IF Nicola Sturgeon "did God" I’d like to think that she would have sufficient reserves of humility and self-awareness to thank The Almighty for sending her Theresa May. At a time when the First Minister might otherwise have expected to be encountering an extended period of intense political turbulence along comes her special friend in Westminster to take the heat off.

In the space of a few months this hapless and unlucky woman has been exposed as Britain’s weakest-ever Prime Minister. There she is in Africa resembling a drunk man looking at the kebab and now here she is being ruthlessly humiliated by European leaders over her Chequers plan. And there she was again yesterday looking like a person on the edge of a breakdown, no doubt having been foolishly told by her advisers that she needed to put on a show of cold but controlled fury. Such emotional intensity is beyond the Prime Minister and when she attempts it she merely invites ridicule. That the men in her own party plotting to exacerbate her discomfort resemble the grotesque 19th century caricatures of Mr Punch is scant consolation.

At next month’s SNP conference in Glasgow it won’t be hard for Nicola Sturgeon to emerge, once more, looking like an authentic and mature stateswoman who was made for this stuff. She and her government have now reached a point in their lengthy spell in office that will define them. With the polling numbers remaining healthy, as they have done for the last four years, they have also been handed a Brexit which has become more chaotic than they could have dreamt. The only big decision facing Ms Sturgeon, it seems, is when before 2021 does she opt for a second independence referendum.

The First Minister, though, will also be acutely aware of another major problem at home which may yet threaten to thwart those ambitions. At what point does it become impossible to disguise the fact that a full-blown crisis in the Scottish NHS is looming? For a decade or so successive health ministers have just about managed to extinguish little fires in several of Scotland’s health authorities: hospital waiting times; A&E numbers and the endless whingeing of GPs who want all the benefits of being in the NHS system but few of the unsocial inconveniences. In key areas Scotland is still out-performing England and unlike the Westminster Government the SNP is not trying to privatise the NHS by stealth. During this period, though, a superannuated health civil service and executive has worked hard to disguise the true extent of the financial apocalypse which is beginning to engulf it.

Last week’s admission from the Scottish Government that there had been a failure in recalling women for cancer screenings, after saying five months ago that the IT issue didn’t affect patients was a symptom of this. This is a mess for the new Health Minister, Jeanne Freeman, left by her predecessor. It was also symptomatic of a service bloated with an army of under-achieving and overpaid chief executives whose default position in dealing with the cabinet secretary for health is to assemble numbers in a palatable form for them and thus live to put an extra year of earnings into their pension pots.

The increasing number of older people in Scotland is creating significant increases in demand for both health and social care services. Everyone knows that, don’t they? In the health service it’s been predicted for years that the current system would just about keep its head above water in coping with this until 2018/19 when it would reach the point of critical mass.

Four health boards have already been put into "escalation" by the Government, escalation meaning next door to the mortuary.

NHS Tayside is replete with so many problems and haemorrhaging so much money that the special measures required to deal with this dysfunctional entity have probably not yet been invented. Tayside’s latest report to its finance committee said that it needed to find £48.1m of savings by the end of March 2019. Thus far £6.8m of savings have been identified.

It’s now seeking more bailouts from the Scottish Government to stop it slipping further into the red. The board already owes ministers £45.6m in unpaid loans, and payments have been suspended due to Tayside’s ongoing cash problems. It’s been suggested the total owed could rise to £60m; these are in addition to the £48m savings for this financial year. These will be required year on year.

At the moment, the Scottish Government seems to plan only one or two years ahead. This allows it leeway with the increasing problem of cash flowing into the system being insufficient to deliver current levels of services. It’s the financial equivalent of running up a down escalator. This week has seen a massive variation in the number of hip operations being delivered. If this was to be delivered more consistently across Scotland more cash would be required. The other three health boards in a level of escalation are also there because they can’t meet their financial targets. The level of deficit for each appears to be in line with the gap being faced by Tayside.

Ms Freeman has a deserved reputation for intellectual rigour and a woman who is not slow to rise to a challenge. She will require all of this and more to deal with one of the core elements of the breakdown at the heart of the health service: an acute crisis in leadership across Scotland’s health boards. This protected executive class is drawn from hospital management but few, it seems, possess the ability or experience to lead our health and care system through the significant change required to respond to the huge challenges.

Ms Freeman may wish to ask why in 2015 the Scottish Government pledged to invest £200m in six new elective centres for a country of only five million people, at a time when we are trying to shift the balance of care from acute to care in the community. That figure is now running 40% over budget and there is no agreement on who is to fund the ongoing costs.

The Scottish Government may be fast approaching a point where it must raise taxes to meet this oncoming financial hurricane in our health service or seek help from HM Treasury. It must decide which would be the lesser of the two evils.