John Swinney unveils plan to cut Scottish NHS boards from 14 to two and cap food prices

Structural NHS overhaul

First Minister John Swinney set out his Programme for Government to the Scottish Parliament on 1 September 2026, outlining a restructuring of public services. Under the headline healthcare reform, Scotland's 14 territorial NHS health boards will be replaced by two strategic health boards split across eastern and western regions. Preparatory work on the regional division began in November 2025, led by the chief executives of NHS Greater Glasgow and Clyde and NHS Lothian. Swinney stated that the reorganisation aims to ensure no patient waits longer than 26 weeks for treatment by the end of 2031. This target replaces earlier benchmarks, including a 2011 legal guarantee capping waits at 12 weeks, as waiting lists currently hold more than 770,000 patients.

This will be the most significant structural reform of the NHS in the era of devolution.

Backlash from unions and industry

Trade union leaders strongly objected to the health board consolidation immediately after the address. Unite warned that the plan will lead to job cuts across the public sector and stated that administrative mergers will not resolve staffing shortages or clinical workloads. Business organisations voiced separate objections to the government's published consultation on statutory food price ceilings. The proposed price cap targets between 20 and 50 basic grocery items, such as bread, milk, cheese, eggs, and rice. The restrictions apply only to retailers employing more than 250 staff with annual turnover exceeding £250 million, of which more than half comes from groceries. An open letter signed by 23 food, farming, and retail organisations stated that supply chain costs drive current prices and warned that statutory controls could raise overall household costs.

The proposals will inevitably result in swingeing cuts and thousands of job losses across the public sector. Our members will not be the collateral damage for the Scottish government's failings.

Public transport and social policy

The Programme for Government also introduced regional fare interventions and social legislation. Single bus fares will be capped at £2 across western Scotland from 7 September 2026, covering Glasgow, Renfrewshire, Ayrshire, Dunbartonshire, Lanarkshire, and Inverclyde. The scheme expands on an existing £2 bus cap in the Highlands and islands, forming part of a wider commitment to establish a nationwide flat fare before the end of the parliamentary term. On social policy, Swinney announced a misogyny bill aimed at addressing violence against women and girls, accompanied by an educational campaign targeted at young men. The government also confirmed plans to pilot a minimum basic income scheme for artists.

Fiscal pressures and civil service consolidation

Wider administrative changes include voluntary merger options for local councils, the consolidation of environmental quangos, and moving Transport Scotland directly into core government. These institutional changes arrive as official projections show a Scottish Government budget deficit of £5 billion by the end of the decade. The administration previously failed to meet targets to clear year-long NHS waits by March 2026, while accident and emergency four-hour turnaround targets have been missed continuously since July 2020. Swinney also published a draft bill on a future independence referendum alongside the policy package.