News that most of Scotland's health boards are missing the national target for urgent cancer treatment is rightly the focus of much criticism.
The NHS's use of the adjective "urgent" to describe a wait of up to 62 days stretches the definition to breaking point anyway. To find that even that accommodating target is not being met is a matter of serious concern.
Patients may benefit from a few days' hiatus between referral and treatment to organise their lives but, after that, the wait for treatment can quickly become an ordeal. Not only must patients live with doubts and anxiety about what further investigations will reveal, but they also know that, if they do have cancer as suspected, the longer they wait, the longer the time the disease has potentially to grow or spread.
As the Health Secretary Alex Neil says, the sooner a patient starts treatment the better their chances of survival. In view of that, the importance of getting to grips with health boards' deteriorating performance in meeting these targets really cannot be overstated.
That means reversing the trend not just temporarily but permanently. Predictably, opposition MSPs are criticising the Health Secretary for failing to act and Mr Neil, equally predictably, is defending his Government's record, highlighting the fact that the figures are still better than in 2007 (which will be of no comfort to those waiting more than 62 days). Mr Neil has also announced £2.5m in extra funding to help health boards meet the targets. Yet none of this addresses the key issue, which is that the NHS is under growing pressure, not least because of the ageing population, and that, on the basis of its current resource level, it cannot continue to produce the same results achieved in the past.
These figures on waiting times for cancer treatment are not the first signs of deterioration in the NHS; recent statistics also show worsening performance in key general waiting times, in A&E waiting times and in the extent of bed blocking, while doctors and nurses regularly complain of understaffing. At some point, ministers and MSPs on all sides must face up to this. The answer to such failures is not to make a small injection of extra money each time a problem is uncovered; it is not just to reorganise existing services: it is to look at the resourcing of the service as a whole and assess how much more funding is required to reach key performance targets, not just at present but in the future.
Dr Brian Keighley, outgoing chairman of the British Medical Association in Scotland, yesterday called on politicians to face up to these "hard questions", criticising attempts to "squeeze more and more" out of the same resources. He referred to what he had seen of the NHS over the past five years as "the continuing crisis management of the longest car crash in memory" and said the system was on "the edge of collapse".
His words echo The Herald's calls, as part of our NHS: Time for Action campaign, for an honest debate about health funding. Only after that can the NHS in Scotland be returned to rude health.
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