Austerity is closing in and, to be fair, we are not alone. You can’t have pandemics and wars without implications. The brief but bizarre appointment of a crass Prime Minister did not help the mix.

However, the Truss factor is marginal to the wider truth and there is no rational reason for Scotland to be immune. Like everywhere else, there will be pressures on public spending and the question is how these will be addressed.

The great unspoken truth about Holyrood is that it has been exceptionally well funded from the outset. Donald Dewar took care of that. As long as it was in the hands of politicians whose vested interest was in making devolution work, that was a happy state of affairs.

For 15 years, it has been controlled by a political force whose vested interest is in showing that it doesn’t work, or is insufficient.

Supposing the £41 billion block grant was doubled tomorrow, they would still find ways of spending the money while complaining it

wasn’t enough.

My introduction to government was very different. When Labour won in 1997, we inherited 18 years of Tory priorities and thrift. Yet the reaction was not to spend more but to spend better. The initial commitment was to keep public spending at the same level; just to do it differently.

Ambulance delays at accident and emergency departments across the country are a question of management, not money, writes Brian Wilson. (Photo by Jeff J Mitchell/Getty Images)

That was an excellent imperative which created a straightforward choice – radical reform had to come through no-cost, low-cost policies or by substituting Labour spending priorities for Tory ones. It worked brilliantly. Every pound mattered. Nobody talked glibly in tens or hundreds of millions. And these were the most productive years of Labour reforms.

The Scottish Government has never been confronted with that challenge. The Nationalists have basked in the safe haven of blame-shifting. Whatever is unaffordable is the fault of Westminster not sending enough money. End of requirement for intelligent thought.

But of course, hated Westminster sends a lot of money, thanks to the Barnett Formula; so much so that the Scottish Government, simply by waiting for the cheques to arrive, has £2000 per head of population more to spend on public services than in the rest of our small island. How do they make such a mess of it?

At First Minister’s Questions this week, I was struck by that dichotomy. Our long-devolved NHS is struggling, under a famously inadequate Cabinet Secretary. Ms Sturgeon’s defence was to gabble soulless statistics about how much more is being spent on every topic raised.

Yet at the same time, she moaned interminably about the failure to provide more money. At some point, does it not occur to even the

dimmest members of her fan club that the problems people face might lie in how money is used, rather than blind demands to increase the quantum?

Anas Sarwar, on target again, quoted a shocking illustration of ambulance waiting times. He did not just pose the question but suggested doing what Ms Sturgeon would never dream of - listening to the people working on the front line, rather than relying on a script laden with selective statistics.

For years, ambulance drivers have been looking for a 30 -minute turnaround when dropping patients at A&E. Now, routinely, they are

waiting three hours and much longer. It follows that they are not available for emergency calls. Anyone who thinks this is a problem of

money rather than management is deluded. So fix it or get out, Mr Yousaf.

It was the same story with delayed discharges which Douglas Ross raised. They are “investing” to address the problem, said Ms Sturgeon … thank goodness for that £2000 per capita bonus which she wishes to cut us off from. But beyond that, her only answer was: “Send more money”.

The test of politicians is not how much they demand but how they use what they have got. Scotland is not exempt from that truth, it’s

going to get worse and blame-shifting will do nothing to relieve our NHS.

NHS pressures are about management, not money - so fix it, or get out Mr Yousaf - Brian Wilson