How is it heard by NHS staff who are utterly exhausted by their work? Exhausted by the numbers of patients to be seen and long hours, exhausted by the excess of need over provision, exhausted by the moral injury suffered when their best efforts fall short of need. It needs to be said that “Our staff are working until they are exhausted”; the "tireless” cliché is insulting and suggests that NHS Lothian lives in the same cloud cuckoo land as too many politicians.
I am too long retired to be personally involved in the medical frontline. My younger colleagues in all parts of the health service are worn down by the pressures of the pandemic in a service that was already understaffed.
It is not the tiredness after an occasional long, hard shift, but living with the expectation and reality that day after day, month after month, the next shift may be as bad or worse.
The health professions need politicians and managers to be open and honest that money and physical resources are the easier components of recovery and resilience planning. Rebuilding and caring for the workforce who have suffered such damage on our behalf will be much harder and even more necessary.
Dr Anthony Birch, Dunblane, Stirling
The new Johnson health and social care policy will pour money into the bottomless pit of our ailing and failing 1940s model of a National Health Service.
The rot set in immediately following Wednesday’s House of Commons vote, when the NHS announced plans to spend millions of pounds not on patient care, but on hiring yet more bureaucrats on salaries of £270,000 per year. Meanwhile, NHS GPs, despite being the best paid in Europe, are permitted to lock themselves away, operate remotely and avoid actually facing their patients.
How long can the overstretched British taxpayer tolerate such poor value for money? Why cannot the UK learn from the many other countries who are “doing it better”? Germany now has six times the provision of intensive care beds compared to the NHS, whilst the UK, with the fifth largest economy, is ranked 15th worldwide in pension provision.
Truly radical reform is essential if we are ever to enjoy a user-friendly, sustainable, integrated, bureaucrat-light, economic model for our health, social care and pensions system.
Elizabeth Marshall, Edinburgh
A clear difference of approach to the setting up of a National Care Service is already emerging. COSLA President Councillor Alison Evison feels that more resources for the existing arrangements is the way forward. First Minister Nicola Sturgeon wants to see "a social care legacy equal to the creation of the NHS after the Second World War” (Scotsman, 8 September). Who is right?
What the Scottish Government is faced with is a network of social care partnerships set up between councils and health boards throughout the country in the last decade or so. The provision of social care also depends on an array of private residential and care homes. Whilst the quality of care in these homes seems to vary widely, there is no getting away from a simple fact: a mixed economy of care is the only practical way to cope with the health needs of an increasingly elderly population. Would a National Care Service seek to take them over – ie take them into the public sector at enormous expense – or would it seek simply to regulate their activity even more rigorously than at present?
The Health Service established in 1948 was comprehensive. It sought to secure improvement in the physical and mental health of the people, the prevention, diagnosis and treatment of illness and, crucially, for that purpose to provide and secure the effective provision of services. It gave the then Minister Of Health wide-ranging powers to secure that provision. Is that what Ms Sturgeon seeks? Or does she want to build on the existing provision to ensure a decentralised care service with well-equipped homes, very well-paid staff, and a level of dignity for all who need care whether in a home or not?
Bob Taylor, Glenrothes, Fife
Now that the Prime Minister has received a Commons majority for his £12 billion tax to pay for health and social care, Scotland will be entitled to its share, about £1.124 billion, which should be put towards the new Scottish National Care Service.
But, instead of propping up the private sector care providers, many of whom provide a dismal, profit-driven service, as will happen in England, the Scottish Government should take advantage of this unexpected windfall (paid for by Scottish National Insurance payers), and create a not for profit National Care Service, equal in status to the NHS.
This would have the twofold benefit of improving care for those who need it, whilst taking a huge amount of pressure off the NHS.
Lee Mackay, Dundee
Most of us are bright enough to know that as one of the top 30 wealthiest countries in the world based on GDP people in an independent Scotland will have a very high standard of living (Martin Redfern, Letters, 9 September).
Claims that we are reliant on “the British taxpayers’ very deep pockets” or that the £1 billion raised from National Insurance could not be replicated in an independent Scotland are nonsense as, for example, if a Scottish government were to tax oil and gas companies at Norwegian levels that would bring in an extra £2 billion in 2021.
The UK Government is making the less well off pay disproportionately for the much-needed investment in health and social care while thousands of wealthy pensioners who have commuted their public sector or financial sector pension pots into ISAs etc will pay nothing towards measures that will benefit them the most. In the UK, tax avoidance by individuals and more significantly by large corporations is encouraged but it has resulted in the most unequal country in Western Europe.
As Laura Waddell (Scotsman 9, September) points out, the point of independence is the opportunity to build better and fairer system not to replicate the old one.
Mary Thomas, Edinburgh
This too shall pass
Laura Waddell (Scotsman, 9 September) suggests, that Scotland should be freed from the Bullingdon goon Boris and go ape with the control freak Nicola. Some choice!
We would do well to remember that the Union has lasted long enough to survive the vicissitudes of a whole range of other political freaks and no-hopers, plus a few giants, during its time. Nothing lasts, and if we keep our nerve we shall before long see the likes of our current leaders disappear over the horizon. We might be luckier next time round.
Dr SR Wild, Edinburgh
While I echo the sentiments of Stuart Crawford’s letter (“Covid vaccine certification is for the greater good”, Scotsman, 9 August) I wonder whether the Lib Dem and Labour stance on certification reflects their respective leaders inhabiting a narrow bubble of middle-class and academic advisers and often young staff who are completely isolated from the views of the electorate in general and indeed their wider party membership.
This also makes the leaders susceptible to highly organised minority pressure groups. It is likely to be a significant factor in why their respective manifestos failed to win public backing in the recent Holyrood election.
While the SNP escape this criticism on the certification issue, they clearly have suffered from the same myopia on, for example, the vexed subject of gender self-identification which, anecdotally, is causing such deep unease throughout the SNP membership.
Kit Fraser, Dunbar, East Lothian
Martin McCluskey (Scotsman, 9 September) hits the nail on the head with his analysis of the current Scottish political scene. It is evident that empty shell of nationalism has caused the decay of Scottish political life. Before the rise of SNP/Green nationalism, debate was between the proponents of decent housing, jobs, education and health provision and the supporters of avaricious, vulture capitalism.
Nationalism was used by the right wing of the Tory Party to achieve Brexit for their own personal gain. One can understand the greed motivation of the Brexiteers better than the fundamentalist “Blut und Boden” appeal promoted by the SNP/Greens.
We are now experiencing the predicted detrimental effects of Brexit. Scots should be aware of the economic arguments against Scexit and consequent resulting increased prices and taxes and cuts to services and supply of goods that even the nationalist economists admit.
Scots voters have to recognise that we can’t make progress as a society and community until the divisive politics of nationalism are consigned to the wheelie bin of history.
James Quinn, Lanark, South Lanarkshire
I see that the new statue of William Gibson – or is it Mel Wallace – at Brechin City has stimulated public opinion. Coincidentally, a plaque has been affixed to the former home of Jim Henson, the Muppets’ creator.
What about a plaque on the Holyrood parliament building simply stating "Muppets"? We could then follow this up with the erection of statues of Kermit, Miss Piggy, Gonzo et al and seek suggestions from the public regarding which MSPs’ faces should appear on the statues. I'm sure this would prove a major attraction for tourists.
Fraser MacGregor, Edinburgh
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