£12.4 billion was spent on health service operating costs last year, according to ISD Scotland. This represents a 2.8% (£335M) increase compared to the £12.0 billion spent in 2017/18. The total operating costs, adjusted for inflation increased by 0.9% compared to 2017/18. This percentage increase has remained the same for the second year running.

Of the £335M increase in expenditure between 2017/18 and 2018/19, £196M (58%) was spent on hospital services, £54M (16%) on community services, £78M (23%) on family health services and £8M (2%) on funds transferred to Local Authorities.

Expenditure on hospital services was £6.8bn, a cash terms increase of 3.0% and a real terms increase of 1.1%, when compared to 2017/18. There was a real terms increase of approximately £230M in hospital service costs between 2014/15 and 2018/19.

A College spokesperson said:

It’s clear that the cost of hospital care in Scotland has been rising, with £6.81 billion being spent on the sector in 2018/19 compared with £6.58 billion in 2014/15. This represents a real terms increase of approximately £230 million, including rises in inpatient services costs and accident and emergency services costs.

Some of the explanations for greater hospital care costs may be the rising costs of medical equipment and medication, and of course increasing demand. But while there may be some uncontrollable factors which influence service costs and demand, we must future proof services now in order to maintain the highest care standards. As part of that, we must see service redesign which can make hospital services more efficient. 

Clinicians must be given all of the tools they require to maintain excellent standards of care and to deliver quality care outcomes for patients.

It’s also important that we get the integration of health and social care right in Scotland. Integration Joint Boards can help manage this process and although they are fairly new authorities, we should expect to see progress soon on reducing delayed discharges from hospital, which can be costly to hospital services.


Paul Gillen

Contact: Paul Gillen p.gillen@rcpe.ac.uk 0131 247 3658