Scotland to reduce health boards to two, minister says travel distances unchanged

Scotland’s health system is set to undergo a major restructuring, with the Scottish Government proposing to reduce the number of mainland health boards from the current 14 to just two. The plan, outlined in a draft policy paper released this week, aims to streamline administration, achieve cost savings and create a more integrated approach to service delivery across the country’s mainland regions. The proposed boards would each cover a broad geographic area, consolidating the responsibilities of the existing regional boards under a single executive structure.

The consultation, which runs until the end of October, has drawn comments from clinicians, local authorities and patient groups who question how the new arrangement would function in practice. Concerns focus on the potential loss of local accountability, the complexity of merging disparate IT systems, and the challenge of maintaining service continuity during the transition. The government has indicated that a phased implementation could begin as early as 2027, with detailed operational frameworks to be developed in partnership with NHS Scotland and other stakeholders.

If approved, the reorganisation would represent the most significant change to Scotland’s health governance in decades. The next stage involves a formal review of the consultation feedback, after which the Scottish Parliament is expected to debate the legislation required to enact the new board structure. Officials say the ultimate goal is to deliver a more efficient, patient‑centred health service, though the practicalities of achieving that outcome remain under scrutiny.