Health / NHS chief warns of ‘difficult choices’ ahead

The health board is ‘working hard to do all we can’ to reduce a projected year-end £4 million overspend

NHS Shetland chief executive Michael Dickson. Photo: Chris Cope/Shetland News

NHS Shetland will have to make some “difficult choices” which may impact service delivery as it continues to grapple with a financial deficit.

That was the warning from chief executive Michael Dickson this week.

In September it was revealed that the health board, which is funded by the Scottish Government, was projecting a £4 million overspend for the 2022/23 financial year if nothing was done to cut the deficit.

There was a warning that the government may have to provide a brokerage loan to balance the books, which would need to be repaid.

So far in the financial year there is an overspend of around £2.7 million.

In a Facebook livestream broadcast this week Dickson explained that Scottish health boards are given funding ‘per capita’ – based on the population number.

He said the finances this year are a “particular challenge”, pointing to rising cost pressures as well as “chaos” in Westminster which is affecting Scottish budget-setting.


Dickson said the health board is doing all it can to reduce the deficit, “but it’s a lot of hard work”.

He mentioned temporary locum staff, who come at an increased cost and are the main cause of overspends.

But Dickson said they are “integral” to services in a setting like Shetland, where recruitment can be difficult.

“This is not going to be an easy year, and I have no easy solutions,” he said. “But I’m not expecting the next couple of years equally to be any easier.”

Referring to new prime minister Rishi Sunak saying the UK Government will have to make some difficult financial decisions, Dickson continued:

“I am very clear; it is certain that we will have to make similar difficult choices in how and the ways that we deliver services over the coming years.

“And yes, that may well impact on what we’re able to do in Shetland.

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“I haven’t got a perfect plan on how we’re going to navigate this – this is going to be difficult; this is going to be a difficult few years, and that will impact on you.

“All I can say is that we will continue to do all that we can in terms of delivering the best services we can with everything that we have. We just simply don’t know what those finances look like in the coming years.”

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