Exclusive:John Swinney told to use 'every lever' to protect NHS and care sector from incoming 'catastrophe'

The Scottish Government has roundly criticised the UK government’s immigration white paper, which includes a proposal to end the social care visa route for new applicants from abroad.

And a union chief is now raising fears the controversial strategy will decimate the care sector in Scotland and add to pressure on the NHS, as the Labour government vows to reduce total immigration.

Unison has held talks with the First Minister about the situation and has now called on Mr Swinney for his Government to bring forward action.

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In a letter to Mr Swinney, seen by The Scotsman, Unison Scotland lead organiser for health-bargaining, Matt McLaughlin, has warned Sir Keir Starmer’s plans will likely “have a direct impact on NHS Scotland and our members working in the NHS and private healthcare/social care settings”.

Mr McLaughlin said he shared Mr Swinney’s view that “in a depopulating and aging Scotland, immigration is not only positive, but it is essential if we are to meet our shared desire to live in a Scotland with high-quality public services”.

The union chief said “we must, without doubt come together as a civic society to press against the elements of the white paper that will damage our public services and economic growth”.

But Mr McLaughlin stressed the Scottish Government “must also use every lever it currently has available to mitigate against what is broadly being described as a ‘catastrophe’ for the health and social care sector”.

The Unison chief said: “If we accept that these measures will be catastrophic – particularly for social care - NHS Scotland must rapidly develop a meaningful contingency plan to deal with anticipated further staffing shortages in social care. For the avoidance of doubt, this should include additional funded beds, bed space, staffing resources.

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“Existing proposals to reform and renew the NHS in Scotland should be rapidly reviewed to ensure that they are able to flex and meet the potential challenges of a revised approach to immigration across the UK.”

The letter has emerged less than 48 hours after it was revealed the number of Scots facing two-year waits for outpatient appointments had reached the highest level on record.

In a sign of the ongoing pressures on the NHS, there were 5,262 waits which had exceeded two years at the end of March, up by 3,930 from the same point last year.

Public Health Scotland also released figures on Tuesday for diagnostic waiting times which cover eight key tests, including endoscopy, colonoscopy, CT scans, MRI scans and non-obstetric ultrasound. The total waiting list size for these stood at 142,747 at the end of March, up by 7 per cent from the previous quarter.

Mr Swinney used his Programme for Government earlier this month to pledge to deliver 150,000 extra appointments and procedures before next year’s election, and give 100,000 patients a GP appointment, focusing on high blood pressure, high cholesterol, high blood sugar, obesity and smoking, by March.

But Mr McLaughlin has called on the First Minister to go further and “rapidly agree a core, funded, staffing model right across the sector, which we can flex to meet anticipated pressures”.

He said: “We believe that government should go further and commit to a higher wage economy in health and social care and so we should commit now to a £16 per hour minimum wage for the NHS.”

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The Unison leader has tabled a host of medium-term asks including a “genuine commitment to a policy provision that facilitates staff to work longer in our NHS”.

He has warned Mr Swinney that “working in the NHS is not the attraction it once was”, adding “the work is physically, mentally and emotionally demanding”.

Mr McLaughlin added: “The NHS in Scotland needs to get better at promoting itself in the labour market.”

The British Medical Association has previously criticised Mr Swinney’s existing strategy, warning the extra capacity was “a drop in the ocean” compared to the 650,000 GP appointments every week in Scotland.

The Scottish Government has been contacted for comment on the Unison letter.