It is worth asking exactly what Scottish Health Secretary Alex Neil means by the term "temporary phenomenon" in the context of today's report in The Herald about NHS plans to spend millions of pounds a year sending patients for private diagnosis and treatment.
In 2007, when the SNP came to power, it declared an intention to clamp down on spending resources from the NHS budget in the private sector. Yet early this month it emerged that NHS spending on private healthcare in Scotland rose by 60% last year, as health boards found themselves unable to meet the Government's 18-week waiting time targets for treatment.
At the time Mr Neil was explicit: the "short-term" use of the independent sector was a "temporary phenomenon", largely caused by capacity problems at two health boards, Lothian and Grampian. Quizzed as to whether spending on the independent sector was likely to increase further, he said such spending would be kept to an "absolute minimum". The use of private providers, he said, "should only be a last resort because we have huge capacity in Scotland".
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Fast forward a few days and an advertisement appeared in the careers section of the British Medical Journal. In apparent contradiction of Mr Neil's assurances, it sought expressions of interest from the private sector for the provision of clinical procedures to Scottish health boards right up to October 2016, with the option of a further 12-month extension. That takes us to 2017, a decade after the SNP promised to halt such spending. It is understood the contracts could be worth £20 million a year.
In fairness, less than half of 1% of the NHS budget goes on private healthcare. Also, the goal of cutting waiting times for patients who require medical procedures is a worthy one and one on which the Scottish Government has in general made good progress. In addition, it is preferable for National Services Scotland to commission private contractors rather than leave this to individual health boards because the national body is in a better position to negotiate reasonable rates.
Nevertheless, Mr Neil's assurances about the temporary nature of the current arrangements seem at odds with invitations to tender for major private contracts extending beyond the next Scottish parliamentary elections. In his interview he made much of his Government's investment in facilities and staff to increase NHS capacity. This appeal for bids from private contractors suggests it does not believe this will be adequate to meet demand.
The original rationale for wanting to rid the NHS of private contractors was that the money was better spent on improving and expanding the NHS. Nor is this just about money. The scandal of NHS Lothian patients who suffered botched spinal operations at the hands of Dr Colin Campbell Mainds after they were diverted to the private BMI Ross Hall Hospital in Glasgow is still fresh in the memory.
Nobody is pretending that running a body as large and complex as the Scottish NHS is simple but a little more frankness from the Health Minister would not go amiss.