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Neil has to be up for the fight on the NHS

WHEN Nicola Sturgeon was moved from the health portfolio last year to take charge of the Government's referendum campaign she was instantly dubbed the "Yes Minister".

Now her successor as Health Secretary, Alex Neil, has been given a new nickname of his own: the "Clean Up the Mess Minister".

He seems rather taken with it.

Mr Neil managed to maintain a diplomatically stony expression when Scots Labour leader Johann Lamont took aim during First Minister's Questions but it didn't take long for the mask to slip. Confronted by hacks during the post-FMQs garden lobby melee, Mr Neil chuckled, smiled a knowing little smile and sauntered off. What he did not do – as Ms Sturgeon might have hoped – was to look aghast and protest loudly: "Mess? What mess?"

Labour's dig follows a slew of stories about problems in Scotland's health service. Recent front-page headlines have referred to a "failing IVF unit" at Glasgow Royal Infirmary and the growing health inequalities between Scotland's richest and poorest communities. There have been reports of patients waiting for 12 hours "in Scotland's A&E crisis" and warnings of further ward closures.

Earlier this week The Herald revealed an ongoing culture of secrecy at NHS Lothian, the health board found guilty of manipulating waiting times to meet Government targets. This latest mess, by the way, was swiftly cleaned up by Mr Neil.

Added to that we know the number of nurses is falling and Scotland's health boards are having to borrow to balance the books. There is a £950m repairs backlog. The Auditor General, Caroline Gardner, said cash constraints had placed the NHS on an "amber warning".

Some of these issues were put to the First Minister on Thursday. He dismissed the criticism on two grounds – firstly that the NHS was better funded than it would have been under a Labour administration and secondly that it retained the confidence of patients, recording an 88% satisfaction rating according to the latest Scottish Household Survey.

It's true that at the last election the SNP promised to "protect" the NHS budget to a greater extent than Labour – but that does not mean health chiefs are awash with cash. The service faces real-terms cuts. As for patient satisfaction, Mr Salmond's point is undermined somewhat by separate figures showing a steep rise in NHS complaints last year.

The real point, though, is this: whatever the merits of Mr Salmond's defence, the health service is becoming a political battleground.

During her five years in charge of the NHS Ms Sturgeon created an image of a well-resourced, well-run organisation that was meeting ever more ambitious targets and was trusted by patients.

For the most part that was true. It was striking how rarely the NHS was the subject of embarrassing headlines.

No longer. Opposition parties now paint a picture of a health service which is struggling to cope, where cash is tight, where staff are overstretched, where pressure to meet targets is breeding a culture of secrecy and bullying, where services are under threat and where patients are losing out.

It's hard to judge at this stage whether that's a fair characterisation. But it is clear the new Health Secretary will not sit back and simply take the flak for problems in the NHS which pre-date his time in office. He knows it is better for him to be a pro-active Clean Up the Mess Minister than sweep things under the carpet, even if it means acknowledging the occasional mess.

And – good news for everyone – that means we should have a better chance of seeing an open and robust debate about the state of health service and how it should be run in tough financial times.

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