HERE we go again (“We were expecting this week’s A & E figures to be bad, but these are awful”, Analysis, The Herald, December 29).

In the 1990s when I was clinical head of the emergency department (ED) of Middlemore Hospital in Auckland, New Zealand, the then health minister, Bill English, shortly to become Prime Minister, dropped by, not to tell me how to run the department, but to ask me: “What do you need?” I told him we needed to double the staff, a remark which at the time I didn’t think went down particularly well, yet, in the event, it happened.

Our politicians, throughout these islands, would do well to follow Mr English’s example. I think the standard of political debate concerning the NHS is, frankly, pitiful. You have been publishing the same story intermittently for years now, in language you might have used in 1948, concerning “A&E”, or “Casualty”, or “Cas” not “seeing casualties” within four hours. For the record, this means that emergency departments are not discharging patients within four hours. This seems to be a surrogate marker for catastrophe. Opposition parties call for the Health Secretary to be sacked.

Political point-scoring is useless in this context. It would be better if a cross-party committee asked clinicians the Bill English question: “What do you need?”

Better funding and better staffing are obvious requirements. Yet there are profound systemic problems within the NHS and it must be the clinicians who take a lead in outlining what they are, and how they should be tackled. One example: few members of the public, least of all politicians, are aware of the turf war that exists between acute medicine and emergency medicine, and that has resulted in an apartheid system of patient care at hospital front doors. Medical assessment units don’t implement a four-hour rule.

The medical assessment unit and the emergency department must amalgamate to form a true specialty of emergency medicine. The entire delivery of hospital acute care would take place around the central hub of the ED, which would no longer function as a first aid outpost, like a dressing station inundated during the Battle of the Somme, but as an integral part of the hospital. Emergency department “waiting times” would cease to have any meaning.

Dr Hamish Maclaren, Stirling.

• AS the calls grow ever louder for the resignation of the inept and frankly hopeless Health Secretary Humza Yousaf, one has to consider who on earth would replace him? In footballing parlance, the subs bench is bereft of talent.

Richard Allison, Edinburgh.

DEVOLUTION WAS A CON TRICK

PRE-DEVOLUTION, Scotland had a few hours a month's debate time at Westminster: Scottish law changes tended to be paragraphs (often undebated) tagged on to English legislation. A tiny number of politicians from Westminster’s ruling party held absolute power over Scotland, wielded from the Scottish Office. Devolution was supposed to change and democratise that, but as we see from recent events, any Scottish Secretary can find a sub-paragraph or a Section 35 in the Scotland Act to override any legislation Holyrood passes.

As Allan Sutherland (Letters, December 30) writes, the gender issue isn’t the thing, it is “affirming the role, process and limits of devolution in all areas” which matters. Scotland has a 1,000-year-old legal system, set within a puppet parliament, which no matter the majority any given legislation has, is always at the mercy of a “muscular unionist” aggressive veto.

As Andy Maciver asserts ("Will the Tories ever learn not to interfere with our Parliament?", The Herald, December 30), any given reasons for Westminster intervention on the gender issue “are largely phoney”, as this is about Westminster showing who is the boss, a playground game that as Mr Maciver suggests will probably blow up in the faces of Kemi Badenoch and Alister Jack. People of all persuasions are coming to realise that devolution was a constitutional con trick whose “pretendy" parliament’s inherent lack of autonomy means it cannot hold, and that it would take shared sovereignty within these islands to prevent the collapse of the UK: con-federalism, the settlement that dare not speak its name. I suspect people in England, Scotland Wales and Ireland would go for it: the ruling elite in England would not.

GR Weir, Ochiltree.

• IT must come down to who you mix with, I suppose. Allan Sutherland (Letters, December 30) complains about the Gender Recognition Reform Bill and suggests that Scotland is ablaze with indignant opposition to it. It so happens that within my family, and a wide circle of friends of (both sexes or genders), most of whom are very politically aware, I have never even heard it mentioned. The Westminster Tory Government, food banks, strikes, poverty, wealth inequality, Brexit, poor public infrastructure, the NHS, lack of sufficient housing, shambolic government – now that's a different matter. As I say, I suppose it's who you mix with.

John Jamieson, Ayr.

MORE REASON TO DOUBT SNP

THE SNP is giving Scotland one final reason to question its financial acumen before the year is out ("Brexit fund has left Scotland £300m worse off, claims SNP", The Herald, December 30). This £300 million is about the same sum of money as the SNP has wasted over the two as-yet-unbuilt ferries at Ferguson Marine. We don't hear an argument over this money from the SNP, only a strident statement that it is to protect jobs on the Clyde.

Meanwhile the next four ferry contracts are being placed at yards in Turkey. You could not make this up.

Dr Gerald Edwards, Glasgow.

TUC SHOULD CALL A NATIONAL STRIKE

AS a lifelong trade unionist who is now retired and enjoying the pension benefits I now have thanks to the trade union movement fighting on behalf of the workers, I am stunned that neither the TUC nor the Labour Party has taken issue with this Tory Government paying British soldiers an extra £20 per day to do the work of striking workers – workers who have every right to withdraw their labour to seek better pay and benefits.

In my opinion by accepting such payments, military personnel are now supporting a Tory Government's political attack on the workers of this country. If the Tories get away this, what’s next: will they ask the troops to dress up as policemen and physically oppress the strikers? Been done before, so I am told.

If this is the way the Tories want it, the TUC should take off the gloves and call a national strike and force an election.

I Archibald, Edinburgh.

GET TOUGH AGAIN ON COVID

WITH the UK Government having done all in its power to lessen the impact of Covid with its vaccination programme, and members of the public being extra-cautious, I feel that all these measures could be to no avail if we allow people from China to travel to the UK without any restrictions ("Relax in virus controls could see millions travelling for New Year ", The Herald, December 29).

It was only recently that China lifted its own restrictions, and as we saw on television with the situation in hospitals there regarding Covid, it is not over by a long shot. With Border Force on strike this just adds to the pressure the Army is under.

The UK should do as other countries and introduce strict measures to halt what could be another pandemic and keep our citizens safe.

Neil Stewart, Balfron.

GLASGOW AND THE ROAD TO RUIN

I DON’T know what the aims and objectives of Glasgow City Council were for this year, but if they included greatly increased numbers of potholes in the city and suburbs, and widespread litter along the pavements and on the verges of main roads, then they have been achieved. The city is a mess and many of the roads are now dangerous.

No doubt we will be soon be faced with an increase in council tax but as with many of SNP-controlled projects this will not translate into any noticeable improvement.

Nigel McMillan, Glasgow.

HeraldScotland: Is today's rugby blighted by bulldozing through the centre of the pitch replacing previous superb runs passing out to the wings?Is today's rugby blighted by bulldozing through the centre of the pitch replacing previous superb runs passing out to the wings? (Image: SNS)

MAKING WINNING CHANGES IN SPORT

I NOTE with interest Martin Hannan's article ("World Rugby need to stop interfering with the laws of the game", Herald Sport, December 28).

I’m no expert but do feel that compared with 60 or so years ago, first-class rugby now seems to have more frequent and longer hold-ups from scrums, lineouts and penalty preparations – while bulldozing through the centre of the pitch seems to be preferred to those previous superb runs passing out to the wings.

Likewise, surely soccer’s offside rule needs to be fixed – if not abolished. Each player is supposed to be marked by an opponent, so good luck to them if scoring from wherever they are. The rules on using hands and arms to fend off opponents, and on late substitutions, also seem too lax.

In tennis it is overdue that the women’s game should now be five sets, though maybe only in mixed doubles in the first season. That change should coincide with abolishing the second service, also long overdue, which wastes players’ energy and lengthens matches unnecessarily. Any player confident enough to go for an ace could still do so, but in the knowledge that failure would lead to losing the point rather than being favoured with a second attempt.

It is odd too that a losing player can win more games and more points than the winner, as in the 2019 Wimbledon final when Federer, with 36 games won, lost against Djokovic’s 32. Perish the thought, and I’m no doubt stirring up a hornet’s nest, but maybe the sets system should be changed to the best of say 65 games?

John Birkett, St Andrews.

MISERABLE SERVICE

I WAS interested to read the views of some correspondents regarding the Christmas Eve service from St Mary's Cathedral in Edinburgh (Letters, December 27 & 30), so much so that I decided to watch it on BBC iPlayer. I can see where they are coming from to an extent, not exactly a traditional service; instead the usual carols were interspersed with Celtic folk music and choral pieces, no doubt trying to appeal to a wider audience.

The overwhelming sense I had was that with only a few exceptions, most of the attendees both in congregation and choir looked miserable, as if they would rather be somewhere else. Not exactly a joyous occasion.

Brian Douglas, Ayr.

SOBER THOUGHT

DOUGLAS Cowe (Letters, December 29) is unfair to criticise the Radio Scotland journalist for saying "'speakin, doin, si, righ". Rather than being slovenly, the unnamed presenter was clearly preparing for Dry January by giving up G and Ts in advance.

Jane Ann Liston, St Andrews.

Read more: We need an urgent rethink as we regress to Victorian times