‘There has to be an urgent, honest debate’

He insisted that services should be free at the point of delivery, available to all and of the same quality no matter where a patient lived, or their background.

Today, these basic aims remain essentially the same, but the demands we place upon the service have grown beyond recognition.

In the Lothians, the number of patients being treated has risen dramatically, even over the last decade.

Advances in medical science, our increased expectations and the Capital’s growing population have all played their part.

But what is clear is that NHS Lothian is simply not equipped to deal with the huge number of patients coming through its doors – and has probably been unable to cope for many years.

So, where do we go from here?

There has to be an urgent and honest public debate about what we expect from the NHS. The questions it needs to address include whether or not the health board receives sufficient funding and whether or not the SNP’s aim to “eradicate the private sector” from the health service is both realistic and helpful.

There must be no “sacred cows” in this debate. It cannot be driven by political dogma, from any quarter.

We should remember how the NHS is currently failing to deliver in the Lothians on Bevan’s vision. It is not by sending patients to private hospitals – their care, after all, is still free at the point of delivery. It is by leaving patients here to wait far longer for treatment than those elsewhere in the country. It is that kind of regional variation in care standards that the NHS’s founder aimed to eradicate when he created a truly national health service.

Transparency is key

You can go almost anywhere in the world and when you mention Edinburgh, it doesn’t take long before the word tram enters the conversation. The project is a PR disaster for the city.

So you might think, therefore, that transparency would be a suitable mantra for those trying to manage the fallout.

Today the News reports on how Lothian Buses aims to hire 11 drivers a full 18 months before the line opens at a cost of almost £500,000. There might be a good reason for this – but how will the public know if no one tells us?

Those running the project must stop running scared and engage with taxpayers who are, after all, paying the bill.