Daily Mail columnist Graham Grant argues that First Minister John Swinney's plan to overhaul the NHS in Scotland could ultimately damage him politically, despite the genuine need to cut waste in a health service he says is burdened by excessive bureaucracy and highly paid managers. While Swinney presents himself as tackling red tape his own government helped create, Grant contends he failed to answer basic questions about the proposals in a recent television interview, and questions whether the SNP can implement such a major reorganisation without repeating the problems seen with the 2013 creation of Police Scotland.

The central proposal would cut the number of NHS health boards from 14 to two, a change one former NHS executive told Grant could take several years, given that the simpler task of merging eight police forces into Police Scotland took roughly two years. Local government reorganisation, including a possible merger of Dundee, Angus and Perth and Kinross councils, is also being considered alongside the NHS changes, though it will not begin before council elections in May 2027. Grant notes concerns about job security among council and NHS staff, the likely cost of "golden goodbye" severance packages for departing executives, and past warnings from Audit Scotland and the Royal College of Physicians that structural change alone does not guarantee better outcomes.