The Scottish Government was not properly prepared for the coronavirus pandemic, the country’s public spending watchdog claimed.
A report from Audit Scotland said a series of gaps in planning exercises were not all addressed.
The missed opportunities were highlighted while the NHS faces a massive backlog for treatment and a huge bill.
Measures to ensure adequate supplies of personal protective equipment (PPE) were also not fully implemented.
Health Secretary Jeane Freeman said she will study the findings.
Opposition parties at Holyrood said the report was a damning indictment.
Auditors praised the government’s quick response once the outbreak was in full swing, but said officials “could have been better prepared to respond to the Covid-19 pandemic”.
The Record has previously exposed how three simulations were carried out across the UK.
Operation Isis reported “unease” over PPE, operation Silver Swan flagged up gaps in social care, and Exercise Sygnus warned about problems with British preparedness for a major outbreak.
Audit Scotland now recommends the government publishes national pandemic guidance for the health and social care sector as a priority, including lessons that have been learned during the Covid-19 pandemic and the previous planning exercises.
Auditor General Stephen Boyle said: “NHS staff have shown extraordinary commitment to treating and caring for Scotland’s people during a pandemic that has highlighted the need to deal with long-standing health inequalities.
“Getting the full range of health services back up and running will be challenging.
“But there are clear lessons to be learned from the pandemic, both in how the country could have been better prepared and in the innovation that we’ve seen.
“It’s essential that these advances are now retained and built upon.”
Scottish Conservative health spokesman Donald Cameron said: “It cannot be dismissed by the usual SNP spin. This is not about the benefit of hindsight.
“The auditor general is clear. The SNP Government failed to heed loud and clear warnings.”
British Medical Association Scotland chairman Dr Lewis Morrison said: “There is obviously some concern that the Scottish Government could have been better prepared and acted quicker on learning from various planning exercises.
“This would seem particularly true on doctors’ experiences of PPE – where early concerns needed to be rapidly addressed.”
Responding to the report, the health secretary said: “As Audit Scotland acknowledge, the Covid-19 pandemic was caused by a new disease with unknown characteristics, and like governments around the world, we have had to respond rapidly to the emergence of an entirely new public health threat.
“At the beginning of the pandemic we put in place longstanding plans to double and then quadruple capacity of our intensive care units. We reconfigured the SEC in Glasgow into a quality critical setting, the NHS Louisa Jordan within three weeks.
“Emergency, urgent and trauma services have continued through the pandemic with as much other non-COVID care as possible and our frontline health and care staff have worked day-in and day-out to care for people across Scotland throughout this unprecedented crisis.
“At no point has our NHS been overwhelmed, which is testament to swift action and extraordinary efforts of everyone involved. At all times the Scottish Government’s actions have been guided by the best and most up to date scientific and medical advice.”
