MORE THAN 18 months have elapsed since the disappearance of the government task force last seen preparing to go into Paisley’s Royal Alexandra Hospital. The task force, an expensively-assembled cohort of managers and civil servants, had been sent to Paisley to tackle accident and emergency waiting times at the hospital. It hasn’t been seen or heard of since.

Two years earlier, another task force was charged by the Scottish Government with overseeing a £50 million action plan to improve emergency care in Scotland’s casualty wards. This followed the revelation that, in January, 2013, some one in 10 patients had been made to wait for more than four hours in our A&E wards.

Last June another task force was sent into the new Queen Elizabeth University Hospital to help improve – you’ve guessed it – A&E waiting times. Health Secretary Shona Robison said the experts would be sent in to improve management systems. All attempts at locating it since or discovering whether it found have proved fruitless.

In fairness, it’s probably not difficult to lose the odd health task force when so many are operating in the same terrain at the same time.

Task forces are the Scottish Government’s favourite type of sticking plaster to make it seem it is dynamic in addressing areas of stress in the NHS. The practice seems endemic in the machinery of Holyrood as the previous Labour administration liked to assemble task forces too.

Compare this to the approach of the Welsh Government which, it seems, prefers not to use task forces in areas of concern in health. Instead it favours a more direct means of getting to the nub of the problem. It has announced that three of its regional health boards had been placed under the second-highest level of monitoring for failures in their systems and in their delivery models.

Cardiff and Vale, Hywel Dda and Abertawe Bro Morgannwg University health boards were raised to “targeted intervention”, one level below “special measures”. All three had come under scrutiny for failing to deliver appropriate three-year business plans covering areas such as quality of care, workforce and finances.

One other Welsh health authority, the Betsi Cadwaladr University health board, is on “special measures” while the Welsh Ambulance Services Trust was taken down from “enhanced monitoring” to “routine arrangements” after a significant improvement.

Thus, the Welsh Government is having an honest conversation with its voters on the delivery of health. In an area that directly affects people’s lives and physical and mental wellbeing, it has ditched the politics. Everyone knows the hospitals and regions that are under-performing and that proof of progress will be required in a year when they will be re-assessed.

In Scotland, meanwhile, Nicola Sturgeon, as promised in her manifesto in April, earmarked another £500m for the “cherished” NHS. Let no one be in any doubt that the Scottish Government cares deeply about the NHS but I fear that she and poor, besieged Shona Robison, are being given the run-around by one of the most bloated and unaccountable executive management cartels that exists anywhere in the UK.

The Scottish Government spends almost £13 billion a year on health, a figure that accounts for more than one-third of the country’s overall budget. Within this are rich pickings for the sprawling tiers of big-earning executives that exist within the NHS in Scotland. There may be an obesity crisis in Scotland; nowhere is that more evident than in the line of senior management that feeds from this £13bn trough.

Why, for instance, was it thought necessary to create five new elective centres at a cost of £200m to replicate on the east coast that which the Clydebank’s Golden Jubilee does? Among clinicians, the talk is that there is no evidence to justify these. Yet, in order to staff them up, doctors will require to be taken from other hospitals; all of this to satisfy a legacy obsession.

Meanwhile, any task force that can discover why we spend more than £150m annually on locums would be welcomed. Much of this goes into the pockets of salaried NHS doctors. A generation ago only doctors were permitted to take their patients’ blood pressures; now you can buy a DIY kit and do it at home.

Similarly, there are dozens of procedures that are the sole preserve of doctors that can just as competently be done by suitably trained nurses and physios. But when there’s an annual budget of £13bn up for grabs doctors, understandably, are reluctant to clamber off the gravy train. From there it doesn’t take a task force to work out why there is pressure on our A&E wards. More than 20 years ago it was recognised that too many people were turning up at A&E. Two decades later, despite the other options of visiting a GP, calling NHS24 and attending out-of-hours minor injuries clinics, there are still too many people attending A&E. It shouldn’t take a task force to work that one out either.

Scotland’s population is ageing and we are not getting any healthier either. The pressures on properly targeted health delivery are not going away any time soon. Meanwhile, the Government sets itself unrealistic targets in cancer, A&E and waiting lists. This peremptory and short-term approach adversely affects other areas.

The Integrated Joint Boards (IJBs) for health and social care were regarded as the "blue-sky" product of one thousand hours spent in executive think-pods. The philosophy behind these is sound: to provide more seamless and integrated care packages for patients. These though, are being sacrificed on the altar of a target culture. Health boards were given a "change fund" two years ago to assist in making the IJBs work. Health professionals I’ve spoken to, though, are reporting that executives threw the money at the targeted areas. Each week they must take a call from NHS chief executive Paul Gray demanding progress reports on their mission to reduce waiting times and cancer figures. It is a politically-driven, short term and subjective approach and it is sucking resources from other critical areas.

Until we begin to see leadership and rapid implementation of 10-year-old strategic plans for our health service, Ms Sturgeon and Ms Robison are destined for the duration of their tenure to send in task forces to sort out the same problems. If you insist on task forces, how about a task force of one to visit Cardiff for a day to assess its monitoring system?

We need to move away from hospital-based care to community-based care and, particularly, social care. Also, Scotland has 14 health boards and 11 special health boards. If we are spending hundreds of millions of pounds trying to implement IJBs why are we still running traditional health boards in the same way and at the same cost levels?

Our NHS is our most cherished national asset but the people we have tasked to run it for us are running it into the ground.