ANDREW McKie tells us that the NHS is in crisis – as if we didn't know ("NHS is in crisis (yet again) and spending ever more money will never fix it", The Herald, October 26). What he ignores is that the trade in private hospitals, private clinics, private care homes, private care at home services, and so on, is booming as never before.

Vast sums are being paid for these businesses, often by US investors. Rampant greed and the profit motive are the driving factors. Professional staff – doctors, nurses, carers and ancillary staff, mostly trained by the NHS itself – are lured away to work for the so-called private sector. It is clear that serious radical (and I mean really radical) measures need to be put in hand urgently, to remedy this; yet there is no sign that any political party has the interest or the bravery to promote them and to tackle the public apathy that must be overcome in order to achieve this.

As a local example of the shortages – which is no doubt replicated in other areas – we are struggling to find someone to replace our retired GP and we are having to rely on the admittedly excellent rota of locums to serve this welcoming and rewarding community in a wonderful part of the Highlands. It should not, and need not, be like this.

Michael Otter, Kinlochbervie.

WHEN WILL THE PENNY DROP?

ANDREW McKie is the latest of your columnists to identify the failings of the NHS and I am wondering how long it is going to take for the penny to drop among our dim-witted politicians.

On Monday, Guy Stenhouse wrote about the unsustainability of the present health service ("The dangers of free healthcare will have to be tackled", The Herald, October 25) and, some months before that, Andy Maciver detailed in stark terms the inefficiencies of the NHS and how unfavourably it compares with health provision in other countries.

It is not "the envy of the world" as dewy-eyed supporters would have you believe. In reality, it is in dire need of reform and overhaul. The dogs in the street know it, I suspect most of the population knows it, but as it is a hot potato politically, our elected representatives do nothing.

Sadly, we cannot debate the issue rationally because reformers will be accused of "privatising the NHS", "casting the poor adrift" and similar nonsense. It reminds me of 40-odd years ago when the country desperately needed a proper immigration policy but none was forthcoming because imaginative, pragmatic ideas were instantly branded as "racist", usually wholly wrongly but it was good political point-scoring. Politicians ignored the issue and kicked it into the long grass. Inaction prevailed.

We are heading down that same road again with "our NHS" unless there is a bold MSP out there who will call it as it is.

Don't hold your breath.

James Miller, Glasgow.

UNHEALTHY CAPITALISM

THIS week's article by Guy Stenhouse finds him in an area which is probably outside his field of expertise, namely health, and which he can only see as a financier.

His basic premise is that we cannot afford free healthcare. Healthcare is undoubtedly becoming more expensive year on year for various reasons. One significant one is the annual increase in new drug costs, which far exceeds inflation and which is largely due to the pricing policy of biotech drug firms which decide what they think the market will pay for their drugs and apply the same price worldwide. I respect their need to make a profit, but how big a profit? This is free market capitalism in action, which Mr Stenhouse espouses. Is it compatible with healthcare?

Sam Craig, Glasgow.

ADVICE FOR QEUH DISCHARGE

I REFER to Ann Welsh’s letter criticising the discharge arrangements at the Queen Elizabeth University Hospital in Glasgow.

On any future discharge from the QEUH, I hope she has a better experience based on my list of suggestions derived from my own hospitalisation there:

1. In most areas within the hospital I found that use of mobile phones is permitted.

2. To summon a taxi, near the main Reception desk I observed there is a dedicated phone line to a private hire company, in addition to a payphone to call any other transport service provider.

3. Outside the main entrance, at most times, I saw a line-up of three or four black hackneys waiting speculatively for passengers.

4. The hospital is extremely well served by buses in all directions – apparently with buses departing every minute in daytime.

5. I believe, in special cases, a homeward patient transfer service can be called upon.

6. Within the ground floor there is a large atrium where one can sit comfortably and wait for one's lift.

7. Outside, both at the front and the rear of the main building, there are wide canopies which provide reasonable shelter from the weather.

8. In non-Covid times I have seen a discharge lounge near the side entrance for departing patients. I am advised this room is presently being used as a Covid test centre.

9. Within the foyer area, during working hours, there are usually volunteers in red T-shirts who will assist in all manners of ways, as well as staffed reception and information desks.

10. I found that NHS staff will help patients wherever possible and most will "go the extra mile" to assist everyone.

Robin M Brown, Milngavie.

THE FEAR OF A NUCLEAR WINTER

WHILE Defence Secretary Ben Wallace is trying to distract us with nonsense about an independent Scotland being a more likely target for terrorists ("Defence Secretary warns of terror risks rise for independent Scotland", The Herald, October 25), the big picture about the accelerating nuclear arms race is quietly kept away from the peasants. Even Mr Wallace must have felt a little embarrassed by this claim. Apparently not starting Middle East wars, not having 240 nuclear bombs on our territory and aspiring to a fairly inclusive culture is the way to increase terrorism.

Meanwhile, if the climate crisis does not get us first, the military/industrial interests in the world's nine nuclear powers are working very hard at great cost to accelerate new technological developments in their capacity for mass destruction. The US thought they were comfortably ahead but China has just tested a "fractional orbital" weapon that can evade US early warning systems. These can fly over the South Pole out of reach of the Pentagon's interceptor missiles and also counter the sea-based Pacific missile systems. Of course this will give the military in all the other nuclear states an excuse for demanding even more money and scientific resources to jump another step ahead.

This is a never-ending game of deadly leap-frog which races ahead with no serious disarmament programme. They don't even pretend any longer. Scotland is getting an extra 40% of nuclear warheads and a new generation of missiles courtesy of the UK state.

Prioritising climate change? Hardly. Unless they secretly believe that the solution to global warming is a nuclear winter.

Isobel Lindsay, Biggar.

SNP HYPOCRISY OVER OIL

NICOLA Sturgeon in her speech on Monday pre-COP26 in relation to transition away from oil and gas “promised job security” for those currently working in the industry ("Sturgeon vows ‘catch-up’ plan after three annual climate targets missed", The Herald, October 26). There is no solid plan for this transition and her “promise” will end up, as ever with her, as fine words and no substance. Time and time again, including duping her supporters into believing she will deliver separation, has she “promised” but not delivered.

As the SNP dream of independence had its very foundation – its economic saviour – on oil and gas production (“it’s Scotland’s oil”), it is utter hypocrisy. Surely disciples will now see through our First Minister and her regime for what they are.

Douglas Cowe, Newmachar.

FAIRER WAY TO COUNT VOTES

THERE is a simple way to deal with the problem of parliamentary constituencies of unequal size, and the inherent unfairness of the votes cast by MPs ("Scottish constituency reform reveals reality of the Union", The Herald, October 25) – weighted voting. If your constituency has 20% more than the average population then your vote counts as 1.2; if your constituency has 75% of the average then your vote counts as 0.75.

This could have upper and lower limits to ensure there isn’t too much imbalance, but it would allow constituencies to retain boundaries that are coherent to their area and urban identity, and perhaps help to reduce the fights that crop up whenever the boundary commission starts to do its job. Much fairer than at present, certainly.

Mind you, if fairness in voting is the aim, then let’s have larger, multi-member constituencies with MPs elected by single transferable vote. Two problems solved in one solution. And I would bet the voter turnout would rise when people realised their votes weren’t mostly wasted votes as now.

Fergus Duncanson, Milngavie.

Read more: Time to hold our noses and work with the Taliban