Leader comment: Honest debate to restore our sickly NHS to health

If some of the graphs showing NHS Scotland's recent performance were the ones hung at the end of patients' beds, relatives would fear for the worst.

Key waiting time targets have again been missed.

They illustrate that underlying the latest figures are chronic ills that appear to be getting steadily worse.

One of the Scottish Government’s major targets, of nine in ten patients being treated within 18 weeks, - that’s more than four months - has not been hit for more than 18 months. It is now nearer eight in ten.

The figure fell for much of last year, and is now at its lowest since the “standard” was introduced in 2011.

Several other core targets also continue to be missed, including for treatment starting within 12 weeks of being agreed by a specialist, for outpatient appointments, and for key diagnostic tests.

The opposition did not pull their punches in condemning both these statistics and the parlous health of the health service compared to how ministers have said it should be.

The Conservatives lambasted the “disastrous slump in these crucial waiting times”, while Labour accused the SNP of “callous mismanagement” and “sleepwalking into a crisis”.

For a government that has been in charge of the NHS in Scotland for nearly a decade, the response seemed breathtakingly complacent, as if it had just inherited the problem.

Officials spoke of changes and improvements “in the coming years”, while health secretary Shona Robison said some “won’t happen overnight” because they were part of a “clear, long-term strategy”.

Well, the strategies as set out by Ms Robison and her predecessors over more than nine years aren’t working - by the yardsticks they set themselves.

There is no doubt the latest statistics are not good figures. That so many targets are being missed suggests there is something fundamentally wrong.

Ms Robison says Robison says the Scottish Government is in the middle of transition to more care at home, so fewer people will need to be cared for in hospital.

But frankly, that doesn’t wash, given that it still means individuals have been failed by the system.

The reality is that things could get even worse because of the ever greater demands on the NHS by our ageing population, and the continuing squeeze on budgets.

However, the difficulty with healthcare is the NHS is such a mainstay of our society, no political party can see any electoral mileage in suggesting radical change.

As a result, there has been no proper debate about the type of health service we can afford.

The thought of limiting care, or not trying to do everything for everyone, is seen as too controversial to be raised.

Hard truths need to be faced. Ministers also need to be more honest about the prospect of the targets they set themselves being achieved anytime soon.

Patients - and taxpayers - need a more realistic assessment of where we are, and what needs to be done to return the NHS to better health.