AS I read the daily reports of the enormous problems within the NHS, I can’t help but think of Captain Blackadder saying to Private Baldrick: “This is a crisis, a large crisis…. and a large crisis requires a large plan.” I would compare the NHS situation with that faced by the Scottish Government when in 2019 it was eventually acknowledged that our country had a crisis with drug-related deaths. A task force was assembled, made up of professionals possessing a wide range of expertise and experience in the subject matter.

The issues that the drug task force faced were long-standing and complex and the collective aims of the group were to document and examine the main causes of the crisis; promote actions to improve outcomes; and advise on changes in practice and in law. I believe that the British Government should take a similar approach with the NHS by assembling a UK-wide task force consisting of NHS experts covering all the main disciplines, combined with medical expertise from the medical Royal Colleges; but with no political involvement. As an outsider looking in, it seems to me that the problems we hear about daily are spread across the whole of the UK and should therefore be scrutinised at that level by key individuals who understand the problems.

The narrative is invariably focused on the need for more staff and more funding, however as so many organisations have found over the years, throwing money or people at a major problem sometimes doesn’t work. Instead, improvements in service delivery and efficiency can be found for example by changing the organisational structure and rethinking the operational and management processes.

A “root and branch” review of the entire organisation would ensure that actions, priorities and proposed solutions were agreed by medical experts. Specialist sub-groups might be required to explore complex issues. As has been the case with the Scottish Drugs crisis, the task force would report back to the Government which in turn would need to be fully committed to providing the financial backing to implement change. Admittedly it would be a huge piece of work and take a long time, but I think it’s much needed.

Brian Watt, Edinburgh.

THE VOTERS WILL NOT FORGET

AN excellent suggestion from Kirsty O’Brien (Letters, January 5) that MSPs should spend a few hours in A&E to find out what life on the front line is like. I feel that such an invitation should also be offered to MPs in England and Wales and Northern Ireland. They also could all benefit from the same experience.

However, it is unlikely that any minister from any part of the UK with powers to present suitable solutions would take up the offer. They would more than likely trot out the figures in millions being spent and the numbers of doctors and nurses being trained, conveniently ignoring the cuts of the last 12 years, promising great things for the future but failing to provide any answers regarding the current crisis.

I fear that the failure to address the problems in the NHS throughout the UK just now will be repeated next year and in future years, along with the usual excuses, global inflation, Putin, Covid, too many elderly patients, and perhaps from a few enlightened politicians, Brexit, which may be contributing to the insufficient number of employees.

We are told that the UK is a wealthy country with a strong economy and that we came through the Covid crisis with flying colours. Where has it all gone wrong ?

The NHS staff provide an amazing service despite the extremely difficult and challenging situations which they have to put up with and despite the financial restraints imposed by bean-counting politicians.

Voters have long memories and the current NHS crisis will be remembered for many years and certainly till long after the next General Election, so any party expecting to be elected to govern the country in the future would be well advised to have some some concrete and workable proposals to provide us with a standard of health service that works well and is fair to all.

Malcolm Rankin, Seamill.

CULPABLE IN PUTIN'S WAR

OF course I agree with David Patrick (Letters, January 6) that Vladimir Putin is responsible for his war. But my point about the EU and primarily Germany bearing “much of the blame” is based on their deliberate policy of putting their energy needs almost entirely in Putin’s hands, and their pusillanimous response to his previous aggressions in Crimea and the Donbas, thus giving him – clearly a neo-fascist dictator by his domestic actions for two decades, hardly surprising for a KGB officer – the confidence to go ahead with, as he thought, impunity.

The UK is also culpable but far less so.

John Birkett, St Andrews.

HeraldScotland:

DON'T SCAPEGOAT OLDER TRAINS

IT is no excuse for Transport Scotland to state that the current ScotRail fleet was inherited from the private operator Abellio upon re-nationalisation in April 2022 as if it itself was not to blame ("LibDems urge end to 1970s-style railways", The Herald, January 4). It fails to mention that the current fleet was part of the successful bid which it accepted when Abellio was awarded the franchise which commenced in April 2015.

The decision to accept the operation of short Inter City HST sets dating from the 1970s has proved to have been a costly mistake, with the company struggling to provide more than half the fleet on most days. Great Western, which operates similar short HSTs, has highlighted the high cost and difficulty of maintaining them and will withdraw all of them before the end of 2023. ScotRail's fleet should be replaced at the earliest opportunity and certainly before the proposed date of 2030 or later. Modern bi-mode units similar to those being operated on the East Coast Main Line should be introduced. They would be able to make use of the expanding electrification whilst operating in diesel mode on the sections still to be completed.

These HSTs apart, it is wrong to equate the cost in taxis to the age of the current electric and diesel multiple units operated by ScotRail. The class 318 units, whilst being the oldest electric units, are the most reliable of any of the electric fleets introduced prior to 2010, being almost twice as reliable as the units introduced at the turn of the century. The Class 156 diesel units, as well as being the oldest, are also the most reliable of any of the diesel units in the fleet, being even more reliable than the modern Class 170 units introduced between 1999 and 2005. It is also worth noting that on December 12 last, when services in Ayrshire and Inverclyde went into meltdown due to the modern Class 380 units introduced 12 years ago constantly breaking down in the cold weather, it was the elderly Class 156 and 318 units sourced from other routes that provided the few services that were eventually operated.

Therefore, so far as trains are concerned it is not always the oldest ones that are most unreliable.

Ian Harrison, Glasgow.

IN SPLENDID ISOLATION

AFTER reading of more deaths of children from Strep A recently ("Five more deaths from Strep A in last week, Public Health Scotland reveals", The Herald, January 5) I am left wondering why what happened to me in my childhood doesn't happen now.

In the late spring of 1943, together with one other unrelated child in the Lancashire town, I was diagnosed with scarlet fever and I was supposed to be put into the local isolation hospital with the TB sufferers. My Welsh granny refused and together with my aunt they undertook to isolate me for the six weeks necessary. Agreement was given. I was kept in a small bedroom in their two-up, two-down, outside-toilet wee house with a disinfectant-soaked sheet over the bedroom doorway. At the time I was four years old and told later that I was really ill, looked like a beetroot but was no trouble.

I had picture books and a doll for company and my lovely Aunty Gwyneth to care for me and the doctor, who called often. On release from isolation, I lost the books and doll but had gained a new baby sister as my mother had been pregnant when I contracted the fever. On being taken to see them I said that I didn't like "it" (the new baby) and asked to go back to my wee back bedroom at Granny's house. I did come to love the new baby when I got used to being in my own home again.

Could it not help if children diagnosed with Strep A were kept isolated for six weeks? Probably not, as times have changed in so many ways and there are more medications available. I don't suppose that children and parents now would agree to having a smelly disinfectant-soaked sheet nailed to the bedroom doorway.

Thelma Edwards, Kelso.

BLAME THE CITIZENS OF GLASGOW

MORAG Gardiner's letter (January 5) was depressingly accurate as a summary of the condition of the once-proud city of Glasgow.

However, while correctly observing the major shortcomings in Glasgow City Council's ability to empty the street bins in a timely manner which contributes to a proportion of the city's litter problem, she omits to mention the main culprits, namely the lazy and feckless minority of Glasgow citizens, drivers and business owners who treat the city streets and green spaces as their own personal litter bins.

Until this is resolved by enforcement of littering fines, a widespread shaming of the habit of littering, more parental guidance at home and citizenry skills education in schools, Glasgow will continue to be the litter capital of Britain.

CR Bell, Glasgow.

A DEBT OWED TO THE KING

GR Weir (Letters, January 6) suspects that the royals mean little to Scotland. In reply, I suspect many in Ochiltree and surrounding districts are thankful to King Charles.

As Prince of Wales, he bought and rescued Dumfries House and Estate for the nation. This has brought employment and much needed investment into a deprived ex-mining community. It has also brought joy and pleasure to many and encourages tourism in

the area. Without King Charles this would not have happened.

The royals frequently visit Scotland. Indeed the late Queen died at Balmoral.

I further suspect I am far from alone in wishing to retain the royal family in Scotland.

Eleanor Guthrie, Larbert.

Read more: SNP ministers should come and see NHS misery for themselves