Former public spending watchdog warns of ‘doom loop’ affecting NHS

A “doom loop” is impacting upon the NHS, a former public spending watchdog said, claiming that the health service is now left “mopping up” as a result of the failure to invest cash in services such as housing.

Caroline Gardner, who was the auditor general for Scotland from 2010 to 2020, also said that the “failure of social care” was impacting on health services.

Speaking at a fringe event at the Scottish Labour conference in Glasgow, Ms Gardner stressed the need to invest in public services.

She told the event, organised by the Royal Society of Edinburgh: “We don’t improve health just by spending on the health service.

“I think we are caught in a doom loop where the health service is mopping up the damage that is caused by the failure to invest in housing and active travel and supporting communities.”

Ms Gardner went on to say that the “failure of social care is driving more and more cost on health services”, adding that this was “squeezing out improvements that might improve the quality of life for people who have got problems the health service can’t fix”.

Speaking the day after figures showed Britain’s economy slipped into recession at the end of 2023, Ms Gardner said there had been a “long period of economic stagnation across the UK”, adding that “actually Scotland is doing a bit worse than the rest of the UK in that picture”.

This, she said, was “damaging for Scotland and its public services”.

Ms Gardner highlighted three key areas where she said Scotland’s performance had “not been good over the last 10 years or so”, saying in the skills sector further education colleges had been “increasingly choked of resources over recent years”.

She also said there had not been “significant infrastructure” spending beyond “big headline projects” such as the Queensferry Crossing and plans to dual the A9 road.

But Ms Gardner said there were “lots of opportunities for looking at where the real pinch points are locally across Scotland and investing in those, to make it easier for people to communicate well, to travel and for jobs to be created”.

With regard to the move towards net zero she added there needed to be some “thinking about how we invest in ways of running the country that head towards carbon neutrality”.

Health Secretary Neil Gray said: “Our Budget targets spending where it will have the most impact to help protect our vital public services, tackle poverty and support the growth of a green, fair economy.

“This comes against a backdrop of a stagnating UK economy that has been seriously damaged by Brexit and a UK Government that is failing to deliver needed investment in infrastructure and public services – such as our NHS.

“We are providing over £14.2 billion for NHS Boards in 2024-25 to support services, a real terms increase of almost 3%.

“We have invested over £2 billion in this budget for social care and integration – delivering on our Programme for Government commitment to increase social care spending by 25% over this Parliament – two years ahead of our original target.

“The National Care Service is a central component of our investment strategy towards sustainable public services and we are determined to take the Programme forward.

“We have led the UK in housing by delivering more than 126,000 affordable homes since 2007, over 89,000 of which were for social rent, including almost 24,000 council homes. We will invest £556 million in affordable housing in 2024-25, the majority of which will be for social rent.”