Radical changes to health and social care must not be developed behind closed doors

Read the ALLIANCE's response to the Programme for Government announced today.

Speaking after the Scottish Government announced a major shake-up to reduce the number of health boards from 14 to 2 in Scotland, Sara Redmond, Chief Officer at the Health and Social Care Alliance Scotland (the ALLIANCE), (1) said any re-structuring will only be successful if it delivers meaningful reform for a system already under pressure.

She said: “We recognise the pressures facing public finances, but there are also very real pressures affecting people’s health and wellbeing. Scotland cannot simply cut or reshape services without fully understanding the impact on people and communities.

“Public service reform will only succeed if it is built around prevention, meaningful partnership with the third sector and the experiences of those who rely on support and services every day.

“At this stage it is unclear how the proposal to merge existing NHS Boards into two ‘superboards’ will deliver on these ambitions. But long-overdue changes to culture, service design and funding arrangements cannot take a back seat to tinkering with organisational structures, simply in pursuit of savings.”

She added: “We will be engaging closely with proposals to reform local government and the delivery of social care, which must be underpinned by genuine, meaningful consultation and co-design with people and the third sector, rather than agreed behind closed doors.

“People across Scotland are already telling the ALLIANCE and our members that the system is difficult to navigate, too often fails to meet their needs and can leave them feeling overlooked. The measure of success will not be how services are organised, but whether people truly experience better care, better support and better outcomes.”

The ALLIANCE is the national third sector membership organisation for the health and social care sector, representing over 3,500 members.

Its manifesto for the 2026 Scottish Parliament election (3) called for investment in prevention work, fair and sustainable funding for the third sector, a Human Rights Bill, and improvements in social care.

Notes to editors

1. The Health and Social Care Alliance Scotland (the ALLIANCE) is the national third sector membership organisation for the health and social care sector. We bring together over 3,500 people and organisations dedicated to achieving our vision of a Scotland where everyone has a strong voice and enjoys the right to live well, with dignity and respect. Our members are essential in creating a society in which we all can thrive, and we believe that by working together, our voice is stronger.
2. The ALLIANCE and our members set out our key priorities in our manifesto for the election, ‘Our Collective Voice’. (3) Amongst the issues the ALLIANCE has called for rapid progress on are: 

• Strengthening human rights in Scotland through a Human Rights Bill to ensure a Scotland where everyone can live with dignity.
• Securing fair and sustainable funding for the essential work of third sector organisations, and recognition as equal partners in service design and delivery.
• Improvements in standards, quality and consistency of social care (4) to allow people to live independently where possible, and improve their quality of life.
• Investing in prevention work, including improving the lives of those people living with long term health and mental health conditions (5), supporting people to realise their right to health and preventing them from reaching crisis point. 

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