NICOLA Sturgeon’s assertion that she will increase NHS elective output to 110 per cent of pre-Covid levels is fanciful, if not a dishonest pre-election bribe ("Sturgeon pledges to ‘remobilise’ health service and maximise hospital capacity", The Herald, April 7). Pre-Covid the NHS never achieved anywhere near 100% capacity for such as hips and knee replacements, as demonstrated by the hundreds of thousands who were failed by the 12 weeks statutory guarantee introduced by her. As a former health secretary such an assertion betrays either a gross lack of knowledge of the workings of the NHS, negligence, or more likely a despicably misleading election gambit.

A recent paper from surgeons in Edinburgh demonstrated that even if the elective surgical service could achieve a 130% increase in output it would take four to five years to clear the backlog of waiting patients even without having to deal with new presentations. Furthermore many surgeons, both consultants and trainees, have been unable to practise their craft for a year and will have lost skills or never achieved them. Many senior consultants may decide relearning for a few years of severe management pressure to achieve unrealistic targets is not worth the trouble, or risk to their physical and mental health, and will, as the BMA has found, take early retirement. Trainees will take longer to gain the skills of a consultant and for years be unable to fill the gaps.

For years under the SNP the NHS has been grossly mismanaged, starting from staff training and bed cuts initiated by Ms Sturgeon, and before Covid was not fit for service and had no surge capacity. Only by extreme efforts has it become a “Covid Service”. The NHS as we have known it, care at the point of need, no longer exists and as a former NHS consultant I am saddened and afeared for the future of the service under the present Government which promises much at election time but achieves nothing and is indeed negligent in the extreme.

Gavin R Tait FRCSEd, East Kilbride.


YOUR campaign against care charges for people with dementia and the response this has provoked from the political parties, who are now competing about which will do most to address the issue ("Labour and Tories pledge to go further to abolish 'dementia tax'", The Herald, April 7) is to be welcomed. But to describe these charges as a tax, even in inverted commas, is both misleading and unfortunate.

If we are to abolish charges for care and make care provision free at the point of need like the NHS, some people and businesses – the rich and profitable – will need to pay more tax. Portraying care charges as a tax panders to those who believe tax and public services are a bad thing and makes it less likely that the real problems associated with care charges will be addressed. Those problems are reflected in the proposals from the various political parties.

On the one hand, the SNP is proposing to double free personal and nursing payments for people in care homes to £421 a week. This is considerably less than the £740 that local authorities now pay for publicly-funded places in care homes, but is far below what many private providers now charge for self-funders, £1,600 a week being not uncommon (" Son in formal complaint over nursing care fees for mother, 97", The Herald, April 6).

On the other hand, the Tories are proposing that free personal and nursing care payments should be worked out separately for each individual. This is unworkable, not least because individual needs vary over time and on a day to day basis. But it also undermines the advantages of care provision in collective settings. On an NHS ward, for example, staffing levels – and therefore costs – are worked out on the basis of what is reasonably required to meet the needs of all. Sometimes staff will be stretched, sometimes less so, but they are deployed for the benefit of all.

Care home providers, however, have long wished for care fees to be assessed individually. They know that once the fees have increased, its almost impossible for families or public authorities to reduce them. This is exactly what happened after free personal and nursing care was introduced. Care homes hiked their fees for self-funders by a similar amount, so few people benefited. The private care home market has ever since increased its fee levels each year beyond inflation, a good example being the recent nine per cent, or £500 a month, increase in fees by the Care Concern Group ("Care home firm slated as fees rise by £500 a month", The Herald, March 29).

Until the fees that private providers can charge are strictly controlled or care is turned into a proper public service like the NHS, the problem of unfair care charges will continue.

Nick Kempe, Glasgow.


TOM Wylie (Letters, April 7) writes that “independence, for the sake of it, will do nothing to improve the lives of the people of Scotland”.

What Mr Wylie fails to appreciate is that achieving independence is not journey’s end, but its beginning. Achieving full control of our affairs for the first time in more than 300 years, and no longer locked into a Union in which, at best we are a junior partner, and at worst as little more than appendage being 8.2 per cent of the UK’s population, will allow implementation of policies corresponding to the expressed views of the Scottish electorate (like not leaving the EU), and better suited to the needs of the Scottish economy, rather than the needs of the UK economy, which is imbalanced to the point of being dysfunctional.

Alasdair Galloway, Dumbarton.


I AM pleased to see George Galloway, All 4 Unity, proposing that, if a putative referendum gave separatists victory, Scottish regions should have a choice of seceding from or remaining in the UK. We all know the districts that supported secession in 2014 – three west of Scotland ones plus Dundee (four out of 32). These are the heavily-populated heartlands of nationalism. There is a strong aversion to separation in regions like Orkney and Shetland and Dumfries and Galloway. I doubt that Edinburgh or Aberdeen would want to be stuck in a separate Scotland.

So let us take this as a realistic proposal. It would indeed be an irony if Nicola Sturgeon broke up a country – just not the one she intended to.

Jill Stephenson, Edinburgh.


IN his polemic about Holyrood politicians ("A parliament of careerists governed by self-interest", The Herald, April 7), Iain Macwhirter misrepresents the Single Transferable Vote (STV) voting system with which he says the Liberal Democrats want to replace the present Additional Member System.

STV would most certainly not "turn Holyrood into one vast list-system". And STV would most certainly not "generate a class of

footloose politicians who owe nothing to their localities". Quite the reverse on both fronts.

Voting in each multi-member constituency is completely separate, with success and failure determined solely by the voters in each

constituency. And there is no "list" – voters are free to choose among all the candidates as they wish.

Far from being "footloose" and without local ties, those candidates elected as MSPs by STV would be elected only because they each had the personal support of a local constituency of voters. MSPs elected by STV-PR would be much more accountable to their local voters and much less accountable to the political party machines.

Changing the voting system for electing the Scottish Parliament to STV-PR would, in fact, address many of the problems Mr Macwhirter correctly identifies.

James Gilmour, Edinburgh.


AM I the only one in the UK to note that every time a broadcaster approaches our esteemed Prime Minister for comment, which incidentally is almost every single day, he is in a different location?

There are some who would say that this is good politics, making contact with voters across the nation.

There are others who will be scratching their heads and asking themselves if this PM, who was quoted as saying "f... business", is, in his own way, doing exactly that.

Having been a senior manager in a manufacturing company I am one of this second group. I know the amount of disruption that such a VIP visit creates to production whether it be a factory, laboratory or even an office. There is the distraction of the MD in advance of the visit and senior managers to make sure that the visit goes off without a hitch, and then you can forget the day of the visit. I cast my mind back to the doctor who threw David Cameron and the camera crew out of his hospital ward.

The only exception to objections being raised I can think of is where the company or institution being visited is craving free publicity.

Ernest Wastell, Meigle, Perthshire.

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