Euan McColm: Michael Matheson far from the right man for NHS in Scotland
One of the reasons given by friends of First Minister Humza Yousaf for his credibility-draining insistence on standing by his under-fire Health Secretary, Michael Matheson, is that he’s the best man for the job.
We are invited to accept that, although Matheson wrongly claimed £11,000 in expenses for internet data run up by his kids on a family holiday and then lied about the matter, there is nobody else able to handle his onerous duties.
If this is truly so, then Scotland’s NHS is in a worse state than any of us imagined.
The truth is that Matheson is a plodder, a supremely unimpressive political operator whose elevation to senior office is not a reflection of his abilities but of the mediocrity of the SNP group at Holyrood. For a very long time, Alex Salmond, Nicola Sturgeon and John Swinney – all skilled politicians – diverted attention from their colleagues, a herd of second-raters.
The matter of Matheson’s expenses – currently the subject of a pointless investigation (we know what he did) by the Scottish Parliament’s Corporate Body – may yet bring him down. It certainly should, but I have little faith in any process which involves politicians investigating other politicians.
While that probe drags on, the Health Secretary is free to show us he is fit to meet the challenges of his role. If his response to newly repeated warnings about the parlous state of the NHS is anything to go by, he should not be considered a serious and capable steward of the health service.
Last week, the former Chief Executive of NHS Scotland, Professor Paul Gray, suggested it was time for a debate about the involvement of the private sector in the service. Gray had previously warned that the service is simply not sustainable in its present form.
Gray’s bleak view of the NHS’s prospects is shared by Professor Andrew Elder, president of the Royal College of Physicians of Edinburgh, who has called for a “national conversation with the public” on the priorities that the NHS should focus on. Dr Iain Kennedy, chairman of the British Medical Association in Scotland, backed that call. If action to repair the NHS is not taken now, he predicted the services would not survive to see its centenary in 2048.
Interviewed on BBC Radio Scotland, Kennedy pointed out that waiting list and waiting time problems were getting worse. The demand for healthcare was increasing, he added, and those running the service had failed to plan for the inevitability.
What was Matheson’s reaction to all of this? It was to insist there would be no shift from the principle of free healthcare at the point of delivery.
That, I am afraid, was an entirely inadequate response.
The NHS, founded in 1948, is undoubtedly a great institution. It has touched all of our lives and it’s hardly surprising that we tend towards sentimentality when discussing it.
But 1948 is a foreign country. It may have been viable to run a service that was free for all in the days when people were lucky to live a couple of years into retirement but, today, increasing numbers of older people stubbornly insist on continuing to live long past what might be considered convenient for the NHS. We have an ever-expanding elderly population which means ever-increasing pressure on the health service.
No serious politician would argue for the dismantling of the NHS but we could do with some with courage enough to be honest about how we sustain it.
Sadly, there is no space for such a discussion.
A decade ago, when then Labour leader Johann Lamont raised the matter of how Scottish Government giveaways such as the extension of the free prescription scheme to include the wealthy might be sustained, she was hammered by the SNP who caricatured her as a grasping “red Tory” who wanted to cut, cut, cut.
This was nonsense. Lamont’s instincts were entirely progressive – shouldn’t, she wondered, those with the broadest shoulders bear more of the burden? But there were cheap political points to be scored and that meant no debate.
Politicians across the spectrum lie to us about the health service. In each and every election campaign, they tell us they can be trusted to put right what is wrong, they promise to slash waiting times, and they assure us they’ll get staffing up to required levels. And they ask us to believe they will achieve all of this without increasing taxes.
All of us – politicians and voters alike – need to get real about this.
We will all, I’m sure, have stories about the NHS at its best, about the dedicated staff who were there when we – or someone we love – needed them. But far too many of us have stories about a service that, through no fault of doctors and nurses, is no longer fit for purpose.
The SNP has, since coming to power in 2007, failed to address the need for reform of the service. Warm words from ministers about staff and costly wheezes like giving free paracetamol to lawyers in the New Town are no compensation for a lack of action.
But who will have the courage to speak the truth? If any senior politician or any party dares suggest that, if we want an NHS that works, some people might have to pay a little towards their treatment, they can expect to be monstered by opponents.
The NHS is in a spiral of decline. If Michael Matheson won’t start telling difficult truths about its future, then we need a Health Secretary who will. Because if politicians continue to shy away from this debate, our health service is going to end up broken beyond repair. And that’s going to happen soon.