As darkness falls, and you draw the curtains and start to wonder what’s in the fridge for dinner, spare a thought for junior doctors whose night shift is just beginning. For them, twilight is not the name of a teenage vampire saga, but of the most dreaded hospital shift. Between Coronation Street and Good Morning Scotland, doctors with less than a year’s experience since leaving medical school can find themselves responsible for upward of 100 patients. The recent revelation that at Gartnavel and Edinburgh Royal Infirmary, to name but two, registrars can have 117 and 104 beds respectively under their sole watch was the stuff of real horror. Who needs vampires when NHS managers and their rotas can scare the living daylights out of their own staff?

Many of those in hospital, fortunately, are unaware of the precarious level of cover should anything happen during the wee small hours that one individual, with a single pair of hands and a hotline to a consultant, cannot remedy on their own. You don’t need me to spell out that such scenarios could prove fatal, and not just for patients. The haunting case of Dr Lauren Connolly, who in 2011 died while driving home at the end of a nightshift at Inverclyde Royal Hospital, did at least lead to the reduction in continuous night shifts doctors were expected to do. Even so, it doesn’t take much imagination to picture a newly qualified doctor today suffering debilitating stress and fatigue because of the strain they are put under, and suffering serious consequences as a result.

I have heard countless hair-raising stories from the graveyard shift from a friend’s daughter who, as a young medic doing her hospital rotations in Glasgow, could not tolerate the conditions in which she was expected to work. The anxiety of making critical decisions on so many desperately ill patients, without the time fully to assess every case was, for her, a nightmare. Convinced that one day she would make a terrible mistake, she hung up her stethoscope and left. Years of training that had cost hundreds of thousands of pounds were thus thrown to the winds. More importantly, the NHS lost one of its most promising new members, a gifted diagnostician who could have gone on to be part of its backbone in years ahead. These days, when her only contact with a hospital is when she’s in the birthing suite, I’ve never seen her happier. By contrast, NHS Scotland is growing more sickly by the month.

Consider, for instance, the number of absences due to mental illness among health service staff. This figure has grown exponentially, from around 86,500 working days lost in 2011 to almost 180,000 in 2014. And that’s without any record of those who fall ill with ordinary ailments, or suffer chronic conditions, brought on by overwork and worry. Victorians were appalled if a daughter wanted to become an actress, but these days you might say medicine is a sure way to ruin. The pressure under which doctors and nurses are asked to perform is reaching workhouse levels, their duties and obligations tightening like screws, as if they were on a torturer’s rack.

It is nothing short of scandalous that the managers and politicians in charge of the NHS have signally failed to protect its original, core values: a duty of first-class care not just to patients, but also to the staff who provide that care, sometimes at great personal cost. As NHS services have proliferated, more and more has been expected from fewer and fewer. To an onlooker it seems that its scope has widened dramatically, sometimes cynically to win votes or chime with fashion, at others to justify further funding. But as in any other business, those in charge of the budget set the tune to which employees must dance. And since many in the NHS are there because of a sense of vocation, and have kind hearts and consciences, they cannot easily walk off into the sunset and find another job. Nor, when their working day or night ends, can a good nurse or doctor clock off if a patient is crying out for help. Those who can do that, or are able to cut corners without a pang have, I suspect, gone into survival mode, knowing that they cannot cope with much more. It might explain the sullen nurse I encountered a few months ago in Edinburgh Royal Infirmary who pointedly ignored her patients for fear, no doubt, of being asked to do something she did not have the time to do.

There is no quick or easy solution to all of this, but one must nevertheless be found. Until these issues are resolved, the health service is failing everybody, including those it most depends on to function. It is, you might say, an age-long problem. NHS, heal thyself.