NHS crisis: SNP and Conservatives need to level with public as health service spirals towards disaster – Scotsman comment

If there is a script for a drama about the collapse of the National Health Service, it appears the Scottish and UK governments are following it.

The NHS risks a downward spiral towards a service of last resort for the poorest (Picture: Neil Hall/pool/AFP via Getty Images)

Nurses on strike over pay and conditions; midwives threatening to join them; so many vacancies for consultants in Scotland that they could staff a hospital; an ambulance strike in England; long waiting times for serious, life-threatening conditions… the list goes on.

Even before Covid hit, the system was beginning to crumble and the situation is worse than ever before. The response from both the SNP and Conservatives seems to be to attempt to muddle through.

The Scottish Government has offered nurses a higher pay rise than in England, but given public spending is 11 per cent higher than the UK average, it has more funds to be able to do so. Yet still the Royal College of Nursing – hardly union militants – has turned down the offer.

It would have been a relief to many if they had settled. But the hard reality is that unless the NHS pays nurses and other staff enough money and provides decent working conditions, they are likely to look elsewhere for employment and the current vacancy crisis will grow.

A poor service, disrupted by strike action, will prompt many patients who can afford it to go private out of fear that the NHS will not be there for them when they need it. A growing private sector will offer alternative employment to disgruntled health service staff, further accelerating a downward spiral that may eventually end in a public health service of last resort for only the poorest.

According to OECD figures, the UK spent an average of US$4,500 per person on healthcare, public and private, in 2019, compared to $6,518 in Germany, $5,739 in the Netherlands, $5,705 in Austria, $5,370 in Canada, and $5,274 in France.

As the saying goes, you get what you pay for. Politicians of all stripes need to level with the public: if greater efficiencies cannot be found to transform the NHS, taxes must go up, or the services on offer must be reduced.

Some might welcome a US-style system. American healthcare is among the best in the world, but only if you can afford it. And, at $10,948 per person, there’s a hefty price to pay.