As Scotland’s political landscape braces for a pivotal year, First Minister John Swinney stands at the center of a storm swirling with questions about the National Health Service, immigration, and—inevitably—independence. With the Scottish National Party (SNP) convening for its 91st annual conference in Aberdeen, Swinney faces both internal and external pressures to define his government’s priorities and his own legacy, all while a general election looms just months away.
Speaking to BBC Scotland News on October 10, 2025, Swinney acknowledged a painful reality: "There is no shortcut to faster diagnosis and treatment in the NHS." As of June, about one in nine people in Scotland was on an NHS waiting list, a statistic that has become a rallying cry for both critics and campaigners. Swinney accepted that "some people have had to wait far too long" for care, citing the story of an eight-year-old girl whose surgery has been delayed by 18 months—an ordeal her mother says has robbed her of a normal life due to declining kidney function.
"I could totally accept the worry and anxiety caused by these circumstances," Swinney said, offering to personally look into the case. He insisted that the Scottish government is "working to expand capacity and increase operations," pointing to record numbers of hip and knee surgeries as evidence. But the numbers tell a more complicated story. The most recent Scottish social attitudes study, covering up to 2023, found that 69% of respondents felt NHS performance was deteriorating. The Royal College of Emergency Medicine, meanwhile, linked more than 800 deaths last year to long waits in accident and emergency departments.
"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 emphasized to the BBC. He highlighted efforts to improve patient flow through A&E and speed up hospital discharges. Yet, as winter approaches, the pressure on the health service is only set to intensify. Swinney told STV News that his government wants "accident emergency turnaround times much faster" and is working to reduce "delayed discharge," which clogs up the entire system.
But the NHS is just one front in a broader battle for public trust and political survival. Swinney’s leadership began in the shadow of turmoil: he took over as first minister after the rapid-fire resignations of Nicola Sturgeon and Humza Yousaf, inheriting a party mired in controversy over gender identity, environmental policy, and a police investigation into SNP finances. According to BBC News, Swinney quickly stabilized the party, calming the waters and shifting focus to "delivering improvements in public services." Allies describe his approach as "stop digging, get delivering." He points to policies like scrapping peak rail fares, reducing child poverty, and lifting the two-child limit on benefits as tangible progress.
Yet, opposition parties remain unconvinced. Labour, which briefly surged after winning a by-election earlier this year, insists Scotland can take a "new direction" under its leadership. The Conservatives argue for cuts in public spending, regulation, and taxation, hoping to distinguish themselves from both the SNP and Labour. Meanwhile, Reform UK’s rise has further fragmented the unionist vote, pushing the Conservatives into fourth place in recent polls.
Financial watchdogs have issued stark warnings about the sustainability of Scotland’s social spending. Persistent long NHS waits, cuts to college budgets, and the emergency release of prisoners from overcrowded jails have all been cited as evidence of government failure. Trust in the Scottish government has declined, as confirmed by the latest social attitudes surveys. Still, opinion polls in October 2025 show the SNP leading Labour by double digits, with Reform UK nipping at their heels.
Amid these domestic pressures, Swinney has also been drawn into the contentious debate over immigration and identity. In recent months, anti-immigration campaign groups have raised the Saltire—the Scottish flag—across the country as part of the UK-wide "Raise the Colours" protest, coinciding with demonstrations against housing asylum seekers in hotels. Counterprotests led by Stand Up To Racism have resulted in several arrests, and local authorities in Aberdeenshire and Falkirk have removed flags on safety grounds, with council staff facing abuse during removals.
In an interview with STV News, Swinney was unequivocal: "I’ve always felt the Saltire is a flag of welcome and inclusion in Scotland and that’s how I’ve always felt about it. I won’t have it redefined by anyone else." He disapproved of the flag’s use in anti-immigration movements, insisting, "The Saltire represents the coming together of people in Scotland." Swinney has repeatedly argued for a "positive approach" to migration, calling the UK debate "counterproductive and damaging." He told the BBC, "We have very low unemployment in Scotland today and our various sectors are short of people and we've got a working age population that is not large enough to support our economy and our 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."
As the SNP conference gets underway, independence remains the party’s central cause, even as public concerns have shifted toward the NHS, cost of living, and immigration. Swinney has published yet another government paper promising a "fresh start" for Scotland should it become independent. But the path to statehood is anything but clear. The UK Supreme Court has ruled that a future referendum would require Westminster’s consent, and Prime Minister Keir Starmer has made it clear he won’t enable a vote during his tenure.
At the conference, Swinney will argue that the "only uncontested route" to another referendum is for the SNP to win an overall majority of seats in the May 2026 Holyrood election. Some within the party advocate treating the election as a de facto referendum, but this approach lacks legitimacy in the eyes of Labour, the Conservatives, Liberal Democrats, and Reform UK, all of whom stress that elections are about more than just independence. Swinney’s team expects to win the internal debate, but by what margin remains to be seen.
The SNP’s challenge is to balance its independence message with the immediate concerns of voters. Recent surveys show that while independence is still popular with a sizable minority, it is not the top priority for most. The public’s focus has shifted to healthcare, living costs, and immigration—issues that demand immediate attention and practical solutions.
As the conference unfolds and the countdown to the general election continues, Swinney’s task is clear but daunting: deliver tangible improvements in public services, defend Scotland’s inclusive identity, and keep the independence flame burning—all while navigating the unpredictable currents of Scottish and UK politics. Whether he can put his own indelible stamp on the SNP and the country it seeks to lead remains the question on everyone’s mind.
