IS THE National Health Service the best in the world? It probably is not as imposed austerity, population challenges and social and cultural issues are all afflicting it. Health services in Scandinavia or Germany might surpass it.

But it’s still a remarkable institution that we must cherish and sustain, as it cherishes and sustains us. Week in, week out an excellent service is provided across all strata of our society, despite the many pressures.

There are issues affecting it and tests to be overcome. But they face every Western country as an ageing population has an impact, medical science improves beyond our wildest dreams and our lifestyle, whether through drink, drugs or obesity, weighs hard upon it. Moreover, behind all of that lurks mental health, a long-forgotten aspect, yet cruel to many and costly to our society.

Yet if the political opposition is to be believed, the NHS is in meltdown in Scotland: don’t get sick as you’ll be doomed. That’s far from the case and it’s not just unhelpful but corrosive too.

Hospitals do have a habit of making you sick, which is why staff seek to move you out as soon as they can. But this constant diet of negativity isn’t effective opposition; it’s destructive.

The Tories regularly berate this or demand that from the Scottish Government. Of course, mistakes are made; things can be done better and leadership’s needed. Yet it appears the Tory attacks are not to improve the service, but at best to deflect criticism from the prescription being applied by their colleagues at Westminster.

The Tory treatment for the NHS in England is proving unpalatable for many and having serious, if not terminal, consequences for the service. The ethos of a service based on need and free at the point of delivery is being eroded.

But, should we be surprised? After, all the NHS hasn’t been with us for ever. Next year will be its 70th anniversary and it came about in the face of relentless Tory opposition. It wasn’t just the nationalisation of steel, rail and coal that the Conservatives opposed but our cherished nascent institution.

The description by Nye Bevan of the Tories as being “lower than vermin” came about as a result of their continued rejection of the NHS. On 21 occasions they voted against it, including second and third readings.

Of course, they’ve tholed it since and we’ve even had weasel words in praise of it. But, it’s always been an uneasy acceptance, swallowed like some nasty medicine.

Now the free marketers are in charge and it’s back to their old order in some ways. The nationalised industries have long since been privatised. Social housing was sold off with calamitous consequences, and health is being viewed as just another commodity to be bought and sold.

As Tory Brexiters seek a trade deal with the United States, chlorinated chicken may be the least of our worries. The Transatlantic Trade and Investment Partnership threatened the NHS and that was a deal with the combined power of the EU behind it.

A Britain desperate for any post-Brexit deal and represented by individuals whose commitment to the NHS is debatable and whose links with private medicine are well documented, may well be susceptible.

What’s the Scottish Tories prescription? They condemn the situation in Scotland where a government seeks to preserve the ethos amidst the challenges but they’re fuelled by an ideology driving privatisation south of the Border. It smacks of rank hypocrisy.

The Government may be the target but the service is collateral damage.

That’s expected from the Tories but it’s shamefully echoed by Scottish Labour, though it shouldn’t be forgotten that Bevan had to overcome right-wing opposition within Labour to aspects of his plans, before he could confront the Tories back in 1945. The health challenges are global and a sensible discussion about how as a society we address them is needed. The solution cannot be, and indeed isn’t always about, more cash.

The health budget could be infinite but our nation’s pockets aren’t. Some hard decisions need to be made and, as ever in politics, it’s about priorities. Where and how do we spend our cash?

Added to that are structural changes in a service that’s top heavy and cultural changes all of us require to make, given the impact of lifestyle on the NHS.

Much will be down to the individual but education and support need given or it just won’t happen. Commercialisation and consumerism undermine even the best intentions of the committed and, as ever, it’s the poor who pay the highest price.

The Scottish Government will have to be bold. Hard decisions will need to be made and even sacred cows sacrificed. It’s not just about the NHS but the sort of society we seek.

Constructive criticism is required as the wider debate unfolds. However, a relentless injection of bile infects the institution without benefitting anyone.