Scotland has thankfully avoided the strike action by doctors and nurses that has struck England, but the long-term challenges faced by our NHS are not so easily ducked.
As we head into winter the health service is again under immense strain. Medics routinely declare that we are at the tipping point. With post-Covid waiting lists becoming longer, the population getting older and the workforce facing unprecedented pressures, we are stumbling towards a two-tier healthcare system in which the better-off pay to be seen and everyone else waits.
Listen to former Scottish health secretaries and they acknowledge that a plan for long-term reform is required. It does not need, in the words of Jeane Freeman, the last occupant of the job but one, “a shed load of money”. It does require, as another former minister, Alex Neil, argued recently, “a ten-year business plan to force us into deciding where the priorities are and what resources are needed”.
The public agrees. Polling by Our Scottish Future, the think tank I help to run, shows that while Scots believe their health service remains in better fettle than the one in England, they want to see reform, they want to see politicians across the UK working on solutions together, and they see the need, where necessary, to make hard choices to improve the service.
As The Times reports, these include the idea of charging people who miss appointments, ending cosmetic surgery and increasing taxes on unhealthy food and drink. There is even slight support in favour of ending free prescriptions for the better-off.
Whether these measures are right or wrong, what the figures show is that the public is up for a grown-up conversation about the future of the NHS in Scotland. People are ready to look at solutions on how to ease pressure on the service. They want to support the doctors and nurses who are collapsing under the strain of their work and move healthcare to a more sustainable model — and it is time our politicians responded.
Bringing together experts in the medical field in Scotland and the UK, Our Scottish Future plans to set out fresh ideas on how to do this. We believe the remarkable advances in medical technology offer a way forward.
Given that the same challenges and opportunities affect all the health services of the UK, we believe UK-wide solutions may be the right way forward. A common approach can ensure that best practice and health innovation are shared to the benefit of us all.
Continuing to muddle through is not an option. That way lies the end of the NHS as we know it. It is time for politicians to come together and embrace reform: the public is waiting.
This article originally featured in The Times Scotland on Monday 9th October