Anas Sarwar has called for “fewer chief executives and more doctors” as he pledged the “biggest reform of the NHS in decades” if Labour wins the next Scottish election.
The Scottish Labour leader said he would end a “growing culture of bureaucracy” and reduce the number of health boards.
In his speech at the party’s conference in Glasgow, Sarwar said that if he became first minister in 2026, Labour would declare “a national waiting times emergency” to try and solve ongoing problems.
And he said the party would introduce “our own Department of Government Efficiency” to streamline government operations, referencing Elon Musk’s controversial agency in America.
The Scottish Labour leader also promised to introduce an “Amazon tax” for online retailers, ban mobile phones in classrooms, and introduce powers to bring in directly-elected mayors for communities.
However, the main focus of his speech was centred around the NHS, which he said was in a “crisis” that was “costing lives”.
Sarwar – a former dentist – said improving the health service was “personal” for him.
“I will take on the top-heavy management that is holding the NHS back and deliver the biggest and most meaningful NHS reform in decades,” he said.
“We will end the growing culture of bureaucracy. We will cut the number of health boards down to three, pushing power away from the boardrooms and to patients and staff on the frontline.
“Put bluntly – fewer managers, more nurses. Fewer chief executives and more doctors.”
He said that as first minister, he would make sure money was spent “on nurses and doctors, not the bureaucrats and the penpushers.
“And we will finally make our NHS fit for the future by embracing digital innovation and technology.”
Later in his speech Sarwar returned to cutting red tape and delivering “value for money”, citing the cost of the new Glasgow prison that will replace Barlinnie.
He said: “As first minister I will respect every penny of your money.
“That’s why we will have our own Department of Government Efficiency to stop the waste and deliver value for money for you, the taxpayer – and that value for money will extend to every part of government.”
He said there were currently more than 130 quangos in operation in the government, which he called a “culture of waste.”
The Unite union protested at the SEC in Glasgow, placing 400 yellow hard hats outside the venue where the conference was being held – representing jobs lost by the closure of Grangemouth.
Earlier this month Sarwar said there had not been enough progress made on supporting workers losing their jobs at the plant.
He called for Scotland to “maximise” clean energy investments and criticised the SNP for “tired, 1970’s opposition to clean, low-carbon nuclear energy”, which he added could bring “billions of investment” to the country.
He added Labour would end the “ideological block” on new nuclear projects in Scotland.
His other pledges included overhauling rates relief for businesses and ending the country’s “housing crisis” – something he said would need “bold action” to get Scotland building.
And he claimed that a Labour government would place “selling brand Scotland” abroad at the heart of economic plans, creating more exports.
Anas Sarwar has used his conference speech to stake his claim to be the next first minister of Scotland.
He recognised that achieving this would mean defying the odds because Labour has sunk heavily in opinion polls since sweeping to power at Westminster last summer.
He made little mention of Sir Keir Starmer in a speech that lasted almost an hour.
Instead he spoke of himself as Scotland’s first minister and of the things he would do in that role (from banning mobile phones in classrooms and ending rough sleeping to whatever it takes to fix the NHS).
It was as if he hopes that the power of assertion will help elevate him from leader of the third party to the highest office in Holyrood politics.
That’s a trick that seemed to do Alex Salmond no harm 20 years ago.
Inspiration was also drawn from David Cameron, who once derided Gordon Brown as being unfit for the digital age.
Sarwar’s version was to dismiss his SNP rival as “analogue John” Swinney. But he knows that toppling the current first minister will be much easier said than done.