There is quiet satisfaction when a diagnosis is proven to be correct, after all investigations are completed.

The now clearly proven diagnosis is that there is a crisis at the heart of the National Health Service in Scotland (NHSiS), made all the more serious by the persistent failures of Nicola Sturgeon and the SNP Government ("Exposed: Full extent of waiting times scandal", The Herald, February 21). However Alex Neil has to be congratulated for a masterful display of denial, obfuscation and bravado on radio when he blamed the whole debacle on an IT failure. It's the oldest trick in the book to blame the messenger.

The problem is not IT but a chronic under-resourcing of the NHSiS, and the unachievable politically-driven waiting time targets. Hospital managers are not fundamentally dishonest, but have had to use every legitimate method to avoid breaching targets, at the risk of their careers if they fail. Unfortunately, quality of patient care comes second.

Loading article content

Alex Neil's lauded new way requires so much management time to produce the result he wishes that all other legitimate management processes fail after a 10% cut in manager numbers in the last few years. Rather than too many managers or secretaries, the NHSiS has not enough in the operational field making the system work.

Not withstanding that there remains a persistent disconnect between the demand on the service and the capacity of the clinical services to meet that demand. Presently huge sums which might address that problem in the long term are channelled to the private sector for instant gratification, and patients are moved around the country for surgery, far from home and family. I reported on this years ago and nothing has changed.

Gavin R Tait,

37 Fairlie, East Kilbride.

Alison Rowat concludes after the Audit Scotland's report published this week that winning and keeping the trust of patients is now a matter of some concern ("Patient trust is now on the danger list", The Herald, February 22 ). If it continues to deteriorate, older readers may be tempted to appropriate the infamous statement by radio doctor and secretary of the BMA Dr Charles Hill when negotiating the inception of the National Health Service in 1948 with Health Minister Aneurin Bevan that "the end is Nye."

R Russell Smith,

96 Milton Road, Kilbirnie.