There is a lot to be celebrated in the Scottish Government’s spending commitments detailed yesterday regarding prevention and health creation. However, the lack of explicit reference to the third sector in commitments related to health and social care will likely receive a frosty reception from third sector health organisations and could undermine wider ambitions.
Firstly, the Scottish Budget 2026-27 and the 2026 Spending Review do contain a lot to be positive about. The shift to prevention and community-based care is well represented in narratives related to the reform of health and social care services. This includes explicit reference in the Spending Review to preventative budgeting approaches currently being piloted. There is also a commitment to increase investment in primary care, including £36 million to establish walk-in GP services in the 2026-27 Budget (although questions remain about how these will operate in practice, particularly how third sector services including Community Link Workers will be able to engage).
There are also some promising commitments related to the wider social determinants of health and causes of health inequality. For example, we were pleased to see planned investment of £20 million in third sector employability programmes to address child poverty. The commitments to increase funding for sport and physical activity for children and young people, as well as additional funding to support active travel, are also welcome given their role in supporting and empowering people to create health and connect with others in their community. In addition, Public Health Scotland appear to be receiving a healthy uplift in funding – a positive development given their focus on prevention, their partnership with the third sector, and their key role in implementing the Population Health Framework.
The third sector also receives some overt recognition in both the Budget and the Spending Review. The Spending Review states that:
‘The Third Sector is essential to communities across Scotland and the delivery of Scottish Government priorities and multi-year funding gives organisations the ability to plan for the future and make the most of their resources.’
In a similar vein, the Budget pledges that:
‘We will make progress on our commitment to fairer funding for the Third Sector and will continue to update and strengthen regulation to support charities in Scotland.’
Despite these positive reflections, one glaring oversight has left us feeling a bit lukewarm. The complete absence of any mention of the third sector in narrative related to health and social care spending is frustrating, particularly given its explicit reference in other portfolio areas. It is also a significant missed opportunity considering the vital contribution of the third sector to long-term ambitions around prevention and community-based care.
Together with colleagues in other third and community sector organisations, last week we published a follow up to last year’s Joint Statement on Prevention where we explore the ‘hard to do’ aspects of the shift to prevention. In this, we called for ‘courageous leadership’ and the need for greater power-sharing with community and third sector organisations. In the Budget and the Spending Review however, the Government appear to have reinforced the narrative that health spend is reserved for public sector bodies.
Responding to the Budget, Tejesh Mistry, VHS Chief Executive, stated that:
“Noticeable investment in creating health within our communities is extremely welcome in the latest Budget. The recognition that supporting and enabling people to be active, connected and able to access healthcare support when needed is crucial as we continue to advocate for the preventative work carried out by Voluntary Health Scotland members. Yet, when we reflect on the enormity of the challenges facing health and social care, we call for more focus to be placed on the role of the third sector for the wellbeing of communities and the health system as a whole.”
We are seeking urgent reassurance from the Government that third sector health organisations will be prioritised in health and care spending decisions going forward. The contribution of our members, and the wider sector, to Scotland’s health and wellbeing is far too important for them to be left out in the cold.
For more information about our key policy priorities, read our Manifesto for Health Creation. If you have any questions about this response, contact our Policy and Public Affairs Lead.
