THE political decision to announce four major trauma centres (MTCs) was an unplanned "back of the fag packet" decision by Alex Neil before the 2015 election. It has been clear to all medical counsel that there is no need or clinical demand for four centres. To maintain skill and activity levels of the staff the population of Scotland merits only one MTC, but politically that is a non-starter. Yet the SNP Government cannot admit the error, and delays rather than cancel and proceed with more realistic and achievable changes in the NHS (“SNP under fire as trauma units delayed by three years”, The Herald, January 12).

The number of very seriously injured patients requiring multi-speciality care, and who presently die through lack of such care is 40 per year. The other thousands proposed for the MTCs are those with complex single injuries which presently are managed, mostly well, in district hospitals. Should these patients be removed to MTCs to justify the expenses, and if elective orthopaedic cases are moved to elective centres of excellence, then the raison d'etre of district general hospital trauma and orthopaedic units, surgeons and theatres will go.

Government persistence with MTCs and such elective centres will cause the closure of local units. No surgeons will wish to practise in such emasculated units.

The Herald and many others repeatedly call for an honest debate about the future of NHS services. The repeated evidence of Government politicking with health, the SNP’s persistent failure to take advice, or acknowledge Nicola Sturgeon’s and Shona Robison’s failure to act in the best interests of the NHS are more and more in evidence. Who has the courage to change the way ahead?

Gavin R Tait,

37 Fairlie, East Kilbride.