The NHS faces ever greater pressures

Brian Taylor: Our NHS is badly bruised – and needs urgent attention
Consider with me the public provision of health care in Scotland. Not simply the Scottish version of the National Health Service, established in 1948. Glance back instead to the Highlands and Islands Medical Service, initially formed in 1913, just prior to the outbreak of World War One. Under that pioneering system, doctors had a basic income – but could continue with private patients. Lack of funds did not prevent people from getting care. In short, medical treatment free at the point of need. The core, to this day, of the NHS. Down the intervening decades, it has become totemic, particularly in politics, to praise the NHS. Is it not wonderful? Is it not glorious? Faith in the health service is the closest we have to a shared religion. We still, rightly, laud the remarkable endeavours of medical, nursing and support staff. Many strive well beyond the allocated call of duty. And yet. We still, rightly, rely upon the NHS to cosset us if our health is failing, to address our medical and surgical needs. And yet. The system established in 1948 – or 1913 – is no longer fit for its much expanded purpose. It is not solely or even primarily a question of money. Demand has utterly outstripped supply and the provision of care is inefficient. The NHS is, perhaps, not completely broken. But it is certainly badly bruised. It requires careful, considered attention. Significantly, that opinion is shared by Audit Scotland who warned recently that the NHS, as presently constituted, was unable to cope. Further, public satisfaction has declined. In the British Social Attitudes Survey, covering 2023, just 24 per cent of respondents said they were satisfied with the health service. The figure in 2010 was 70 per cent. For all that we thank and praise individual staff for their care and attention, for all that we are grateful and relieved, we are far from content, overall. It will not do. Things must change.