Scottish hospitals do not have enough nurses and may not be making effective use of those available, according to Audit Scotland.

The Auditor General, who ensures value for money in public spending, has recommended that hospital managers look again at how they plan their workforce.

His report was described as "damning" by the Scottish National Party, which said it highlighted the crisis in Scotland's wards.

Getting the right number of nurses in place and managing them effectively is a complex task Auditor General Robert Black

But Health Minister Malcolm Chisholm said the Scottish Executive was committed to increasing the numbers of nurses.

Nurses and midwives account for almost 50% of all NHS staff in Scotland and cost more than �1bn each year.

Audit Scotland carried out a survey of staffing levels and the way staff are deployed.

It suggested that there were wide variations between hospitals.

The Scottish Executive has repeatedly pledged to make nursing a more attractive and a more family-friendly career.

Quality of care

However, Auditor General Robert Black found that less than half of Scotland's hospital trusts had enough nurses to cover for maternity leave.

He also found that 50% of wards were understaffed.

The report said this was putting pressure on staff, which could in turn lead to a compromise in the quality of care.

John Swinney: "Disastrous management"

The staff shortages also contributed to an increase in the amount of money spent on temporary bank and agency nurses, which rose from �25m in 1997/98 to �35m last year.

Mr Black said: "Nurses play an essential role in caring for patients and are a much valued NHS resource.

"Getting the right number of nurses in place and managing them effectively is a complex task but vitally important if we are to ensure that patients get the care they need and that the best use is made of resources.

"Nurse managers need good information on costs and quality to manage their staff effectively but there is significant variation in the availability of this information."

The report makes a number of recommendations for action by trusts, NHS boards and the health department.

Staffing levels

It acknowledged that the health department had made a "good start" on workforce planning.

However, it said more work was needed to get nurse staffing levels right across Scotland.

SNP leader John Swinney said: "The full extent of Labour's disastrous management of the nursing crisis is laid bare by this report.

"For almost half of our children's wards to be understaffed is simply appalling and Audit Scotland themselves say it is damaging patient care."

There are more nurses than ever working in the NHS in Scotland Malcolm Chisholm Health Minister

He said that an 11% pay rise for nurses would give Scotland a competitive edge in the recruitment market.

And he accused the Scottish Executive of "wasting millions" on nursing agencies.

Conservative deputy health pokesman Ben Wallace said: "The report is a damning indictment on Labour's tardiness in modernising nurse management."

However, Mr Chisholm said the executive was committed to increasing the numbers of nurses.

"The major challenge from the report is how we can measure the real number of nurses working with patients in wards," he said.

"There are more nurses than ever working in the NHS in Scotland and I want us to continue to create more posts so that we can create new opportunities for nurses to care for patients."

He added that workforce planning was at the heart of modernising the NHS in Scotland.