Scotland’s cherished National Health Service (NHS) is facing a period of reckoning, as new polling reveals overwhelming public concern about its future and a growing appetite for reform. According to research conducted by the Diffley Partnership for the think tank Enlighten, a staggering 93 percent of Scots believe the NHS needs either significant or moderate change. The poll, which surveyed 1,020 adults between October 5 and 15, 2025, arrives just ahead of a major conference in Edinburgh hosted by the Royal College of Physicians of Edinburgh (RCPE), Chest Heart & Stroke Scotland (CHSS), and Enlighten, drawing together politicians, medical leaders, and patient advocates for urgent talks on the health service’s future.
The numbers are sobering: 71 percent of respondents say the NHS is worse now than it was a decade ago, and 77 percent fear it will be even worse in another ten years if nothing changes. Perhaps most strikingly, while 88 percent of Scots want healthcare to remain free at the point of use—a core founding principle of the NHS—half now support a bigger role for private providers in delivering services. As the pressures mount, a national conversation is taking shape over what the NHS can realistically provide and how it should evolve.
Professor Andrew Elder, president of the RCPE, did not mince words in his assessment. “The college recognises that under the current funding envelope, it is not possible to continue providing everything that modern healthcare can now offer, from ‘cradle to grave,’” he said, as reported by The Scotsman. Elder called for a frank discussion about increasing public funding, or—if that proves impossible—making reasoned decisions about what can and cannot be provided via the public purse. “Policymakers cannot continue to pretend that the NHS can do everything for everybody all of the time, with no change in funding. This would only let down patients.”
The poll’s findings echo on the front lines. Chris Deerin, director of Enlighten and chair of the political panel at the conference, noted, “The people on the front line of delivering health and social care in Scotland are increasingly telling us that the system is unsustainable, often stretched beyond capacity and overly complex. We also know that the nation’s health is deteriorating, that inequalities are widening and that with an ageing population demand for health and social care services can only grow.” According to Deerin, the polling “shows that the users of the services see that too, and accept that the status quo is not an option.”
Jane-Claire Judson, chief executive of Chest Heart & Stroke Scotland, agreed that change is overdue. “People living with long-term health conditions are increasingly being left behind. The NHS itself is not irreparable; what’s unsustainable is our inability to create and implement the change needed to tackle current challenges. Real change must be rooted in humility and courage from Scotland’s political leaders and must be driven by the lived experiences of those who rely on our services,” Judson said, as quoted by The Scotsman.
The appetite for reform is not limited to the medical community. The poll found that 63 percent of Scots now view the current NHS model as unsustainable. While 29 percent would prefer to see the private sector’s role expanded, only 28 percent said they would pay more tax to fund healthcare, highlighting a split in public opinion over funding solutions. The desire for reform also extends to social care, with 88 percent saying that system needs change, yet only 42 percent of respondents report understanding how social care is funded and delivered.
The political stakes are high. Health Secretary Neil Gray, who attended the Edinburgh conference, emphasized the government’s commitment to the NHS’s founding principles. “This poll shows that 88 percent of people believe healthcare should be free and we will always protect the founding principles of the NHS—publicly owned and free at the point of need. That’s why we are investing a record £21.7 billion in health and social care this year, targeting areas with the longest waits, tackling backlogs, and ensuring patients get the care they need faster,” Gray stated, as reported by The Scotsman. He highlighted that over £110 million is being invested specifically to reduce long waits, with expectations to deliver more than 213,000 additional procedures and appointments over the year. Gray also pointed to recent successes, noting that the NHS performed a record number of hip and knee operations last year, and July 2025 saw the highest level of operations since February 2020.
Yet, for many, these efforts are not enough. Scottish Labour health spokeswoman Jackie Baillie delivered a scathing critique of the current administration, stating, “It’s no surprise people are worried about the state of our health service when one in six Scots are stuck on an NHS waiting list and getting a GP appointment feels like winning the lottery.” Public health spokesman for the Scottish Conservatives, Brian Whittle, added his own warning: “Without urgent action on preventative care and boosting GP numbers, Scotland’s NHS risks being overwhelmed.”
The conference itself brought together a spectrum of political voices, including Labour Deputy Leader Jackie Baillie, Lib Dem Leader Alex Cole-Hamilton, Patrick Harvie of the Scottish Greens, and Brian Whittle of the Conservatives. All were tasked with responding to Professor Elder’s challenge: to lead or contribute to a national conversation, with input from both the public and healthcare professionals, and to collaborate on meaningful reform.
The event’s organizers hope that this gathering will mark a turning point. As Deerin put it, “We hope that our conference today can provoke, inspire and encourage constructive debate around what reform to the NHS and social care might look like.” The conference’s timing could not be more urgent, given the relentless pressures facing the health service and the stark polling data showing public faith is faltering.
Behind the statistics, the real-world consequences are already being felt. The NHS is under greater pressure than ever before, with backlogs, long waiting lists, and an ageing population all contributing to rising demand. The vision of a “cradle to grave” NHS—once seen as a birthright—may no longer be possible without significant changes, whether through increased funding, a reimagined service model, or a greater role for private providers.
As Scotland’s leaders grapple with these choices, the message from both the public and professionals is clear: the time for difficult conversations has arrived, and the status quo is no longer an option. Whether through more funding, structural reform, or new partnerships, the future of Scotland’s NHS hangs in the balance.
