Readers' Letters: Yes the NHS has problems, but what are the solutions?

It was interesting to read the letter from senior health and care professionals and The Scotsman’s editorial stating that it suggested solutions (Perspective, 10 June). Using words and phrases such as “stretched”, “unsustainable”, “cross-party” and “complex”, I could have written the letter at any time since I started in the NHS 44 years ago. I did not read of any solutions.

With improvements in public health and individual treatments –surgical or pharmacological – over those years we have moved a whole cohort of the population into a state of relative frailty. Many of us now spend the last several years of life with a chronic illness.

Conditions which would have carried you off quickly, such as cardiovascular disease and many cancers, are now chronic and treatable, often in older people who would never have been considered suitable for treatment only 20 years ago. We have also seen over-investigation, over-diagnosis and over-treatment in those frail people, often with little benefit to quantity or quality of life.

How can First Minister John Swinney, far left, and Health Secretary Neil Gray, seen with blood transfusion workers in Edinburgh in January, treat the Scottish NHS? (Picture: Peter Summers/Getty Images)

While this seems a huge success for healthcare, it is a disaster for the public purse. Acute hospitals have become very expensive nursing homes, with 40 per cent of beds blocked by patients who should be elsewhere, all exacerbated by the closure of cottage hospitals and care homes.

So there needs to be a new realism about what the state will provide and where that will happen.

Build more care homes and supported housing. Move frontline staff away from resource-intensive health promotion to treating illness. Be realistic about how much intervention you wish in the last few months of life.

My fear is that changes will become bogged down by long consultations and the need for yet more data and information, rather than action. There is an old saying that you don't fatten a pig by weighing it. Let's just feed it.

John Locke (Retired GP), Kirkcudbright, Dumfries and Galloway

Healthy talk

It was with a great sense of relief that I encountered both the front page and the editorial of The Scotsman on 10 June. The contents of an open letter from “senior health figures” was put before readers and the “unsustainable” current NHS dispensation and “deteriorating health of the nation” which it seeks to serve was made plain.

This accelerating decline is often the the topic of concerned dinner party and pub conversations and debates which do not bear fruit in electoral or popular outrage until folk find themselves or their loved ones languishing in an understaffed ward, waiting for the toilet or a drink of water, or waiting many months for cataract or hip surgery. The long wait for diagnostic tests is a theoretical matter until we witness the anguish and agitation of a loved one waiting to have cancer excluded or confirmed.

This excellent letter also underlined the fact that “spending more money” per se will avail us nothing. Our money is currently being spent on multiple layers of top down management and its attendant suffocating beurocracy, public scrutiny of which may begin to unravel root causes for both recruitment and retention issues and resource mismanagement.

The wider issue of the health rather, than the sickness, of Scotland is one that I hope may also find urgent priority soon among the mainstream media. There is absolutely no doubt that the health of this nation could be transformed over the next decade in all domains when the vested profit driven interests of the medical and food industrial complexes turn their attention to other areas of capital gain.

We need to heed the insistent call for national public scrutiny of the NHS driven by educated and experienced citizens and service users rather than appointed expensive NHS boards and their political masters who are failing us.

(Dr) Andrew Docherty, Selkirk, Scottish Borders

Council tax tricks

There seems to be some suggestion that that nice Mr Swinney is thinking of introducing a council tax freeze again, as per his financial slight of hand which took in so many people in 2007, and which has gotten so many local authorities into trouble with their finances now.

We all know how it works. The Scottish Government say the council tax has been frozen, thereby saving people from escalating costs. But it requires money to freeze it, and it is predominantly lower and middle wage earners who pay for the policy, which disproportionately benefits larger houses. It is a clear example of the tax burden being transferred from higher to lower worth individuals and families. Having been squandered in this way, the money is then no longer available for other uses.

The government have to pay an ever increasing sum to sustain the policy (an amount increasing by £70 million per annum from 2007), which eventually gets to eye-watering levels. It still is not enough to cover the full costs, so local authorities inevitably dig into their reserves, which then reduce progressively over time, to the dangerously low levels we see today. Taking the decision over how much to pay away from local councillors strips them of their responsibilities, and decreases the strength of our more local democracy in turn, with low turnouts at council elections. There is often no genuine election for seats, and the standard of councillor elected gets lower and lower.

John Swinney cannot be allowed the same trick twice. We need to discuss what actually happened in the years since 2007, and just how damaging to Scotland it actually was. If we let him get away with it again, then we really are as stupid as he thinks we are.

Victor Clements, Aberfeldy, Perth and Kinross

Behind the beat

You will always get rogue members of the police force who don’t adhere to the law, but there is a real problem when the public don’t have faith in the authorities to pay heed to the law themselves. (“Public ‘none the wiser’ about police gender stance”, 11 June)

The Supreme Court ruling issued on 16 April 2025, almost two months ago now, made it clear that the legal definition of a woman is based on biological sex. So why are we having to continually ask Police Scotland how they are recording men in their statistics, by their biological sex or how they view themselves? Why should it take so long to amend policies if they were previously recording men as women? There is no ongoing review required. The law is the law.

The longer this takes, the more the public will determine that Police Scotland is dragging its heels on enforcing the law within their own institution.

Jane Lax, Aberlour, Moray

Rules are rules

So John Swinney claims EU membership could bring an independent Scotland “security, stability and opportunity”. I, too, regret Brexit, but let us never forget that all those voting for independence in 2014, by voting for Scexit also voted for Brexit – Brussels made this very clear before the referendum. Plus, perhaps unsurprisingly, Swinney ignores that Scotland's excessively high deficit levels – over three times higher than the 3 per cent tolerated by EU fiscal rules – means that, whatever narrative SNP politicians might spin, the EU would reject an application from Scotland, probably for many years, until Holyrood's overspending was brought under control by cutting public services and raising taxes.

Martin Redfern, Melrose, Roxburghshire

Election needed

The sanctions imposed on Israeli ministers Itamar Ben-Gvir and Belzalel Smotrich (your report, 11 June) are but the tip of the iceberg, given Israel's deplorable and unacceptable behaviour in Gaza and on the West Bank. Belatedly, more and more Israelis agree.

Severe sanctions on Benjamin Netanyahu and his far right, and fragile, coalition government, are the very least we should do. Instead, several Western governments, most of all the US, but also ourselves, unbelievably continue to supply Israel with arms.

Over 54,000 deaths, and rising, many of them children, are only part of the Palestinians' suffering. Starvation is another lethal tactic, for which the Israelis will never be forgiven.

The absurd notion that Israel is the only democracy in the Middle East should urgently be put to the electoral test. A general election should be called, a disgraced government should be ousted and Benjamin Netanyahu should be arraigned for the war criminal that he is. Nothing less will do.

Ian Petrie, Edinburgh

Make way

Brian Bannatyne-Scott bemoans the “total unfairness to car users” that motorists apparently suffered from a few years ago (Letters, 9 June). To comprehend this unfairness, let us consider the footprint of 50 cars with a single passenger – the occupancy for 66 per cent of all journeys – according to Transport Scotland – compared with that of a single, only partially occupied, double-decker. It turns out that a bus is easily 12 times more efficient in terms of congestion.

To reassure Mr Bannatyne-Scott: to the best of my knowledge, the 24/7 bus lane proposal from a few years ago has been replaced by 7/7/7 (7 days from 7 to 7), matching current travel patterns, both for cars and public transport. If there are empty bus lanes during these hours, maybe we should ask for more buses to ensure balance and harmony on our roads.

Harald Tobermann, Chair, Edinburgh Bus Users Group

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