Scotland’s proposed division of the NHS into East and West would place nearly three-quarters of the country’s most deprived neighbourhoods inside the western region. At the same time, that region contains a majority of the hyperscale data-centre locations identified in a national campaign inventory, major electricity transmission projects, and communities already facing serious problems with drug mortality, fuel poverty and access to specialist healthcare.
These developments are being advanced through different government, regulatory and commercial processes. There is no evidence that the NHS boundaries were designed to accommodate industrial development or disguise its health consequences. But the geographical overlap raises an important question: when new industrial facilities are built in communities already experiencing poor health, how will Scotland identify any additional harm?
An examination by Modern Scot of Scottish Government deprivation statistics, National Records of Scotland mortality figures, energy infrastructure plans, planning records and parliamentary evidence identifies a substantial concentration of existing health and social disadvantage in the proposed NHS West area.
THE WEST WOULD INHERIT 1,030 OF SCOTLAND’S 1,395 MOST-DEPRIVED NEIGHBOURHOODS
Using the published Scotland East and Scotland West planning boundaries, the two regions would have substantially different social profiles.
The West comprises 18 council areas and approximately 3,067,140 residents, or 55.3% of Scotland’s mid-2025 population. East comprises 14 councils and approximately 2,478,360 residents, or 44.7%.
The more significant difference emerges from the Scottish Index of Multiple Deprivation (SIMD 2020). Adding the official council-area figures gives West 1,030 of Scotland’s 1,395 neighbourhoods classified within the most deprived 20%. East has 365.
That gives West 73.8% of Scotland’s most deprived neighbourhoods, despite containing only 55.3% of its population.
Glasgow City has 339 of those neighbourhoods, North Lanarkshire has 153, and South Lanarkshire has 88. Other western councils with substantial concentrations include North Ayrshire, Renfrewshire, Inverclyde, East Ayrshire and West Dunbartonshire.
The SIMD measures relative deprivation across several domains, including income, employment, health, education, access to services, crime and housing. It does not mean everyone in a deprived neighbourhood is poor. It also has limitations in identifying dispersed rural and island deprivation.
Nevertheless, the imbalance is substantial. Scotland’s proposed western health authority would be responsible for a markedly greater concentration of the communities already identified by the Government as experiencing multiple forms of disadvantage.
The proposed division raises a fundamental question about whether Scotland’s NHS is being reorganised around administrative convenience rather than the unequal healthcare needs of its population. The eastern region would include Edinburgh’s financial and technology economy, while the western region would encompass some of Scotland’s most economically disadvantaged communities and geographically isolated patients. These inequalities existed long before the proposed restructuring, but the Government has yet to demonstrate how two enormous health authorities would be funded according to their substantially different needs.
On 1 October 2026, the British Medical Association in Scotland formally opposed the merger, warning that centralisation could worsen existing health inequalities and weaken local accountability. In a parliamentary answer on 28 September, ministers confirmed that detailed impact assessments would be undertaken during the next phase of planning. The question is why such a fundamental restructuring was announced before those assessments were available to demonstrate that its proposed structure would not deepen the inequalities it is supposed to reduce.
FIVE OF THE SIX COUNCILS WITH ELEVATED DRUG-DEATH RATES ARE IN WEST
Scotland registered 1,133 drug-use deaths in 2025, an increase of 11% over the previous year, according to National Records of Scotland figures published on 23 September 2026.
Over the five-year period 2021–2025, six council areas recorded drug-use death rates significantly above the Scottish average.
Five are in the proposed NHS West: Glasgow City, North Ayrshire, Inverclyde, West Dunbartonshire and East Ayrshire. The sixth, Dundee City, is in East.
Glasgow alone recorded 196 drug-use deaths in 2025.
The national statistics also reveal the extraordinary relationship between deprivation and mortality. In 2025, the age-standardised drug-use death rate in Scotland’s most deprived areas was 15 times the rate in the least deprived areas.
The distinction matters for future public-health monitoring. Communities with elevated mortality and longstanding social disadvantages already have complex healthcare needs before any additional industrial developments are introduced.
These figures do not establish that West has five times the drug-death rate of East. They identify the distribution of the six councils whose rates were statistically above the national average. A complete regional mortality-rate comparison would require a separate age-standardised calculation.
DATA CENTRE DEVELOPMENTS ARE CLUSTERING IN PARTS OF THE WEST
The proposed distribution of hyperscale data centres adds another layer to the regional comparison.
Action to Protect Rural Scotland maintains a published inventory of hyperscale data-centre projects at varying stages of development. Counting the 23 named locations in its current table, including separately listed developments at Ravenscraig and Chapelhall, gives 14 locations in the proposed NHS West and nine in East.
These are proposals and development opportunities, not 23 operating or approved facilities. The inventory is maintained by a campaign organisation and should not be treated as an exhaustive government register.
North Lanarkshire accounts for six listed locations: two at Ravenscraig, one at Plains, one at Newhouse and two associated with the Chapelhall AI Growth Zone.
Other western locations include Larbert in Falkirk, Hunterston in North Ayrshire, Greenock in Inverclyde, Bishopbriggs in East Dunbartonshire, Haspielaw in South Lanarkshire, Hurlford and Ochiltree in East Ayrshire, and Chapelcross in Dumfries and Galloway.
Across four western councils alone—North Lanarkshire, North Ayrshire, Inverclyde and East Ayrshire—the inventory identifies ten locations. All four councils have at least 30% of their neighbourhoods classified among Scotland’s most deprived 20%.
That is a council-level comparison. It does not establish that every development site is itself located within a deprived neighbourhood.
The East also has significant proposals, including Auchtertool in Fife, South Gyle and Wester Hermiston in Edinburgh, West Calder, sites in the Scottish Borders, Dunbar and Cockenzie in East Lothian, and Blackdog in Aberdeenshire.
Nevertheless, the western concentration raises questions about the cumulative impact of multiple industrial installations in areas already facing social and health disadvantages.
THE £8.2 BILLION LANARKSHIRE AI GROWTH ZONE: WHO RECEIVES THE BENEFITS?
On 29 January 2026, the UK Government designated Lanarkshire as an AI Growth Zone, announcing £8.2 billion in proposed private investment and more than 3,400 anticipated jobs.
The programme is being developed around DataVita’s operations in the Airdrie area, with CoreWeave among its commercial partners. Government announcements identified approximately 800 potential higher-value AI and operational jobs, with the remainder largely connected to construction and supporting infrastructure.
An associated community fund was presented as potentially worth up to £543 million over 15 years, linked to data-centre capacity coming into operation.
These are announced commitments and forecasts, not evidence that the full investment, employment or community funding has already materialised.
North Lanarkshire has a documented history of industrial change and concentrated deprivation. According to the council’s own SIMD 2020 analysis, approximately 35% of its neighbourhoods were within Scotland’s most deprived fifth, and 50,897 residents were classified as income deprived.
Major investment could bring substantial benefits to those communities. But its contribution must be measured through permanent local employment, wages, apprenticeships, procurement, electricity infrastructure, community payments and environmental safeguards—not simply the headline capital expenditure.
Local residents should be able to establish precisely what they receive in exchange for hosting these developments, and whether the promised economic benefits reach the communities experiencing the greatest disadvantage.
THE ELECTRICITY GRID IS EXPANDING THROUGH COMMUNITIES ON BOTH SIDES OF THE PROPOSED DIVIDE
Scotland’s electricity transmission network is undergoing major investment to connect renewable generation and meet growing electricity demand.
SSEN Transmission’s Pathway to 2030 programme includes new overhead lines, substations and subsea electricity connections across northern Scotland. Projects involving NHS West territory include a proposed 400kV overhead line between Spittal and Beauly in the Highlands, major substation infrastructure around Beauly, and a Western Isles high-voltage direct-current connection.
The Western Isles project includes approximately 81 kilometres of subsea cable and around 80 kilometres of underground mainland cable between Dundonnell and the Beauly area, together with converter stations. That link is not an 80-kilometre overhead power line.
In central Scotland, SP Energy Networks is also advancing the Denny-to-Wishaw reinforcement, including a proposed new 400kV overhead-line corridor and associated substation works affecting areas within the western NHS planning geography.
The East is not spared major transmission development. SSEN’s proposals include a new 400kV line between Beauly and Peterhead, infrastructure through Aberdeenshire and a proposed 400kV line between Kintore and Tealing. SP Energy Networks has further projects around Tealing, Kincardine, Fife and the east-coast electricity links.
There is therefore insufficient evidence to claim that the West would receive most of Scotland’s new transmission infrastructure. A complete comparison would require the lengths of planned overhead lines, underground cables and associated substations to be measured against the regional boundaries, together with the homes and communities affected.
What is clear is that western communities already facing significant disadvantage are among those proposed to accommodate substantial new transmission and data-centre infrastructure.
Grid projects can also deliver benefits, including better reliability, renewable-energy connections and economic activity. Those benefits must be considered alongside landscape disruption, construction traffic, land use and the environmental assessment of individual projects.
FUEL POVERTY ADDS ANOTHER EXISTING HEALTH PRESSURE
Fuel poverty is not confined to the West, but several western councils already experience rates significantly above Scotland’s average.
The Scottish Government’s local-authority housing survey, published in May 2026 and covering 2022–2024, placed the national fuel-poverty rate at 31%.
In West Dunbartonshire it was 43%; Na h-Eileanan Siar, 40%; Dumfries and Galloway, 38%; East Ayrshire, 38%; and Glasgow City, 35%.
The highest rate in Scotland, however, was in Orkney at 51%. Orkney is in the proposed East. Shetland, also in East, recorded 40%, as did the Western Isles in West. Dundee, in East, recorded 38%.
These exceptions are important. Both proposed NHS regions contain communities where heating costs, housing quality and geographical isolation create substantial hardship.
In September 2026, Scottish Government modelling estimated that approximately 820,000 Scottish households would be in fuel poverty during October–December 2026, representing 32% of all households. Approximately 440,000 were projected to be in extreme fuel poverty.
There is no established evidence that the proposed data centres will cause nearby households’ energy bills to rise. Their electricity demand may create additional requirements for generation and networks, but the costs, charging arrangements and eventual household impacts require specific analysis.
The legitimate question is whether major new electricity-consuming developments will generate measurable benefits for nearby fuel-poor communities, and how their infrastructure costs will be recovered.
WHAT ARE THE ACTUAL ENVIRONMENTAL AND HEALTH RISKS?
The Scottish Environment Protection Agency recognises that large data centres may rely on substantial numbers of backup generators. Some developments may also include additional on-site electricity generation where grid capacity is insufficient.
SEPA identifies combustion equipment as a potential source of air pollution, including nitrogen oxides. These emissions require appropriate assessment and, where applicable, environmental authorisation.
This is not merely a hypothetical concern invented by campaigners. On 3 September 2026, Scottish Green MSP Ross Greer told Parliament that a proposed 300MW data centre at Larbert included 200 diesel generators near a care home. He said the developer’s own application identified a major adverse environmental impact. Those statements should be assessed against the submitted planning and environmental documents; they do not establish that the generators have operated or caused pollution.
Noise, cooling requirements, water use, construction emissions, habitat disturbance and land-use change also require consideration. The scale and significance of each risk depend on the design, operating conditions, location and mitigation measures of the individual facility.
High-voltage electricity transmission introduces a separate scientific issue. The UK Health Security Agency states that research has identified an association between higher residential magnetic-field exposure and childhood leukaemia in some epidemiological studies, but that the overall evidence is not strong enough to establish causation. Public exposure should comply with the applicable international guidance.
It would therefore be inaccurate to claim that overhead power lines have been proven to cause cancer or that data centres have already damaged the health of surrounding communities.
Equally, uncertainty about a potential risk is not a reason to abandon environmental scrutiny. Authorities need to establish exposure levels and assess potential effects before approving major developments.
THE DANGER OF OVERLOOKING NEW HEALTH IMPACTS IN ALREADY DEPRIVED COMMUNITIES
The most serious question concerns how future health problems would be investigated.
Where a community already experiences high rates of chronic disease, poverty-related illness, substance-related mortality and poor access to services, detecting an additional health effect from a new environmental exposure can be difficult.
Researchers must distinguish changes caused by ageing, smoking, occupational exposure, housing conditions, deprivation and other established factors from changes potentially associated with new industrial activity. Simply comparing an area’s illness rates before and after construction would not establish causation.
But failing to collect reliable baseline evidence before construction would make a later investigation harder.
This creates a potential accountability problem for communities hosting large industrial developments. If emissions monitoring, exposure assessments and appropriately designed long-term health studies are inadequate, residents may find it difficult to demonstrate whether their health has been affected.
That risk is particularly important where several projects are proposed close together. Assessing each facility independently may fail to capture the cumulative effects of multiple sources of air emissions, noise, traffic and other disturbances. Effective environmental assessment must consider the interaction of developments where relevant.
The responsibility should not fall on residents who become ill to reconstruct the environmental conditions that existed before a development was approved.
Authorities should require reliable baseline air-quality measurements, clear generator operating limits, assessments of cumulative exposures, public access to monitoring results and transparent arrangements for investigating complaints and future health concerns.
THE GOVERNMENT HAS ALREADY RECOGNISED THAT DATA-CENTRE ASSESSMENT NEEDS TO CHANGE
On 16 September 2026, the Scottish Government issued a new planning direction requiring environmental impact assessment for new data-centre developments exceeding 50MW of power capacity. It took effect on 17 September.
The Chief Planner’s letter acknowledged that evidence about the environmental impacts of data centres continues to develop, and identified energy demand, water consumption, greenhouse-gas emissions, biodiversity, noise and potential air-quality impacts as considerations.
The new requirement is an important safeguard. It also raises questions about earlier screening decisions and developments that had already entered the planning process.
On 21 September, Scotland’s Planning and Environmental Appeals Division confirmed that an environmental impact assessment was required for a proposed data centre at Lancaster Avenue, Chapelhall, North Lanarkshire, under the new direction.
An environmental impact assessment is not, however, a guarantee that every potential health consequence will be discovered. Its effectiveness depends on the quality of the submitted evidence, the scope of assessment, scrutiny by regulators and the conditions imposed on any permission.
THE MOST GAELIC-SPEAKING REGION ALSO HAS SOME OF THE HARDEST HEALTHCARE JOURNEYS
The 2022 Census identifies approximately 69,700 people across Scotland able to speak Gaelic. Aggregating council-area results places roughly seven in ten of those speakers in the proposed West.
The highest concentrations include Na h-Eileanan Siar, Highland and Argyll and Bute, while Glasgow is also a major centre of Gaelic-speaking population.
Those figures have implications for service planning, particularly in areas where Gaelic is used extensively in daily life. Not every Gaelic speaker requires clinical communication in Gaelic, but the distribution is relevant to accessible services and the preservation of linguistic provision.
Some of the most geographically isolated western communities also depend on air and ferry connections to reach specialist healthcare.
At a Scottish Parliament Transport Committee hearing on 24 June 2026, NHS Western Isles representatives explained how reductions in air services threatened access to visiting specialists.
They told MSPs that changes could put 289 ophthalmology theatre clinics and 2,835 outpatient clinics or appointments at risk under the affected arrangements. In a review of 866 return patient journeys, 332 patients required escorts.
The evidence illustrated how travel disruption can affect families, employment, childcare and the feasibility of attending treatment.
East also includes Orkney and Shetland, whose patients face major island-transport challenges. The division is therefore not a simple separation between an accessible East and an inaccessible West.
What remains unclear is whether the proposed two-board NHS structure will protect existing cross-regional specialist referrals and provide sufficient financial and practical support to patients required to travel long distances.
TWO NHS AUTHORITIES, BUT NO PUBLISHED GUARANTEE OF HOW THESE UNEQUAL HEALTH NEEDS WILL BE FUNDED
The Scottish Government’s Programme for Government 2026–2031 proposes replacing the existing 14 territorial NHS boards with two strategic health boards. Ministers say the change is intended to improve coordination, efficiency and access to care.
The East and West geographies used in this analysis follow the previously published sub-national NHS planning alignment, which groups seven existing boards in each region. The detailed legal and operational arrangements of the proposed two-board system are not yet settled.
The NHS reform and the expansion of data-centre and electricity infrastructure are separate policy processes. There is no demonstrated causal connection between the choice of NHS boundaries and the location of industrial projects.
Yet their overlap is a legitimate matter of public interest.
The West would inherit a larger population, nearly three-quarters of the most deprived neighbourhoods identified by SIMD, five of the six councils with elevated drug-use death rates, and several communities facing substantial fuel-poverty and specialist-transport difficulties. It also contains a majority of the named hyperscale data-centre locations in the reviewed campaign inventory.
Meanwhile, large electricity infrastructure programmes are advancing across both regions, creating further obligations to assess environmental effects, community benefits and health safeguards.
Before approving the new health structure and the continuing wave of industrial developments, the Scottish Government should publish clear answers to several connected questions.
How will NHS funding reflect differences in deprivation, health outcomes, age and geography? Will patients retain access to established specialist hospitals across the East–West boundary? What independent environmental-health baseline data will be collected around hyperscale data centres and transmission projects? Who will investigate cumulative exposures where several developments are concentrated within one area? And will local communities receive publicly accessible information enabling them to assess the results?
A government cannot demonstrate that an industrial transition is fair merely by announcing investment. It must also demonstrate that the people hosting the infrastructure will share in its benefits, that their existing health needs will be funded, and that any future environmental harm can be identified and addressed.
Those safeguards are especially important when major developments are proposed in communities already carrying a disproportionate burden of disadvantage.
Sources and References
- Scottish Government — Programme for Government 2026–2031: Delivering a Stronger NHS and Public Services. Official proposals to replace Scotland’s 14 territorial NHS boards with two strategic authorities.
- Scottish Parliament — Written Question S7W-03235, answered 28 September 2026. Government response concerning local NHS accountability, the proposed two-board structure and forthcoming impact assessments.
- British Medical Association Scotland — Withdraw and Rethink NHS Board Reduction Plans, 1 October 2026. BMA Scotland’s formal opposition to the restructuring.
- Scottish Government — Scottish Index of Multiple Deprivation, Council-Area Table. Official figures for the number and proportion of neighbourhoods within Scotland’s most deprived 20%.
- National Records of Scotland — Mid-2025 Population Estimates, published 14 July 2026. Population statistics for Scotland’s 32 council areas.
- National Records of Scotland — Drug-related Deaths in Scotland, 2025. Published 23 September 2026; national mortality figures, council-area statistics, deprivation and drug-use death rates.
- Action to Protect Rural Scotland — Hyperscale Data Centre Map and Project Inventory. Locations, proposed capacity, developers and planning status of Scottish data-centre projects.
- UK Government — Lanarkshire AI Growth Zone Announcement, 29 January 2026. Proposed £8.2 billion private investment, employment projections and community-funding commitments.
- North Lanarkshire Council — Scottish Index of Multiple Deprivation 2020. Council-level deprivation and income-deprivation statistics.
- SSEN Transmission — Pathway to 2030 Electricity Network Projects. Proposed overhead transmission lines, substations and electricity network expansion across Scotland.
- SSEN Transmission — Western Isles High-Voltage Direct Current Link. Project details, proposed infrastructure and route information.
- Ofgem — Early Construction Funding for Major Electricity Transmission Projects, May 2026. Regulatory decisions supporting electricity network investment.
- Scottish Government — Scottish House Condition Survey: Local Authority Fuel Poverty, 2022–2024. Fuel-poverty rates by council area.
- Scottish Government — Fuel Poverty Scenario Modelling, October–December 2026. National projections of fuel poverty and extreme fuel poverty.
- Scottish Environment Protection Agency — Data Centres in Scotland: Regulatory and Environmental Guidance. Air emissions, combustion equipment, backup generators, energy consumption, cooling systems, water use and environmental regulation.
- Scottish Parliament — First Minister’s Questions, 3 September 2026. Ross Greer’s questions concerning hyperscale data centres, diesel generators and the proposed Larbert development.
- UK Health Security Agency — Electromagnetic Fields: Sources and Health Effects. Scientific evidence concerning exposure to electricity transmission infrastructure and potential health effects.
- Scottish Government — Chief Planner’s Environmental Impact Assessment Direction for Data Centres, 16 September 2026. New assessment requirements for data centres exceeding 50MW, effective 17 September 2026.
- Scottish Government Planning and Environmental Appeals Division — Chapelhall Data Centre, Case EIA-320-003. Environmental impact assessment decision issued 21 September 2026.
- Scotland’s Census 2022 — Ethnic Group, National Identity, Language and Religion. Official Gaelic-language and country-of-birth statistics.
- Scottish Parliament — Transport Committee, 24 June 2026. NHS Western Isles evidence concerning patient travel, air-service reductions, specialist treatment and patient escorts.
- Scottish Government — NHS East and NHS West Sub-National Planning: Freedom of Information Review, 30 March 2026. Official correspondence concerning the development of regional NHS planning arrangements.
Editorial methodology: East–West regional comparisons were calculated from published council-area statistics using the existing NHS sub-national planning alignment. Unless otherwise stated, these are editorial aggregations rather than separately published Scottish Government regional statistics. The final boundaries of the proposed two-board NHS structure have not yet been confirmed.
