John Swinney has admitted he cannot say how many NHS jobs could disappear under plans for the biggest restructuring of Scotland’s health service in decades.
The First Minister was repeatedly asked to put a figure on potential job losses after announcing that Scotland’s 14 territorial NHS boards will be replaced by just two strategic organisations.
Swinney acknowledged that he expects overall public-sector employment to fall during the current parliamentary term but said he could not yet provide a number for the NHS.
The admission comes after he unveiled what he described as the “most significant structural reform of the NHS in the era of devolution” in his Programme for Government.
Under the proposals, familiar organisations including NHS Greater Glasgow and Clyde, NHS Lothian, NHS Grampian, NHS Highland, NHS Lanarkshire and NHS Tayside will disappear in their current form.
Initial work envisages Scotland being divided between two strategic boards covering the east and west of the country, although different arrangements are being considered for island communities.
Speaking on BBC Scotland’s Sunday Show, Swinney was pressed on the consequences for the NHS workforce.
He said: “I can’t put a specific figure on that today and I simply wouldn’t be giving a comprehensive answer if that was the case.”
The First Minister said the government now had to work through its programme of reform with the objective of improving the services people receive in their own communities.
Swinney has previously ruled out compulsory redundancies as the reforms are implemented. He told the BBC that he had been “open about the fact that public sector employment will fall” over the parliamentary term.
Each of the existing territorial boards currently has its own organisational structure, with functions including senior management, finance, human resources, communications, planning and other administrative services.
One of the central arguments for restructuring is that removing organisational boundaries and reducing duplication could allow NHS resources to be used more effectively across Scotland.
The reforms are being developed against an increasingly difficult backdrop for Scotland’s public finances, with a potential £5 billion funding shortfall forecast by the end of the decade.
The health board plans themselves have been under development since last year.
Initial modelling divides mainland Scotland into eastern and western organisations, with the chief executives of NHS Lothian and NHS Greater Glasgow and Clyde involved in leading the work.
The future of the island boards remains less certain. One option under consideration would see responsibility for healthcare in Orkney, Shetland and the Western Isles integrated more closely with local authorities, although no final decision has been made.
The changes have prompted concern about whether creating two enormous organisations could result in services becoming more centralised and patients having to travel further for treatment.
Swinney sought to address those fears on Sunday. Asked about people who already travel considerable distances for healthcare – including women in Caithness who may have to travel to Inverness for maternity services – the First Minister said it was “not my intention” that patients should have to travel further because of the restructuring.
Unite has described the health board restructuring as a “slash and burn programme for the NHS”.
Scottish Labour acting leader Jackie Baillie said the government needed to be clear about how many jobs were at risk and what the reforms would mean for services.