Leader: Pledges on NHS are welcome, but questions remain

JUST how good is the National Health Service in Scotland? Given that health spending accounts for about a third of the total budget of the Scottish Government and is a service upon which we all depend, the public has a right to know. However, can this simple question be answered accurately?

Now, in order to discover how good or bad something is you need to be able to compare it to a similar service, what is known in clunking management jargon as benchmarking. The NHS in Scotland was established as part of the great post-war social reforms of the Labour government but, since devolution, has been under the control of politicians at Holyrood. It is, therefore, logical to seek to compare healthcare north of the Border to that south of Hadrian's Wall. Sensible, but very difficult.

There are some indications. For example, we can compare the promise made yesterday by health secretary Nicola Sturgeon, that all patients will soon face a maximum wait of 18 weeks between being seen by a GP and treatment, with the position in England. In Scotland 85 per cent of patients are seen within 18 weeks, compared with just below 90 per cent south of the Border, though latest figures there show the situation deteriorating.

Beyond that, comparisons are very difficult, as the statistics are collected differently, something which was pointed out in a report last year by the Centre for Public Policy for Regions, which noted only that we spend about 2,000 per head on health in Scotland, some 250 more than in England, and have 30 per cent higher levels of staffing, but we are not seeing health improvements one might expect given this level of government spending.

It is in this context that we have to view Ms Sturgeon's promise and the attitude the SNP government has taken to the NHS in Scotland in relation to England, something Alex Salmond illustrated when he appeared on the BBC's Question Time before the election, when he claimed to have eradicated private healthcare from the Scottish NHS. What this conveniently ignores is Scottish waiting lists in many areas, particularly orthopaedic surgery, are considerably shorter because of the extent of a thriving private health sector, through which patients avoid long delays for treatment to conditions which while not life-threatening can make life a misery.

Ms Sturgeon's promise is welcome as far as it goes, but we still do not know how much better the NHS in Scotland should be performing, given the large sums of money it receives. Nor do we know whether improvements south of the Border - where the government and its predecessor have moved to diversity of provision and competition - might deliver better service north of the Border were the SNP not wedded to a dogmatic "state good, private bad" mentality. It is not good enough for the answer to the question of how good the NHS is in Scotland to be: "We just don't know."