No amount of bluff and bluster by First Minister Nicola Sturgeon can hide the fact that the responsibility for the performance of the Scottish NHS rests with her administration – the Scottish Government. It follows, therefore, that no amount of bravado or Smart-Alec tweets can shift the blame for NHS failures from Ms Sturgeon to Donald Trump, Boris Johnson or the fact that Scotland is in the United Kingdom.

This reality, the reality that since Scottish devolution began in 1999 the NHS buck stops with the First Minister of Scotland, was brilliantly exposed by Andrew Neil when he interviewed Ms Sturgeon last week.

Rather than require a law to protect Scotland’s NHS from some ethereal and imagined threats from Mr Trump settling a free trade deal with the UK, Neil presented real and hard evidence there was a case for a law protecting our NHS from Ms Sturgeon. It was devastating television and, irrespective of the result, must go down as one of the memorable moments of the campaign.

Nicola Sturgeon has sought to deflect attention away from her own failings by raising the spectre of Donald Trump facilitating profiteering out of the NHS, says Brian Monteith

To say Ms Sturgeon must take responsibility for the Scottish NHS because she has been First Minister for the last five years does not even begin to emphasise her culpability. It should be remembered that for seven years she was an uncritical deputy leader to Alex Salmond, supporting all his administration’s spending and management as they impacted on the NHS. Where is the regret for the bad decisions that led to growing shortages of nurses and doctors or hindered patient outcomes?

More crucially, Ms Sturgeon served as Scottish health secretary for five years. We can now see that many of her decisions – be it on nurse training and recruitment levels, agreeing to what hospitals or departments might stay open or must be closed, or how new building projects might proceed – have impacted heavily on the NHS performance levels Scots now face.

Ms Sturgeon has sought to deflect attention away from her own failings by “othering” responsibility to foreigners (always a favourite among nationalist parties) – by blaming the Westminster governments and its initial but now relaxed austerity programme, or raising the spectre of Mr Trump facilitating profiteering out of the NHS.

These two fallacies need to be exposed for the utter nonsense they are.

Ever since the recession of 2007-8, all governments of any political colour have sought to protect the NHS from spending cuts. Indeed, over time there have been increases in English NHS spending that, when matching funds were passed on to the Scottish Government, the SNP has chosen to spend elsewhere. With public spending now loosened, blaming Westminster simply does not stick.

Ms Sturgeon’s alternative of an NHS in an independent Scotland offers the public no certainties. First, the funding of the SNHS would be greatly imperilled due to the need, overnight, to take on a public finance deficit of circa £12 billion. It would not be possible to continue the current arrangements where Scots benefit from free personal care of the elderly, free prescriptions, free eye tests – all introduced, it should be said, by the Labour-Liberal Democrat administrations between 1999 and 2007. Nor could we sustain the far higher level of NHS expenditure per person than what is enjoyed in England – where its taxpayers’ surplus helps to fund those unique benefits.

The scary threat of our NHS being eviscerated by the super-austerity required to make Scotland’s finances balance and not run out of control cannot be diminished by fine-sounding empty rhetoric about faster economic growth. Something would have to give, some part or – more likely – many parts of Scotland’s health service would be significantly curtailed or reduced.

This inconvenient and uncomfortable reality is not scaremongering, it is simply to acknowledge that, due to political decisions taken at Holyrood, we have a level of service provision that could not be sustained after leaving the UK without brutal changes to financing the NHS and other public services that might need to be sacrificed instead.

It also has to be acknowledged that the ethos of the Scottish NHS – what we believe should be its central mission, to provide high quality healthcare to all, free at the point of use and funded by general taxation – was British in its conception and delivery. Public expectations in Scotland that this ethos could and should continue would be severely challenged; one only needs to go to the Republic of Ireland to find €40 charges for GP visits to understand that every country provides healthcare differently.

Whether or not one accepts these arguments, it surely cannot be denied that Ms Sturgeon and her views represent a real threat to Scotland’s NHS.

The First Minister also argues that Brexit represents a dire threat to the NHS because it will allow free trade deals with the US that might, for instance, lead to sections of the NHS being auctioned off to private US companies or the NHS drug costs might rise. Such threats are, naturally, denied, and it is difficult to see how any UK government could politically accede to such arrangements. But what is all too easily forgotten is that the “threat” of NHS services remaining free to patients but being delivered commercially existed while in EU membership and was made real by the Transatlantic Trade & Investment Partnership proposed by US president Barack Obama and supported by the EU. TTIP, as it was known, became a serious issue during the EU referendum and galvanised many trade unionists to support leaving the EU to protect the NHS and other public services.

Even without such a deal as TTIP or a Trump derivative it would only take a directive from the EU Commission and a separate Scotland – taken back into the EU by Ms Sturgeon – would have to comply with any tendering for hospital and clinical services. Again the evidence, such as EU directives about rail and postal provision, shows that UK governments have had to follow directives that the public was never asked about or voted for.

The reek of hypocrisy from Ms Sturgeon in suggesting it is Mr Trump who is to be avoided when her own approach proffers a real threat to external management of Scotland’s NHS needs to be recognised. Neil spotted it and called her out but, as the potential threat from the EU tendering demonstrates, it is far deeper than even he had time to explain.

Scotland’s NHS is Nicola Sturgeon’s responsibility and she cannot be allowed to duck it.

Nicola Sturgeon deflects from SNP failings by raising spectre of Donald Trump - Brian Monteith