2nd September 2026
There is one number that is beginning to dominate the argument about John Swinney's plans for reforming Scotland's public services.
20,000.
That is the number being used by Scotland's largest trade union body, the STUC, when warning about the possible loss of public-sector jobs over the next few years.
It is a big number.
But it is also a number that needs some explanation.
Because the Scottish Government has not announced that 20,000 people are going to be made redundant.
Nor has it announced that 20,000 NHS jobs are going to disappear.
What has happened is rather more complicated, and potentially much more interesting.
The Scottish Government had already committed to reducing the devolved public-sector workforce by around 0.5% a year. The Government estimated that this could amount to roughly 11,000 full-time-equivalent posts by 2029-30. The expectation was that much of the reduction would come through people retiring, staff leaving and not being replaced, tighter recruitment and changes to the way services are delivered. Compulsory redundancies were described as a last resort.
Then came the bigger calculation.
If frontline health and social-care employment is protected because Scotland's ageing population means more people will need those services, where do the reductions have to come from?
That is where the Institute for Public Policy Research's Scottish analysis produced the much larger figure of around 20,000 jobs outside protected areas of public services. Its argument was essentially that a relatively small reduction in the overall public-sector workforce becomes a much larger reduction in those parts of the public sector where staffing is actually allowed to fall.
Now Swinney has added another piece to the jigsaw.
Scotland's 14 territorial health boards are to be replaced by two Strategic Health Boards.
That is an enormous structural change.
The Government says the purpose is to simplify the NHS, reduce duplication, make better use of resources and free up capacity for patient care.
The political argument will quickly become whether this is really a reform of the health service or a cost-cutting exercise dressed up as reform.
The answer is probably somewhere in between.
There is undoubtedly duplication within a system containing 14 territorial boards. There are chief executives, senior management teams, finance departments, human resources, procurement, IT, communications, estates and other corporate functions spread across the country.
If you merge organisations, some of those functions can be combined.
That is not particularly controversial. Any private company that merged 14 regional businesses into two would expect to find savings.
The difficult question is how much.
And that is where the public needs much more information.
If the Government says the purpose is to make the NHS more efficient, it should be able to tell us how much money it expects to save.
How many senior posts will disappear?
How many administrative posts?
How many buildings will no longer be required?
How much will be saved through combined procurement?
How much will be spent on redundancy or voluntary severance?
And, perhaps most importantly, how much of the saving will eventually reach frontline healthcare?
Because creating two enormous health boards does not automatically make the NHS more efficient.
It could simply create two enormous bureaucracies instead of 14 smaller ones.
That is the danger with structural reform.
Governments can spend a great deal of time changing the organisation chart and discover several years later that the underlying problems remain.
There is also a particular issue for the Highlands.
NHS Highland and NHS Grampian are among the boards that will disappear under the new arrangements.
For people in Caithness, that immediately raises a familiar question.
Will this actually bring decisions closer to patients, or will it take them further away?
There is a long history of concern in the far north that organisations serving Caithness and Sutherland become increasingly distant as structures are centralised.
That is why the job question cannot be separated entirely from the service question.
If a finance department in Inverness disappears because functions are transferred to a much larger organisation, that may be an efficiency saving.
But if the work simply moves to another location, the job has not necessarily disappeared from the NHS. It has disappeared from the local economy.
That distinction matters enormously in rural Scotland.
A job in Caithness supports a household in Caithness.
The household buys goods locally.
It pays council tax.
It uses local shops and services.
The wages circulate through the local economy.
Move the job to Edinburgh or another major centre and the Scottish Government may still count one fewer NHS post in one organisation, but Caithness has lost an income stream.
This is one reason why headline job numbers can be misleading.
The real economic impact depends on what happens to the jobs.
Are they abolished?
Are they left vacant when somebody retires?
Are employees transferred to another organisation?
Are they moved geographically?
Are they replaced by technology?
Or are they simply renamed?
These are very different things.
There is another complication.
NHS Scotland currently employs around 160,000 people across its regional and special health boards and public-health body.
That is an enormous workforce.
Even a relatively small percentage change therefore produces a large number when converted into people.
And the NHS has another problem that makes this particularly difficult.
It needs more staff in some areas.
Scotland's population is ageing.
Demand for healthcare is increasing.
There are shortages in particular professions.
And the latest workforce figures have shown continuing recruitment into the NHS rather than a simple collapse in employment. One recent analysis reported that more than 3,000 more people joined NHS Scotland than left during the first three months of 2026.
So the Government faces an awkward balancing act.
It wants fewer people employed in the public sector overall.
But it may need more people in some parts of the NHS.
It wants to protect frontline services.
But it also wants to reduce costs.
It wants to reduce bureaucracy.
But it is creating a completely new structure that will itself require management during the transition.
And restructuring costs money.
There will be IT systems to change.
Buildings to rationalise.
Contracts to review.
Staff to move.
New management structures to establish.
There may be redundancy and voluntary severance costs.
There will almost certainly be disruption.
That means the Government needs to distinguish between long-term savings and short-term costs.
A restructuring programme can eventually save money while costing considerably more in its first few years.
That is not an argument against doing it.
It is an argument for being honest about the arithmetic.
This is where I think the 11,000 and 20,000 figures become useful.
Neither should simply be treated as a prediction of exactly how many people will receive a redundancy notice.
The 11,000 figure is closer to the Government's stated workforce-reduction ambition.
The 20,000 figure is a modelling exercise showing what could happen if frontline services are protected while the wider public sector has to carry a disproportionate share of the cuts.
The eventual number could be lower.
It could be higher.
It could also look very different from either figure because of retirements, recruitment controls, automation, transfers and organisational mergers.
But one thing seems increasingly clear.
Scotland's public sector is going to become smaller.
The Scottish Government has little choice if it is serious about dealing with the projected gap between what it wants to spend and the money available.
The question is how it becomes smaller.
If the reduction comes mainly through natural turnover and better technology, the immediate impact on households may be relatively limited.
If it comes through large-scale redundancies, the economic effect will be much greater.
And if it comes through reducing services rather than simply reducing bureaucracy, the public will notice that too.
There is another issue that politicians rarely discuss.
Public-sector jobs are not simply numbers on a spreadsheet.
They are also local economic activity.
That matters enormously in places such as Caithness.
A significant public-sector employer can underpin a local economy in a way that is difficult to replicate in a rural area where there are fewer large private employers.
If a government department, NHS organisation or council reduces its workforce, the effect does not stop at the employee's front door.
It reaches local shops, tradesmen, landlords, restaurants and other businesses.
That is why a programme designed to save public money can have a secondary effect on the private economy.
The Government needs to calculate that too.
There is, however, an argument on the other side.
If Scotland has too many people employed in administration, duplication and bureaucracy, keeping those jobs simply because they support local economies is not a sustainable economic strategy.
The answer cannot be to employ people indefinitely in jobs that no longer need to exist.
The real challenge is to replace those jobs with productive employment.
That is the part of the reform programme that deserves much more attention.
If an administrative NHS job disappears, can the person be retrained?
Can they move into a shortage occupation?
Can the private sector absorb some of the skills?
Can new businesses be created?
Can public procurement be used to help local companies grow?
Can Scotland turn public-sector reform into a private-sector growth opportunity?
If the answer is yes, then the reduction in public employment need not automatically mean economic decline.
But if the answer is simply that people will leave the public sector and there will be fewer jobs available, the consequences could be much more painful.
That is why I would be wary of both extremes in the current argument.
It is too early to say that John Swinney is about to sack 20,000 people.
But it is equally misleading to suggest that the restructuring will have no significant effect on employment.
The Government has already committed to reducing the workforce.
The NHS is being fundamentally reorganised.
Public bodies are being merged.
Back-office functions are being consolidated.
Technology is being introduced to replace some manual processes.
And ministers are talking openly about making the state smaller.
The direction of travel is therefore clear.
What is not yet clear is where the axe will finally fall.
For people in Caithness, that is perhaps the most important question of all.
Will public-sector reform mean fewer people employed?
Or will it mean fewer layers of management?
Will services be delivered differently?
Will jobs move elsewhere?
Will savings be reinvested locally?
And will the promised efficiency actually be visible to patients and taxpayers?
Until the Government publishes the detailed numbers, nobody can honestly say whether the final figure will be 11,000, 20,000 or something else.
But there is enough information now to say something else with confidence.
Scotland is entering a period of public-sector change on a scale not seen for many years.
And when organisations as large as the NHS are reorganised, the consequences will be measured not just in balance sheets and organisational charts.
They will be measured in jobs, communities and the quality of the services people receive.
That is why the number of jobs lost matters.
But perhaps an even more important question is this:
What will Scotland get in return for losing them?