Debbie Ewen: We shouldn't limit our ambitions when it comes to the NHS

In the last few weeks, I’ve been out and about in West Lothian as part of Alba’s 2026 campaign. People have been only too willing to share their stories and concerns about life today in Scotland. One of the most common complaints I’m hearing are frustrations with the NHS, and more specifically, NHS waiting lists.

Many voters are angry that a system they’ve paid into whilst in good health, is now failing to deliver when they really need it. Everyday living is, in some cases, being seriously impacted by the failure to receive timely diagnosis and treatment.

One man described becoming more isolated as his mobility worsens daily and he’s in constant pain. Another voter is delighted to see me and tells of her isolation waiting to receive a diagnosis for her husband’s dementia. No good outcome there, she’s now on anti-depressants and feels unable to cope, her husband is, finally diagnosed, but still waiting for a care package to be put in place.

Scotland has always been proud of our NHS and rightly so! In many areas the Scottish NHS continues to offer world class, innovative treatment to their patients. We definitely punch above our weight in our offering of free, universal health care for Scots and a dedicated staff who deliver a fantastic service against all odds. Our system is the envy of those countries where a universal public health system doesn’t exist in any meaningful way.

However, things are definitely not what they used to be. Just ask any health professional working in the NHS and they’ll share their concerns about increasing pressures and limited resources.

Some of the statistics from Public Health Scotland’s own website make for sobering reading.

In March 2025 approximately 1 in 9 Scots were waiting for some type of outpatient consultation or inpatient treatment.

Waiting lists for diagnostic tests (such as MRI, CT, ultrasound scans etc.) showed a 7% increase in March 2025 when compared to the previous quarter. Even more concerning is the revelation that waiting lists are 60% higher than they were pre-pandemic.

Dementia diagnosis delays are particularly alarming—with patients in Lothians and Ayrshire and Arran facing waits of over a year.

By the last quarter of 2024, only 67% of patient pathways for inpatients and day case treatments met the 18-week waiting standard. with almost a quarter of waits exceeded a year, with significant numbers waiting more than two or three years!

The Scottish Government has committed some new money to try and provide additional capacity and reduce waiting lists. However, what we need is wholesale structural reform and significant investment to clear the backlog and improve health outcomes.

A £30 million investment in 2024–25 delivered an extra 75,500 appointments and procedures with notable reductions in waiting lists in specific treatment areas such as Urology, Ophthalmology, and general surgery. Further funding has been earmarked for additional capacity. and 150,000 extra appointments and procedures are expected to be available by March 2026.

Diagnostic waits have reduced from a previous high and there has been additional investment in dental and diagnostic improvements. At the moment however, that additional funding is not making enough of a difference. Cabinet Secretary for Health, Neil Gray, resembles King Canute – trying to halt the tide and just getting his feet wet! 

Some people proudly announce that our NHS is better than England and Wales. It’s frustrating, that stunted by the constraints of the Union, the limit of ambition for Scotland is to be marginally less bad than our neighbours! Where is our vision for the country we could be and the health service we could have? I, for one, have far loftier ambitions for us and our NHS!

There’s no doubt that the current waiting list crisis is changing the face of healthcare in Scotland and not in a good way. Nearly a third of households are turning to private healthcare to circumvent long waiting lists, and private admissions are up 31% since 2019. All very well if you can afford it but where does this leave those who can’t? Those who have no savings, or house they can remortgage. Yet again those with least, left languishing in poor health at the bottom of an ever increasing waiting list.

Wasn’t that one of the reasons the NHS was created in the first place? To remove health inequalities and improve the health of the nation. If Reform gain a foothold in Scotland in 2026 things will only get worse and we’ll have to fight tooth and nail against privatisation of our cherished health system.

The current situation is a huge problem and requires not just additional spending, but widespread root and branch review of the unwieldy system currently operating - its management systems and priorities included! I certainly don’t have all the answers, but I do know that a government hamstrung by a UK calling the shots, will never be able to make the changes needed. 

Only the full powers of independence will allow us to make widespread changes needed to give us the NHS we deserve. 

[Debbie Ewen is the ALBA Party's Women's Convener and sits on the Party's National Executive Committee]