NHS Tayside and NHS Fife would be scrapped and folded into a super health board based in Edinburgh or Aberdeen under a Scottish Labour plan to save the health service.
The move – bound to spark controversy and scrutiny – was confirmed by Anas Sarwar in his keynote speech to the party conference in Glasgow.
He criticised the current health service bureaucracy, saying his plan would cut the number of “pen pushers”.
The Scottish Labour leader accused the SNP of “failing to ensure the NHS was fit for the future”.
“Right now we have 50 health boards for a population of five and a half million people and they are not incentivised to clear their backlogs.
And because of our bureaucratic and archaic structures, in many cases patients are forced to wait for longer in their own health board area even when there is capacity in other parts of the country.”
He said that, if elected next year, his party would ensure patients are seen based on “need” and not an “outdated postcode lottery”.
This would include axing the current regional health boards such as NHS Fife or NHS Tayside, and folding them into three covering the north, south, and west of the country.
‘We will put patients first’
The party is yet to set out which of the three Tayside and Fife would fall under.
Mr Sarwar added: “Instead of a system that puts health boards and their managers first, we will put patients first.
“Health boards will only be paid when they deliver the care people need.
“Under our plans, the money will follow the patient.
“And conference, to deal with this national emergency we will use capacity wherever it is – even if it means travelling to other parts of the country or using private sector capacity to save lives.”
Mr Sarwar said his plan would “push power away from the boardrooms”, but it is likely to prove controversial.
Rather than being run locally, it could see NHS bosses based in Aberdeen making decisions about health care provision in Tayside.
Forcing people to travel to other parts of the Scotland for treatment, rather than receiving it at their local hospital, may also prove unpopular.
Scottish Labour’s other health care pledges for the 2026 Holyrood election include a promise that Scots will be able to see a GP within 48 hours.
He also branded First Minister John Swinney as “analogue John”, saying some parts of the NHS in Scotland were using outdated technology like fax machines.
SNP depute leader Keith Brown branded Mr Sarwar’s conference speech as “lacklustre”.
He said:Â “His speech would have benefitted from an apology for the litany of broken promises he and Keir Starmer used to get elected – to the workers at Grangemouth, to households struggling with energy bills, to the pensioners who have had their winter hearing support cut, and to the Waspi women that Labour betrayed.
“Labour under Anas Sarwar and Keir Starmer are in complete disarray – breaking promise after promise and seeing their support plummet as polls suggest they are locked in a battle for second place with Nigel Farage.
“It is no wonder the sharks are beginning to circle around the Labour leader.”
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