Scotland's NHS is in crisis as people fail to realise that they too could become a statistic – Alastair Stewart

Was the COP26 climate summit a success? MP and summit president Alok Sharma nearly broke down in tears when he admitted the final deal was watered down. If only we cared as much about the state of our day-to-day public services.

Alastair Stewart's family recently waited five-and-a-half hours for an ambulance to arrive to attend to an elderly relative (Picture: Jeff J Mitchell/Getty Images)
Alastair Stewart's family recently waited five-and-a-half hours for an ambulance to arrive to attend to an elderly relative (Picture: Jeff J Mitchell/Getty Images)

An odd juxtaposition plagued the summit. Some quarters obsessed over Nicola Sturgeon's selfie scrapbook. Others delighted in helping US Congresswoman Alexandria Ocasio-Cortez find a can of Irn-Bru. About 100,000 activists marched despite Covid-19. Four hundred private jets landed to tackle carbon emissions.

“So it goes”, to borrow from Kurt Vonnegut.

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Environmental activists like Greta Thunberg have made climate change an ethical debate. Green credentials are not fashionable opt-ins but controversial opt-outs. Avoiding corporate and social responsibility could well mean customers boycott, abandon or condemn your enterprise.

Political consciousness seems to be unusually focused in Scotland. The independence debate has proven that. Hundreds of thousands are galvanised and mobilised over institutional and leadership failures to solve the climate crisis.

So, why is there such a forgiving tolerance to chronic failures about the state of public services? Where are the protests, the marches, the outrage and the demands for reform?

The military has again been brought in to bolster the NHS front line to help tackle the crisis in the Scottish Ambulance Service. Deputy First Minister John Swinney apologised to the family of Richard Brown, who died while waiting five hours for an ambulance. Mr Swinney said he “should not have had the experience that he had”.

A survey of Scottish Ambulance Service staff by the Unite trade union revealed 88 per cent of 300 respondents said they did not feel valued by the government; 79 per cent believed the service was understaffed; and a shocking 98 per cent said measures announced in September to improve the situation would not be enough to deliver services effectively in winter.

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We have all become far too immune to disasters waiting to happen. Political rhetoric and apologies and promises about doing better are meaningless.

It is also a weakness of human nature. No one worries about 'net' services until we fall and need them – how often do you call an ambulance, ring the police or call the fire brigade? Probably not enough to keep their demise in your thoughts.

It should be a sickening thought that this could happen to you or your family. You should be petrified. Instead, we are deafened by the silence.

Last weekend, our family waited for five-and-a-half hours for an ambulance to arrive for an elderly family member. Flawless paramedics came in the middle of the night with colleagues in military fatigues. It was a stark realisation of the real-world strains on the ground that you normally do not obsess over. Until it happens to you.

Since then, I've tried to reconcile in my mind the things that we choose to care about. Seventy-one per cent of respondents to the Unite survey said over six hours was the longest 999 they had been involved in from call to completion: a cancerous cognitive dissonance is perpetuated by obsessive political loyalty, general disinterest and public detachment.

The hypocrisy is all the more grating because of Covid-19. A passing interest in the state of the health service was common long before the pandemic. But it became socially reprehensible not to clap for the NHS workers last year.

Flash forward and those efforts seem collectively tokenistic as there has been no significant change, no sweeping effort to reform and no political support befitting frontline staff.

In his poignant book Letters To My Grandchildren, Tony Benn ponders how the entire country's social and economic force was marshalled to fight for its survival in the Second World War. As a consequence, there was also full employment.

That demonstration of the state’s tremendous power gave rise to the post-war consensus and the welfare state. From 1948 until Margaret Thatcher, it was impossible to imagine stepping back to the status quo.

The most significant difference between the welfare expectations created by the Second World War and the mobilisation effort against Covid-19 is there has not been a post-pandemic consensus. If there had been, we would not so casually tolerate the very same service, 70 years later, being forced onto its knees and kicked by inaction.

A plentitude of studies has tried to explain why we cannot seem to care beyond our line of sight, despite our interconnected, virtual world.

In his famous 1972 essay, Famine, Affluence, and Morality, moral philosopher Peter Singer argued that proximity and distance make no difference to our duty to help others in need. It is not acceptable to be aware of the problem, but presume that we do not need to fix it just because it is not in our vicinity.

The 19th-century political theorist William Lecky likewise wrote that human concern is an expanding circle which begins with the individual, then embraces the family and “soon the circle… includes first a class, then a nation, then a coalition of nations, then all humanity, and finally, its influence is felt in the dealings of man with the animal world”.

The undercutting thread between these two observations and today is social media, 24-hour news coverage and casual small talk. Even if you turn off all your notifications, tailor your social media feeds and try hard not to be aware of the problem, it will still seep through.

This returns to the problem at hand: why is more not being demanded may well be answered by the protests in Glasgow. Until people are mobilised, until a problem becomes such suffocation on decision-makers' time, then nothing will change.

The German journalist and satirist Kurt Tucholsky, not Stalin as sometimes suggested, said: “The death of one man: this is a catastrophe. Hundreds of thousands of deaths: that is a statistic.”

What he wrote ironically has become our reality – something must be done.

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