Scotland’s proposed 2025-26 budget plan includes record spending on health and social care of £21.7bn across the NHS to improve access to primary care, reduce waiting times and “shift the balance of care” to preventative and community-based support. Three major capital hospital building projects are also to be funded, and councils will receive additional allocations for social care services.

In her foreword to the draft 2025-26 budget, the Cabinet Secretary for Finance Shona Robison writes that health and social care reform is a ‘key element’ of the government’s approach to improving public services. 

To meet this, £100m has been earmarked for ‘reform and improvement measures’ within the total health and social care budget. 

Addressing the Scottish parliament, Ms Robison said that this budget is “filled with hope” for Scotland’s future: 

“We know how important public services are to the quality of life and the success of our nation and none more so than our health service. 

“My biggest financial commitment is therefore to our NHS. The budget provides a record £21bn for health and social care – an increase of £2bn for frontline NHS boards.” 

This “record uplift”, Ms Robison says will make it easier for people to access GP appointments, improve A&E and ensure more people across Scotland get the care they need in time. 

The Scottish government’s budget will support the expansion of Hospital at Home and improvements across primary care, including new core funding for enhanced frailty, cardiovascular disease and other essential GP services. 

Despite recent figures suggesting NHS Scotland is ‘lagging behind’ England, Ms Robinson said this new injection of funds will support preventative, emergency and primary care. 

She said almost £200m will be spent to reduce waiting times and reform the NHS, with a commitment, by March 2026, no one will wait longer than 12 months for a new outpatient appointment or inpatient or daycare treatment.

The government’s budget also commits to delivering a series of new acute care facilities, including the replacement of the Eye Pavillion in Edinburgh, the long-promised rebuilding of the Belford hospital in Fort William and a new Monklands Hospital in Airdrie.

Long term conditions spending has been increased by more than 200%, to support access to diabetes tech and continue policy work in a number of other conditions, while funding for services for people living with Long COVID has doubled. 

Social care 

An increase for social care support from £205.8m this year to £828.3m in 2025-26, will mainly go to local government with an additional £376.5m added to its core settlement to increase adult social care staff pay to £12.60 per hour and support free personal nursing care. 

New within the 2025-26 budget is a dedicated £33m to develop the children’s social care workforce within the local government settlement. 

An additional £5m has been announced for voluntary sector short breaks for Scotland’s unpaid carers and to expand support for disabled people through the independent living fund. 

Meanwhile, Ms Robinson says £2.5m will be dedicated to delivering on the government’s Disability Equality Action Plan. 

Ms Robison told parliament that “substantial” financial pressures persist, but that fair pay across health and social care will be prioritised:

“In the face of a Tory cost-of-living crisis, I am proud that the pay deals give Scotland’s nurses and public sector workers higher salaries than the rest of the UK. 

“We’ll provide £4m for the hospice sector and, from 2025-26, we’ll align the support we provide for pay uplifts in the hospice sector to the outcomes of the NHS Agenda for Change negotiations. 

“This will ensure that hospices will get the additional funding that’s needed to see their health and care staff match pay increases with NHS staff.” 

However, she said that the UK government’s national insurance hike has “short-changed” Scotland. 

The Scottish government said this extra pressure is part of the reason why it has no plans to take forward a public health supplement on retailers, called for by doctors and alcohol support charities. 

Alcohol and drug policy will receive £80.9m in 2025-26 while the new budget dedicates £270.5m in total to mental health services. 

However, these represent small increases for both, with alcohol and drug policy seeing only £100,000 more than last year. 

Mental health funding is to rise by £3m in the 2025-26 budget, after mental health funding reduced by £18.8m in “difficult cuts” during this year. 

Innovation 

While digital health and care will see a £2.7m decrease in funding, the government says its budget ensures ‘enterprise and innovation are at the heart’ of its economic strategy. 

A pathway to accelerate the take-up of new health innovations within the NHS will have its budget increased, alongside other efforts to promote, develop and adopt innovative products and services. 

Health and Social Care Secretary Neil Gray said these funding measures will “drive forward” the government’s vision for people to live longer, healthier and fulfilling lives.

“The funding outlined will support NHS reform and our efforts to improve population health with a focus on prevention and early intervention.”  

He added that, if approved, the budget will “unlock investment” for long-term, lasting improvements.

Read more: “Difficult” budget cuts to health and care;  Watchdog: action needed now on NHS reform; “Huge alarm” at hospital discharge delays; Chief medic: Innovate to tackle health & planet crises; “Constructive talks” on doctors’ pay underway; NHS Scotland: waiting lists and beyond; Major shake-up in NHS service planning