Scotland’s First Minister has acknowledged there is no quick fix to the NHS crisis gripping Scotland, as latest figures reveal more than 800 deaths last year were believed to be linked to long accident and emergency waits.
John Swinney conceded that some people have had to wait far too long for treatment but insisted his government was working to expand capacity and increase operations to deliver progress across Scotland’s health service.
Speaking ahead of the Scottish National Party’s annual conference in Aberdeen, which runs from 11 to 13 October at The Event Complex Aberdeen, Swinney defended the government’s record whilst accepting the scale of challenges facing the NHS.
The First Minister’s comments come as the Royal College of Emergency Medicine revealed that 818 excess deaths were associated with stays of 12 hours or longer in Scottish A&E departments during 2024, representing a third more fatalities than the previous year.
The shocking figure, calculated using a standard mortality ratio which estimates one additional death for every 72 patients who experience an eight to 12-hour wait before admission, has been described as a national tragedy by medical professionals.
Dr Fiona Hunter, Vice President of RCEM Scotland, stated the deaths represented heartbreaking stories of mums, dads, brothers, sisters and grandparents whose losses have shattered families.
“These are patients who are sick and need further care on a ward, so they are forced to endure extreme wait times for an inpatient bed to become available,” Dr Hunter explained during a presentation at the College’s Future of Emergency Care event in Edinburgh last month.
The First Minister faces mounting pressure over NHS performance, with one in nine people in Scotland currently on an NHS waiting list. As of June 2025, approximately 840,000 Scots were awaiting treatment, tests or appointments.
The most recent Scottish social attitudes study, covering the period up to 2023, found that 69 per cent of respondents felt NHS performance was deteriorating. This represents the highest perception of declining standards since the survey began in 1999.
Only 23 per cent of people surveyed said they were satisfied with the way the NHS runs, down sharply from 64 per cent in 2019, marking the first year since 2005 where more people were dissatisfied than satisfied.
Swinney told journalists his government was focusing on reducing waiting times and ensuring more people receive treatment, pointing to recent data showing record numbers of operations being performed.
“What we are doing, what we are focusing on, is about doing all we can to reduce waiting times and make sure more people are being treated,” Swinney stated.
“The most recent data shows, for example, we’ve had record numbers of operations. We’ve had record numbers of hip and knee operations and these are some of the things people have had to wait quite a long time for.”
However, the First Minister was forced to confront a particularly distressing individual case involving an eight-year-old girl with a serious kidney condition who has been told to expect a 19-month wait for surgery.
The child’s mother told media outlets the delay meant her daughter could not live a normal life due to her declining kidney function, highlighting the human cost of extended waiting times across Scotland’s health service.
Swinney said he could “totally accept” the worry and anxiety caused by such circumstances and offered to personally investigate the case, demonstrating the political sensitivity surrounding NHS performance ahead of next year’s Holyrood election.
The First Minister emphasised there was no simple solution to the crisis, stating the Scottish Government needed to ensure proper patient flow through A&E departments and hospitals.
“There is no shortcut. We need to make sure we get a flow of patients into A&E, so they can get assessed quickly, so they are able to be released home,” Swinney explained.
“We have very high levels of patient discharge from hospital, we take all of these steps to make sure people receive care that they require.”
The comments came as Swinney sought to avoid industrial action by hospital doctors, who are preparing to ballot for strike action. He pledged the Scottish Government would work constructively with the British Medical Association to resolve the dispute.
During recent First Minister’s Questions, Swinney admitted people were waiting too long in accident and emergency departments, whether for four-hour, eight-hour or 12-hour waits, but pointed to July 2025 figures showing the lowest number of 12-hour waits of any month since September 2023.
The First Minister has consistently argued that many challenges in the NHS stem from the aftermath of the Covid pandemic, which left the health service struggling to recover from unprecedented pressures.
A record 76,510 patients waited 12 hours or more to be admitted, discharged or transferred from A&E in 2024, representing an increase of 20,432 people compared to the previous year.
Of those experiencing extreme waits, 58,906 were waiting to be admitted to a ward for further care, underlining the system-wide pressures affecting Scotland’s hospitals.
The Royal College of Emergency Medicine’s workforce census revealed concerning staffing shortages, with one whole-time equivalent consultant for every 4,692 attendances, below the recommended ratio of one consultant per 4,000 attendances.
The census found that 38 consultants and 10 specialist and associate specialist doctors plan to retire within the next five years, whilst rota gaps persist across emergency departments.
Dr Hunter warned that without government action, the cost would continue to be measured in lives, urging all political parties to adopt recommendations in the College’s manifesto ahead of the 2026 Scottish Parliament election.
Scottish Conservative shadow health secretary Dr Sandesh Gulhane accused SNP ministers of presiding over completely avoidable deaths resulting from chronic mismanagement of emergency care.
Scottish Labour leader Anas Sarwar has repeatedly challenged Swinney over NHS waiting times at First Minister’s Questions, accusing him of putting his party before patients and failing NHS staff every day.
The interview also saw Swinney address immigration policy, describing the UK debate as counterproductive and damaging. He called for a positive approach to help grow Scotland’s working age population.
“I think we have to have a rational and considered debate about migration because I can’t talk to a single business sector or area of activity in our country that doesn’t tell me they are short of people,” Swinney argued.
The First Minister pointed to very low unemployment in Scotland and said various sectors faced shortages, with the working age population insufficient to support the economy and activities.
“Scotland has always been a welcoming country, an inclusive country, that we bring people together, and that’s the type of Scotland I want to live in,” Swinney declared.
He said the nation should embrace migration and be proud of doing so, positioning himself against what he characterised as hostile UK government immigration policies.
The Scottish Government has announced additional investment of £200 million to further reduce waiting times, including the deployment of specialist frailty teams in every core A&E department.
Officials noted that the number of emergency medicine consultants in NHS Scotland has increased by 21 per cent over the past four years, though critics argue this has been insufficient to meet growing demand.
Scotland’s core A&E departments have consistently outperformed those in England and Wales over the past decade, according to government figures, though performance remains well below pre-pandemic levels.
The SNP conference in Aberdeen will provide a crucial platform for Swinney as he seeks to rebuild support ahead of next May’s Holyrood election, with polls suggesting the party faces significant challenges in retaining power.
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mage Credit:
John Swinney — portrait (cropped, 2016) by Scottish Government, licensed under CC BY 2.5
