Nicola Sturgeon's "transformational" increase in Scottish NHS spending is less than the rise planned by the Tories in England and may not be enough to keep up with demand, an impartial analysis of her election manifesto has concluded. The respected Institute for Fiscal Studies (IFS) said the SNP's promise to increase front-line health spending by £2.5 billion over the next five years would lead to an annual rise of 2.1 per cent above inflation. But the analysis said this was less than the 3.4 per cent increase planned by Boris Johnson's government for the English NHS and slower than what may be needed to keep up with cost and demographic pressures – even before the Covid pandemic. The IFS also warned that the array of spending pledges unveiled by Ms Sturgeon had a "significant net cost" and questioned how they will be paid for given her promise not to increase income tax rates over the next parliament. With a "tight fiscal environment" expected to pay for the huge borrowing during the Covid pandemic, the IFS said "tricky trade-offs" will be required, including "as yet, unspoken" tax rises and cuts in other areas of public spending. David Phillips, an economist who co-authored the analysis, concluded: "The tougher fiscal situation an independent Scotland would face in at least its first few years would make the challenge of delivering these commitments even harder." The analysis was deeply embarrassing for Ms Sturgeon, who claimed the NHS was at the "heart" of the manifesto with a "transformational increase in frontline health spending". She said the pandemic required an "exceptional response" as she unveiled a 20 per cent rise in health spending over the next parliament. But Mr Phillips, an associate director with the IFS, said the health spending plans "look rather low" and the increases were the same that have been implemented over the last five years. He tweeted it was also "less than 3.4 per cent promised to NHS England in its long-term funding plan, and what's needed to keep pace with costs and demands. Top ups likely!" Paul Johnson, the IFS director, tweeted: "Traditional sort of manifesto from the SNP. Promises of lots more spending with not much indication of how it will be paid for." The IFS said it was "disappointing" the manifesto does did not provide information on how much the various pledges would cost altogether. But it said the document continued the SNP's "trend of making services free for everyone" rather than targeting those on the lowest incomes, with Ms Sturgeon also promising to abolish NHS dentistry charges. "This will benefit mainly middle and higher-income working age individuals who don’t already qualify for free dentistry though receipt of certain benefits," the IFS said. The SNP also plans to extend free school meals to all children in the first year of primary school but the IFS noted that the poorest youngsters already get this benefit, so the pledge will mostly benefit wealthier families. It warned that the "main effect" of a pledge to reduce business rates on the highest value commercial properties will be rent increases, "primarily benefiting landlords rather than making premises more affordable for the businesses that occupy them." But Mr Phillips said that the proposals would mean "substantial gains for certain groups of households", including the elderly thanks to a pledge to abolish charges for all social-care services received at home. Maurice Golden, the Scottish Tories' economy spokesman, said: "These respected independent analysts have immediately picked giant holes in the SNP manifesto and exposed Nicola Sturgeon's pledges as brazen pre-election bribes. "We know that if implemented, many of these headline-grabbing spending announcements would only be possible due to additional funding from the UK Government." Kate Forbes, the SNP Finance Secretary, said: "The long-term funding for NHS England revenue is only until 2023/24, our commitment runs for a further 3 years. "As we have throughout the last parliament, the SNP will continue to pass on all Barnett consequentials from health spending. It’s worth noting our plans comfortably exceed those already announced by the Scottish Tories."