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<\/p>\nInvisible and anonymous \u2014 two words that have been used this winter to describe Caroline Lamb, the head of the Scottish NHS.<\/p>\n
Despite appalling waiting times, a flu spike that is pushing hospitals further into crisis and doctors planning to strike, Lamb has rarely been seen, according to staff.<\/p>\n
\u201cI would estimate less than 1 per cent of the NHS workers could tell you who is the chief executive,\u201d Andrew Buist, a GP who recently led the British Medical Association Scotland\u2019s GP committee, said. A frontline union representative said: \u201cWe do not see much of her or other senior people.\u201d In August, The Scottish Sun reported that Lamb had not visited a single hospital for more than a year.<\/p>\n
Lamb, who trained as a chartered accountant, was appointed to the top post in January 2021 and has a salary of more than \u00a3200,000.<\/p>\n
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Elizabeth II presented the George Cross to representatives of the NHS, including Lamb and Eleanor Grant, a palliative care nurse, in July 2022<\/p>\n
AARON CHOWN\/PA<\/p>\n
Since then, waits for planned treatment have soared. This summer, Scottish Labour figures showed that waits of more than two years were 800 times more common in Scotland than in England.<\/p>\n
Tech advances have also been slow. The blurb on Lamb\u2019s Scottish government web page says that advancing use of digital technologies is one of her main priorities, and she led the Scottish government\u2019s digital health and care directorate before her promotion. But although patients in England have had access for six years to an NHS app to manage appointments, test results and conditions, in Scotland the first iteration of the platform has only just gone live \u2014 to dermatology patients in Lanarkshire \u2014 and a full roll-out is not expected until 2030<\/a>.<\/p>\n The Covid-19 recovery plan published during Lamb\u2019s first summer in charge bears little resemblance to what has happened. Plans to open 11 new treatment centres are in disarray and hospital activity, which were supposed to exceed that of 2019 by 10 per cent, still lag behind.<\/p>\n The atmosphere at the top, one union figure said, was one of lethargy. \u201cI think she and her team are happy with the status quo because that is the easiest place to be,\u201d a seasoned NHS operator said. \u201cEven if you did [have the vision to accelerate improvement], why would you when you cannot change the mind of government ministers.\u201d<\/p>\n Another political insider noted a weariness in the civil service about suggestions of any reform that might rattle a special adviser to the SNP<\/a>. Those in charge, they said, had little choice but to \u201cmanage decline\u201d.<\/p>\n Lamb with Michael Matheson, then the Scottish health secretary, in 2023<\/p>\n ALAMY<\/p>\n If there was one top priority, they added, it was staff pay. Strikes by doctors and nurses over salary have been avoided in Scotland, and nurses have been given the best pay deal in the UK. However, those leading unions and professional bodies north of the border have said their relationship with the Scottish government is at an all-time low.<\/p>\n In November, an announcement about new regional working arrangements, designed to encourage health boards into better collaboration, provoked anger among staff as days of rumour and denial were followed by an invitation to a meeting at the 11th hour. Somehow the Scottish government has ceded to pay demands \u2014 inflating the salary bill with the inevitable opportunity cost elsewhere \u2014 and still annoyed the workforce.<\/p>\n The spending watchdog Audit Scotland summed up the situation in its 2025 report on performance: \u201cThe NHS in Scotland<\/a> has not improved in line with commitments made by the Scottish government, despite having more staff and more money.\u201d<\/p>\n Some say Lamb\u2019s job is simply impossible. The budget will never stretch to meet need and her political masters are interested only in saying they are better than England and better than they have been before. Taking tough decisions to lead the health service out of the quagmire would, they suggest, be an uphill struggle for anyone.<\/p>\n Lamb at the UK Covid-19 inquiry<\/p>\n UK COVID-19 INQUIRY\/PA<\/p>\n Those who have met Lamb regularly describe a \u201cpretty constructive\u201d and honest relationship. Karen Titchener, the new patient safety commissioner appointed by the Scottish parliament this year, said: \u201cWe have good leadership in Caroline Lamb and [the Scottish health secretary] Neil Gray<\/a>. I think they are aware how terrible things are out there. I really do think they want the best \u2014 it is just a question of how does the system support that?\u201d<\/p>\n She noted that governance, following through commitments and accountability for delivery all needed improvement.<\/p>\n From the outside, it is hard to tell why Gray did not announce the \u00a320 million to boost winter capacity until mid-November. Had planning really been left so late, or was this moment in Holyrood just political window dressing focused on scoring party points rather than managing healthcare?<\/p>\n![\"Scottish](\"https:\/\/www.newsbeep.com\/au\/wp-content\/uploads\/2025\/12\/\/018505ee-cfee-48fd-ac70-45d88412fb76.jpg\")
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