Bosses at the health board aim to get rid of 1,300 posts to plug the hole in its finances, official papers revealed.
They say they can do that over several years through “natural staff turnover”, but it is feared cuts to backroom staffing will have an impact on patients.
The decision to shrink the workforce comes as the board benefits from having at least £62 million of debt written off by the Scottish Government.
The plans are revealed in an assurance report to the board from September.
It said there was an “acceptance that staff levels need to reduce by 10%”.
Gillian Murray, who has been campaigning for better mental health services after failings in the care of her late uncle, said the decision shows that “balancing the books obviously means more to them than saving lives”.
“People in Dundee are dying because NHS Tayside is a shambles and to cut the workforce is another slap in the face for all of us,” she added.
Murdo Fraser, the Conservative MSP in Perthshire, said: “Local people will be wondering what impact these massive reductions in staff will have on their already pressured services.”
Annie Ingram, NHS Tayside director of workforce, said no one will lose their job but said spending on the workforce is higher than health boards of a similar size.
She added: “We are carrying out a review of staff numbers, grades and skills, which is being carried out in partnership with our staff and our trades unions, to ensure we have a safe, affordable and sustainable workforce.”
The NHS in Scotland is not financially sustainable and its performance has continued to decline, the public spending watchdog has warned.
Audit Scotland said health boards were “struggling to break even” and none had met all of the key national targets – with NHS Lothian not meeting any.
It highlighted increasing demand on NHS services, and rising waiting lists.
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
But the watchdog’s report prompted widespread criticism of the Scottish government, with the Conservatives claiming it should “make shameful reading for the SNP”.
The report said pressure is building in several areas – including the recruitment and retention of staff, rising drug costs, Brexit and a significant maintenance backlog.
It said “decisive action” was needed to protect the “vital and valued service”.‘
What does the report say?
The report warned that the NHS in Scotland is “not in a financially sustainable position”, with NHS boards “struggling to break even, relying increasingly on Scottish government loans and one-off savings”.
And it said the “declining performance against national standards indicates the stress NHS boards are under”.
The only target met nationally in 2017/18 was for drugs and patients to be seen within three weeks.
Only three of Scotland’s regional health boards met the target for patients beginning cancer treatment within 62 days of being referred
The proportion of youngsters seen by CAMHS within 18 weeks fell from 83.6% in 2016/17 to 71.2% in 2017/18.
The Scottish government invested £13.1bn in NHS services last year, but Audit Scotland said when inflation was taken into account there was a 0.2% real terms drop in cash.
Health boards made “unprecedented” savings of £449.1m, but many relied heavily on one-off savings for this, while three boards – NHS Ayrshire and Arran, NHS Highland and NHS Tayside – needed £50.7 million of loan funding from the government to break even.
This was “significantly more” than in previous years, with Audit Scotland saying four boards have predicted they will need a combined total of £70.9m in this current financial year.
The report said the “NHS is managing to maintain the overall quality of care, but it is coming under increasing pressure”, adding Brexit would create “additional challenges” for the health service.
However the scale of these challenges was “difficult to assess” because of “significant uncertainty” over the terms of the UK’s withdrawal deal from the European Union, and because data on workforce nationality is not routinely collected.
Auditor General Caroline Gardner said: “The performance of the NHS continues to decline, while demands on the service from Scotland’s ageing population are growing.
“The solutions lie in changing how healthcare is accessed and delivered, but progress is too slow.”
What has the Scottish government said in response?
Health Secretary Jeane Freeman said the government was already taking forward Audit Scotland’s recommendations.
She said NHS funding had reached “record levels of more than £13bn this year, supporting substantial increases in frontline NHS staffing, as well as increases in patient satisfaction, reductions in mortality rates, falls in healthcare associated infections, and Scotland’s A&E performance has been the best across the UK for more than three years.”
She added: “While our NHS faces challenges, common with health systems across the world, we are implementing a new waiting times improvement plan to direct £850m of investment over the next three years to deliver substantial and sustainable improvements to performance, and significantly improve the experience of patients waiting to be seen or treated.
“Ultimately we want to ensure people can continue to look forward to a healthier future with access to a health and social care system that continues to deliver the world-class compassionate care Scotland is known for.”
What other reaction has there been?
Conservative health spokesman Miles Briggs claimed the NHS was “facing an unprecedented challenge” with boards across the country “staring into a black hole of more than £130m.
He said: “For a government which has been in charge for more than 11 years, this should make shameful reading for the SNP.”
Labour’s Monica Lennon added: “After more than a decade of SNP complacency our NHS is in crisis.”
Dr Lewis Morrison, chairman of the British Medical Association (BMA) in Scotland, said the “stark warning” from Audit Scotland “could not be any blunter”.
But he added this would “come as no surprise to frontline doctors who have faced the consequences of inadequate funding year after year”.
And RCN Scotland director Theresa Fyffe said the report “underlines what those in the nursing profession have been warning about for a number of years – an unsustainable pressure on staff to deliver more care.
“This leads to staff burnout and, in some cases, a choice between staying in the profession and their own health.”
A WEST of Scotland MSP has called for improved access to mental health services, particularly among young people
To mark World Mental Health Day last week, Labour’s Mary Fee lodged a motion at the Scottish Parliament calling for greater support for people who need help with their mental health.
Ms Fee’s motion says every individual who experiences poor mental health should have access to well-funded and adequately resourced support services within their local communities.
It is estimated that one in four people in Scotland suffer from poor mental health.
This year’s annual theme for World Mental Health Day, that took place on October 10, is young people.
Research conducted by Stonewall Scotland in 2017 found that 58 per cent of lesbian, gay or bisexual pupils and 96 percent of transgender pupils have deliberately harmed themselves.
Ms Fee said: “It is important that politicians, public servants and public bodies help to raise the profile of mental health.
“I believe that in order to break the stigma around mental health we must widen the conversation and deepen our knowledge and understanding of the range of mental health issues that people may experience throughout their lives.
“I am unequivocal in my belief that mental health should be treated with the same priority as physical health.
“It is a scandal that nearly one-third of young people are waiting longer than 18 weeks for vital mental health treatment. It is simply unacceptable.”
In marking the 70th anniversary of the NHS, Scottish Labour outlined a 10-point plan in which they pledged to provide access to a mental health counsellor for every school pupil in Scotland and improve the access to crisis mental health services.
The Scottish Government has since promised to invest in extra mental health services in schools, though Ms Fee warned that any dilution of the pledge will cause greater difficulties for children and young people accessing much needed treatment and support.
Clydebank MSP Gil Paterson added:“Most families will have known of someone with a mental health problem who has kept it hidden.
“The Scottish Government have done a lot of work on raising awareness of mental health and tackling the stigma associated with it.
“This work has resulted in a lot more people coming forward for treatment and the Government recognises that this puts added demands on the service, which is why the SNP Government has allocated an extra £250 million for mental health services, which includes £60m for schools to support 350 counsellors and 250 extra school nurses so that every secondary school will have a counselling service.
“I have asked a series of questions at the parliament about exactly what has been done to support mental health services in the past and the Post will be first to know when I get the answers.”
Drug use to tackle mental health conditions in Tayside and Fife has rocketed by nearly two-thirds, it has been revealed.
NHS Tayside has increased its use of anti-depressants by more than 73% since 2007/8, while treatments for psychosis and related disorders have risen by 42%.
Pharmacies under the health board handed out nearly twice as much dementia medication, an extra 95%, and there was also an increase in the number of doses used to treat ADHD of nearly 175%.
NHS Fife recorded a slower rise in every treatment type except anti-depressants, where there was an increase of more than 90%. However, it experienced an overall rise of nearly 65%.
Only hypnotics doses decreased, with a drop of nearly 11% for Tayside and just over 2% for Fife. NHS Tayside, which paid out nearly £9.5 million for mental health drugs last year, an increase of more than 37% on 2016/17, insisted drug therapy can be important to recovery.
A spokeswoman said: “Increased levels of identification and diagnosis of mental health conditions, including dementia, means that more patients are accessing important treatments that can improve quality of life.”
TWO women bereaved by suicide have forged a bond as they fight for changes to health services to better protect vulnerable patients.
Karen McKeown and Gillian Murray met after the Sunday Post told how Karen’s partner took his own life despite repeatedly asking for help.
Luke Henderson died on December 29, 2017 after eight attempts to get help from NHS Lanarkshire in less than a week.
Gillian Murray’s uncle David Ramsay also took his own life two years ago today, after he was told to go for a walk and pull himself together by medical staff at NHS Tayside.
He had been rejected for treatment twice at the psychiatric unit at Ninewells hospital in Dundee, where an inquiry is under way into a series of serious concerns. Both Luke and David’s cases were raised in the Scottish Parliament by MSPs, and Karen met the mental health minister Clare Haughey on Thursday, although says she left feeling disappointed.
The mum-of-two said: “I appreciate that the minister listened to me, but that is really all she did. I don’t want sympathy, I want action, answers. Smiling and nodding your head just isn’t good enough.”
Karen was joined by MSP Monica Lennon during the 30-minute session.
The MSP has vowed to continue to push for answers on Luke’s case and both Karen, from Motherwell, and Gillian will campaign to demand a national inquiry to help establish stronger safeguards for vulnerable, potentially suicidal patients.
Karen and Gillian think the Tayside inquiry should be extended to cover the whole of Scotland.
Karen said: “This isn’t just happening in one place. Gillian and I are covered by two health boards and very similar problems happened with our relatives.”
Gillian added: “I know there are problems happening all over Scotland, that’s why we want an inquiry nationally.”
The Scottish Government said: “The tragic death of Ms McKeown’s partner is currently under investigation by NHS Lanarkshire. A key action in our new suicide prevention plan is to ensure we learn from every death by suicide and ensure lessons are acted on.”
Since I spoke out about what happened to Luke, I couldn’t believe the number of people who sent me messages saying they had similar experiences. One of them was Gillian, and her uncle David’s case was just so similar to Luke’s.
It looked as if he was experiencing psychosis, the same as Luke was.
The whole family didn’t seem to be believed by doctors, who said David was showing no signs of suicidal ideation. That is the exact same thing they said about Luke.
They told me Luke was ‘forward planning’ because he was saying he was looking forward to Christmas – two days away.”
People are dying, and it can’t keep happening. Karen has been through what nobody should have to.
Her partner killed himself in their home, even though she tried to get him help. Their children have to grow up without a dad. Nobody should have to suffer like this, and Luke should never have suffered either. He should have been given help, just like David should have been.
How many more people have to live like this, or die before the NHS will sit up and listen?”