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\n At FMQs<\/a>, Mr Swinney was challenged by Scottish Labour<\/a> leader Michael Marra after BMA Scotland called on ministers to withdraw plans to slash the number of mainland health boards.\n<\/p>\n \n This came after Dr Nora Murray-Cavanagh, the new chair of BMA Scotland, said the proposal to replace 14 existing health boards with two strategic bodies would be costly and time-consuming, with \u201cno clear evidence\u201d that it would improve patient care.\n<\/p>\n \n She said doctors accepted that reform was necessary but described the Government\u2019s proposal as the \u201cwrong set of reforms\u201d, warning it could lead to a \u201ccostly, time consuming, resource-sapping reorganisation\u201d without sufficient engagement with staff.\n<\/p>\n \n In the Holyrood<\/a> chamber, the Scottish Labour leader told MSPs the intervention \u201cshould concern us all\u201d and accused the Government of pursuing rushed reforms which raised more questions than answers.\n<\/p>\n \n However, Mr Swinney pushed back against the BMA\u2019s assessment, saying: \u201cI\u2019ve seen the comments from the BMA this morning, and this morning I\u2019ve been engaged with clinicians in the Golden Jubilee Hospital who disagree fundamentally with the points made by the BMA.\u201d\n<\/p>\n \n He said there was an \u201cactive debate\u201d over the proposals and insisted ministers would continue to engage with health staff and other organisations as the plans were developed.\n<\/p>\n \n The First Minister said the wider public service reform programme was not set \u201cin tablets of stone\u201d, arguing the Government was attempting to determine which powers should sit at national, regional and community level.\n<\/p>\n \n The exchange then widened into a row over pensions and the UK Government<\/a>\u2019s plans to reform the state pension triple lock as part of proposals to fund a new National Care Service in England.\n<\/p>\n \n Mr Marra accused Mr Swinney of having \u201cmisrepresented\u201d the UK Government\u2019s position, stressing that pensions would continue to rise and arguing that Scotland could receive significant additional funding as a result of increased social care spending south of the border.\n<\/p>\n \n The Scottish Labour leader said: “We need considered honesty in this debate. That\u2019s what people deserve, and it\u2019s how we should proceed.\u201d\n<\/p>\n \n The current triple lock guarantees that the state pension rises each year by the highest of inflation, average earnings growth or 2.5%.\n<\/p>\n \n Under the proposed reforms from 2030-31, pensions would continue to rise by at least inflation or 2.5%, with a separate mechanism intended to ensure they keep pace with average earnings over the longer term.\n<\/p>\n \n However, Scottish Government analysis estimates pensioners north of the border could collectively receive around \u00a31.3 billion less a year by 2039-40<\/a> than they would if the existing triple lock continued indefinitely, rising to around \u00a34bn by 2049-50.\n<\/p>\n \n It said the latter figure was equivalent to a real-terms difference of almost \u00a32,000 per pensioner each year by 2049-50. The \u00a34bn figure is a Scottish Government<\/a> calculation based on Scotland\u2019s projected share of UK pensioners and UK-wide savings estimates, rather than a Scotland-specific estimate produced by the Department for Work and Pensions.\n<\/p>\n \n Mr Swinney repeated the \u00a32,000 figure at FMQs, telling Mr Marra: \u201cThe consequence of the changes announced by the Prime Minister on Tuesday will be that pensioners in Scotland will lose out on \u00a32,000 a year, and they will get no enhancement in the provisions proposed by the Prime Minister, because all of that money will be used to pay for social care in England.\u201d\n<\/p>\n \n The eventual financial impact on Scotland is not yet clear.\n<\/p>\n \n The Institute for Fiscal Studies told The Herald that Holyrood could receive \u00a31bn a year or more through the Barnett formula<\/a> once the English care system was fully established if the reforms resulted in increased UK Government departmental spending.\n<\/p>\n \n But the amount would depend heavily on how Westminster funded the policy. Scotland would not necessarily receive the same boost if money was found by reallocating existing departmental budgets, while income tax increases in England, Wales and Northern Ireland would have different implications because income tax is devolved in Scotland.\n<\/p>\n \n The pension argument resurfaced when Scottish Conservative leader Russell Findlay<\/a> challenged Mr Swinney over welfare spending and taxation.\n<\/p>\n \n Scottish Conservative leader Russell Findlay accused Mr Swinney of refusing to confront the pressure on Scotland\u2019s finances, arguing that if the First Minister would not cut benefits he would have to raise taxes. \u201cIt really is that simple,\u201d he told MSP\n<\/p>\n