THE First Minister took to the stage on Monday to tell us of her plans to deal with the current healthcare crisis ("Covid and staff levels ‘will hit care homes bid on NHS crisis’", The Herald, January 10), but words alone will not suffice when the NHS workforce is currently exhausted and on its knees.

I remain of the belief, as I stated in a letter to you on September 1, 2020, that the core failure in healthcare planning in Scotland is that we have major healthcare decisions being made by people (politicians and advisers) with little or no practical clinical experience.

Clinicians warned the Scottish Government of the perilous cracks in the Scottish healthcare system months ago. In addition, back in March 2022, the Nuffield Trust published a comprehensive report, entitled Health System Recovery From Covid-19, International Lessons For the NHS.

One conclusion of this report is that it is not possible to continually run routine day-to-day health services at more than 90 per cent capacity and then expect them to cope whenever there is a surge in demand. The same report also concluded (almost a year ago, remember) that "many countries must balance the need for measures that reduce waiting times and backlogs in the short term with those which build workforce future resilience in the long term, and avoid actions which could increase burnout or lead to more staff leaving the profession". Sometimes I wonder if anyone advising the Scottish Government has ever even read this report, never mind considered its recommendations.

To anyone who has ever worked in frontline healthcare it will be clear that the response to our current dire situation needs to take place on two levels. First, in the short term, politicians need to stop talking from afar and start visiting that front line, collecting information first hand from those working under intolerable pressure to keep the system afloat.

Make health the number one political priority across Scotland for the next two years and prioritise spending to improve staffing levels and to re-energise the workforce. How any further money is then spent should then be decided by doctors, nurses and paramedics at a local level; they are the people who know what is going wrong and they are best placed to know how to fix it.

In the longer term, we must have a wide-ranging, independent, root and branch review of healthcare provision. This would involve collecting comprehensive performance data from the NHS across the whole of the UK and then comparing this with data from other countries across Europe. This would allow us to identify those clinical and administrative areas where other countries' outcomes are much better than ours and what we must then do to match their success in these areas. To succeed in this will need hard work, a collective open mind and an absence of all ideological prejudices – but succeed it must, for the sake of ourselves and our children.
Michael Laggan, Newton of Balcanquhal, Perthshire

Sturgeon has been a disaster

WATCHING Nicola Sturgeon struggle in her BBC interview on Monday (January 9), there was no contrition or apology for her own culpability when as Health Secretary she set in train the destruction of the NHS in Scotland. No admission she cut the number of nurse training positions, cut the number of medical training positions, was party to the SNP ploy of limiting the number of Scots-domiciled medical students while allowing universities to fill medical schools with English and Chinese students who leave the country after graduation.

This is notwithstanding her rubbishing of Professor David Kerr’s 2005 radical plans to modernise the service. There was no apology for the closure of 1,900 hospital beds and multiple convalescent units, an action with direct consequences on the present 1,300 “blocked beds” which are a major factor leading to the A&E chaos and patient delays.

Where was the money due to the NHS on the Barnett principles spent when not on the NHS? Real NHS financing has been reduced for years under Ms Sturgeon.

The SNP alleged policy of moving to community care is denied by its action in promoting large acute hospitals; the Queen Elizabeth University Hospital, and the Monklands replacement, when what are required are community and convalescent units, and increased locally-accountable social care. The proposed National Care Service will be a bureaucratic disaster and will destroy local council services and oversight. The integrated health and social care organisations have been a clear failure. Too many bureaucrats and fewer careers. It is the centralising SNP way.

The problems of A&E are not of A&E – the Queen Elizabeth A&E has 33 consultants – but is of the lack of downstream care facilities. If these were sufficient A&E would be transformed.

Ms Sturgeon is lauded as an exceptional politicianm but truth be told she has been a disaster for the NHS in Scotland, and clearly has no idea how to solve the problems of her own making. She must dislike Hamza Yousef intensely to have given him what was a “hospital pass” no doubt in the hope that blame would bypass her. The poor man is lost beyond salvation, but the real culpability lies elsewhere.

Without a radical review of the future needs for healthcare, many of which are obvious but denied or ignored, the NHS in Scotland is doomed to a two-tier system when those who can, pay, and those who cannot suffer and wait. Indeed that situation is already here.

Quality healthcare provision, free at the point of need, is the raison d’etre of the NHS. The destruction of the service will be the legacy of Ms Sturgeon and the SNP.
Gavin R Tait FRCSEd, East Kilbride

Private care the norm for the rich

RISHI Sunak won’t say whether he and his family use private health care – they do – and that it’s "not appropriate" to talk about it – it is ("Sunak hints at shift in strategy as unions double down on NHS strikes", The Herald, January 9).

In November the Guardian reported that Mr Sunak is registered with a private GP practice that charges £250 for a half-hour visit, offers appointments in the evenings and at weekends, charges £400 for home visits, £150 for an email or phone consultation, and £80 for prescriptions.

Dr John Puntis, co-chair of Keep our NHS Public, said using private health care is the norm for the rich and powerful and that “those making decisions about vital public services are often least likely to use them, which of course reinforces their ideological animosity”.

If our so-called public servants were required to use public services like the people they purportedly serve, then you can be sure these services would be adequately funded.

Scotland funds its health service more generously than England’s but is constrained from doing more because it isn’t the currency issuer – England is.

The UK Government doesn’t believe in well-run and funded public services. This alone is a compelling reason for Scotland to restore its sovereignty.
Jackie Oudney, Edinburgh

We should be better than England

AS a frequent listener to First Minister’s Questions, one of her stock answers when questioned on poor figures for public health and services is to acknowledge things are not where she would like them to be but that her figures are better than in England, which seems to satisfy her devoted following – and I notice that the same argument has become a fairly regular one in your Letters Pages. Given that Scotland gets £126 public expenditure per head for every £100 in England, should it not be that anything less than a 26% betterment from the metrics south of Hadrian’s Wall should be classified as abject failure?
Duncan Sooman, Milngavie

So where are the solutions?

SCOTTISH opposition parties call for the head of Humza Yousaf, while offering no solution to the winter challenges in our NHS. The current problems our health service is experiencing are not confined to Scotland; they are also besetting all governments, including those of England and Wales.

The Scottish Government has held resilience meetings in 2023 in an effort to address the challenges; meetings have also taken place with nursing unions and the offer currently on the table is the best offer anywhere in the UK. Nurses in Scotland are the best-paid in the UK. But we have still heard no constructive solutions from the opposition in Scotland. And what is their continual criticism doing to the morale of the hard-pressed NHS staff ?

Some of the issues affecting our health service are a result of Brexit (something Scotland did not vote for) with the shortages in the workforce and this can only be addressed by Scotland rejoining the EU.
Catriona C Clark, Falkirk


Read more letters: This is the last straw. Yousaf must now go


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