THE current serious crisis faced by the Scottish Ambulance Service is not confined to one dreadful case in which a critically ill patient died after a 40-hour wait, though it is understandable that such an incident should spark an outcry.

Over the summer, the service has been dealing with 10,000 more calls a month than at this time last year, and waiting times from calls to delivery at hospitals have gone from around an hour to six hours as an average. One GP declared: “Forget about the ambulance, they don’t exist. This is third world medicine.”

More than a week ago Unite, the trade union, urged that “major incident status” should be invoked. On Wednesday Humza Yousaf, the Health Secretary, asked patients to “think twice” before calling 999 – something his political opponents described as “reckless”. The First Minister then declared that she would be “going back to [her] office to finalise the detail of the request for military assistance”, leading to criticism from opposition leaders that the Government’s reaction has been “too little, too late”.

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There is certainly criticism to be made of why there was not action of this sort weeks ago, since the First Minister herself conceded that hospital trusts in England had already taken similar steps, and the strain has been evident for months. But Ms Sturgeon’s point that other UK health authorities face comparable difficulties is, if no excuse for a dilatory response from her administration, accurate enough.

The unprecedented pressure on ambulances is in part the result of unprecedented pressure everywhere. The pandemic caseload continues to threaten to overwhelm capacity, while other health conditions – the treatment of which has been disrupted for 18 months – add an enormous backlog. Restricted access to GPs has exacerbated long-term conditions, and new cases and isolation of contacts limit the availability of front-line staff.

At the most basic and practical level, this means fewer staff, pressure on beds and delays in admissions and, consequently, ambulances and staff tied up at A&E while hospitals try to find capacity. That in turn means they are unable to tackle as many responses.

That is a good reason for effectively deploying the additional resources that have been provided for the NHS as a matter of urgency, especially since Gordon Brown’s think tank, Our Scottish Future, found that Scots, in common with the other UK nations, placed the NHS top of their list of political priorities. It is also an argument for continued vigilance and personal responsibility from the public in minimising Covid’s effects, and a potential justification for decisive Government measures to control the virus’s spread – even if they are sometimes unpopular and restrictive.

Some of these difficulties, however, pre-date the pandemic and there are several measures on which the Scottish NHS performs less well than health authorities elsewhere in the UK. Waiting lists, now at more than 600,000, were at 450,000 even before coronavirus; the Government’s own targets on A&E waiting times are consistently missed; the 12-week treatment time that it made legally obligatory has been breached more than 300,000 times; the waiting time target for cancer patients has not been met for the entire duration of Ms Sturgeon’s period in office.

The SNP talks a good game when it comes to its support for the NHS, and its messaging has been effective in emphasising the importance it places on it. But everyone but ministers acknowledges the obvious fact that delivery does not match the rhetoric.

Health care has been devolved since 1999 and the SNP in power since 2007. In that period, health spending increased more slowly than in England (by 63 per cent rather than 80 per cent through the 2000s, and three per cent compared with 10 per cent through the 2010s, according to the Institute for Fiscal Studies). Even the “massive increases” promised at the last election are lower than England’s, and prompt the question of why they had not been a priority for the previous 14 years of SNP Government.

The current emergency is not entirely the Government’s fault, but it is entirely its responsibility. Its new start needs to begin now.