social care system capable of meeting demand. Last year’s figure is the highest yet. The only year in which there was a significant drop was during Covid when patients were decanted willy-nilly into care homes.
Debacle over ‘National Care Service’
I asked at the time why care homes could not be used more extensively in normal times – not least because, as Audit Scotland again points out, the average daily cost of a hospital bed last year was £618.12, compared to £144.72 for a nursing home and £126 for a residential care home placement.
That is an issue which has been crying out to be addressed for years and has been the subject of the usual boasts and bombast, while the actual outcomes are laid bare in these statistics. Back in 2016, when Nicola Sturgeon was in her pomp, she promised a Scottish National Care Service as a social reform on a par with the NHS.
This was to be a legacy which would make her the Nye Bevan of the book festival circuit. In practice, it turned into the usual shambles with nine years wasted, every piece of professional advice ignored, local authorities marginalised and £27 million down the drain before the whole concept was abandoned a year ago. And all the time (Covid excepted), the numbers kept rising.
Dying while waiting for social care
Care homes are closing and care workers are difficult to recruit. Spending Scottish Government money to alleviate these factors would provide a lot better value than forcing hospitals to retain patients with no need to be there, creating massive knock-on effects for other aspects of health care. It is a national disgrace with no solution in sight.
The chief executive of Scottish Care, Donald Macaskill, told a conference recently: “In many parts of Scotland, on average, the waiting time for a financial assessment to be undertaken, which this time last year was between six and eight weeks, is now between 16 to 18 weeks.
“What is happening, in the terms used by Age Scotland, is that people are literally dying whilst they're waiting for social care, either to move into a care home or to have a home care package delivered to them.”
Of course this is a complex problem which requires dedicated political commitment to resolve. It is more than a decade since the SNP government promised to “end bed-blocking”. There are now 720,000 pieces of human evidence to the contrary.
The appropriate question in May should not be “could anyone do better?” but “could anyone conceivably do worse?”
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