Audit Scotland has predicted that it will be impossible for some Scottish health boards to balance their books.
The prediction comes amid a turbulent financial period for the NHS.
Audit Scotland provides the Auditor General and the Accounts Commission with services to check that public money is spent efficiently and effectively.
And the organisation is very concerned about the state of finances in the Scottish NHS.
“NHS boards are facing increasing costs each year, for example drug costs increased by 10%, allowing for inflation, between 2012/13 and 2014/15. NHS boards will need to make unprecedented levels of savings in 2016/17 and there is a risk that some will not be able to achieve financial balance,” the Audit Scotland report asserts.
In order to address the situation, the watchdog believes that massive savings will need to be made during the existing financial year.
Meanwhile, NHS funding is failing to keep pace with the increasing demands on services in Scotland.
Thus, it is perhaps not surprising that performance is also beginning to diminish for the Scottish NHS.
Audit Scotland’s annual report on the NHS said performance had actually declined in six of the eight targets measured over the past four years.
Health Secretary Shona Robison insisted the Scottish government had made “significant improvements”.
Robison also spoke of an explicit strategy that exists with the intention of turning the fortune of the NHS in Scotland around.
The report claimed that Scottish NHS organisations face a challenge in balancing performance requirements with expenditure needs.
“Boards are struggling to meet the majority of key national standards and the balance of care, in terms of spending, is still not changing. It is difficult balancing the demand for hospital care, alongside providing more care in the community. Boards need to ensure they maintain high-quality hospitals, while investing in more community-based facilities.”
An ageing NHS workforce in the nation is also problematical, with problems training and recruiting staff also apparent.
Commenting on the issue, Caroline Gardner, the Auditor General for Scotland, suggested that joined-up thinking is essential in solving the problems.
“The Scottish government has had a policy to shift the balance of care for over a decade but despite multiple strategies for reform, NHS funding has not changed course. Before that shift can occur, there needs to be a clear and detailed plan for change, setting out what the future of the NHS looks like, what it will cost to deliver and the workforce numbers and skills needed to make it a reality.”
Already there has been considerable political debate in Scotland over the Audit Scotland report.