Scottish Labour is prepared to make a “big judgment call” on restructuring the NHS, party leader Anas Sarwar has said.

Labour has long said it would scrap the 14 territorial health boards and replace them with three to cover the whole country, with resources diverted into frontline services.

Such a move – which Mr Sarwar has said is to cut down on middle and upper managers and slash bureaucracy – would likely require substantial redundancies for executives.

The second phase of how we reform our NHS is to reduce the bureaucracy in the management because we've got to make that big judgment call

Anas Sarwar

Speaking to the Press Association while campaigning in Glasgow on Sunday, Mr Sarwar said Labour would begin a “staged process” in the NHS if it wins on May 7.

The first stage would be the declaration of a “waiting times emergency” in the health service and buying up capacity in healthcare settings to alleviate pressure, before turning to restructuring of the NHS.

“The second phase of how we reform our NHS is to reduce the bureaucracy in the management because we’ve got to make that big judgment call,” he said.

“The idea right now that we need 50 boards, 14 territorial boards, six specialist boards and 30 integrated joint boards for a population of 5.5 million people – it’s an archaic system and doesn’t work.

“We have got to fix the NHS and make it fit for the future, and that should be the responsibility of government – yes to fix the immediate mess, but to build a better future for the National Health Service, and that’s exactly what we’ll do.”

Asked about the prospect of severance payments to senior managers, Mr Sarwar said: “If you’re asking me directly if I want fewer chief executives, fewer finance directors, fewer high-salaried people that aren’t clinicians, and instead use that money to have more nurses, more doctors and better treatment – yes, that’s exactly what I want.”

The Scottish Labour leader also continued his confident streak on Sunday, despite his party struggling in the polls.

Labour continues to battle with Reform UK for second place in most opinion polls, but Mr Sarwar has said he will prove people wrong.

Asked if he still believes he can buck the polls, he said: “Absolutely – because I think this is the record number of undecideds we’ve seen in an election campaign, probably in Scottish political history.

“What I’ve got to persuade people of in the next two weeks is, yes, we must reject the poison of Reform, yes, we must beat the SNP, but also, yes, we must change the outcomes for people in Scotland.

“If that’s what you want to do, there’s only one route to that change and that’s to vote for me and Scottish Labour.”

SNP candidate and social care minister Maree Todd said: “Labour’s manifesto and the IFS are clear that Anas Sarwar would cut NHS budgets by £1 billion, which would send progress in our NHS backwards with crippling cuts.

“John Swinney said he would drive improvements and we are now seeing that our plan is working.

“Waiting lists are falling, operation numbers are up and we have more GPs per head than anywhere else on these islands.

“We haven’t lost a single day to strikes in our NHS and we have GP walk-in centres springing up across the country – that’s exactly what you get from John Swinney’s reliable and trusted leadership.

“Anas Sarwar might want to cut our NHS to the bone, but the SNP will see our plan through that is delivering real progress for our NHS.”

Scottish Lib Dem leader Alex Cole-Hamilton said the scrapping of health boards would “do little” to help rural and island communities.

“Our NHS is in need of change with fairness at its heart after 19 years of SNP mismanagement but I disagree that these plans are the right way to go about it,” he said.

“Scrapping health boards will do little to deliver for island and rural communities, which are already feeling the damaging effects of centralisation under the SNP.

“Scottish Liberal Democrats have set out plans for a fair deal for rural healthcare, which would improve access to the range of services, treatments and diagnoses available locally.”

Scottish Tory health spokesman Dr Sandesh Gulhane said: “John Swinney’s failing SNP have let the health service fall into a state of permanent crisis.

“The public have lost all trust in the SNP implementing a proper plan to get our NHS back on track.

“Long waits for planned operations, cancer treatment, accident and emergency, and diagnostic tests have all skyrocketed in Scotland due to the SNP’s mismanagement.