Lib Dem challenges Scottish ministers to make emergency care ‘fit for purpose’

SNP ministers must be “squarely focused” on improving emergency care as winter approaches, Scottish Liberal Democrat health spokesman Adam Harley has insisted.

He made the plea in the wake of recent figures showing the number of patients who waited longer than the four-hour target time in Scotland’s accident and emergency wards had reached its highest monthly total.

Official figures for August showed that 50,747 patients took longer than this to be either admitted, transferred or discharged.

And while the Scottish Government announced details of its winter preparations for the NHS, Mr Harley was clear that “right now the system simply isn’t working as it should”.

Speaking at the Scottish Liberal Democrat conference in Edinburgh, the MSP said: “Doctors say they are terrified of what this winter might bring, and so the government needs to be squarely focused on making sure emergency care is fit for purpose today.”

Mr Harley continued: “If we ask patients what they want, the answer is quite simple. They want to call an ambulance and know it will arrive quickly. They want to turn up at A&E and not be left waiting for hours on end. They want to have an operation that they might have been waiting weeks or months or years for.

“NHS staff want something pretty straightforward too. They want to provide good quality care, to finish their shifts when they are supposed to finish them and go home in the knowledge that patients have received the care they need.”

While he said these principles should be at the heart of NHS reform, he raised concerns about plans announced by First Minister John Swinney to cut the number of regional health boards in Scotland from 14 to two.

Ministers use these plans as a “convenient answer to every single question on workforce shortages, long waiting lists, and NHS staff stretched to breaking point”, the Lib Dem claimed.

But he told the conference he was “deeply sceptical” about what he insisted was a “major centralisation” of health services.

“As Liberal Democrats we believe that decision-making should sit as close as possible to local communities,” Mr Harley added.

“That particularly matters in remote and rural and island communities who already feel really far removed from decisions as it is.”

The Liberal Democrat went on to call for the further roll out of safer drugs consumption rooms throughout Scotland, saying this could provide “life-saving support” in the midst of Scotland’s drugs deaths crisis.

The number of people in Scotland killed by drugs rose to 1,133 in 2025, with the country continuing to have the highest drugs death rate in Europe.

While the Scottish Government has outlined efforts to try to tackle this, Mr Harley said: “We’re now five years into the mission to tackle the drugs deaths crisis and it has taken a tragic turn for the worse.”

As a result he insisted the roll out of safer drug consumption rooms is needed “across Scotland, not just in Glasgow, so that people at the greatest risk can have life-saving support, because we need to stop people dying”.

But he also stressed the need to provide people with help to “turn their lives around” with the MSP saying: “That means ensuring also people have access to life-changing rehabilitation services, so they have the opportunity and support to rebuild their lives.”

The Liberal Democrat also used his speech to criticise the Scottish Government for dropping plans for legislation to better support neurodivergent people and those with learning disabilities.

Mr Harley accused the government of “turning a blind eye to the needs of neurodivergent people” and added: “That’s the sort of thing that leaves people feeling totally scunnered with politics, and I really don’t blame them.”

A Scottish Government spokesperson said: “The Scottish Government is committed to improving A&E performance, delayed discharge and tackling long delays.

“Our dedicated health and social care staff are the cornerstone of our winter response every year. They show great resilience and determination to meet pressures on our healthcare system – which are not unique to Scotland – head on and we remain focused on ensuring people get the care they need, as quickly as possible.

“Health Secretary Angela Constance is clear that the status quo cannot continue and reform and improvement is needed across the whole system, which is why she published a new national plan in August to improve the flow of patients through hospitals.

“The Health Secretary set out a further range of winter planning measures that we have been working on with NHS boards and local authorities in a statement to Parliament earlier this week.

“Our plans for NHS reform will simplify how people get the care they need and remove the current geographic and bureaucratic barriers that exist between 14 health boards, which we know are currently causing unwanted variation and duplication.”