The consequences for the NHS are disastrous. Very sick people are cared for or die lying on trolleys in corridors, as highlighted by the RCN’s excellent report covered in your article, while others are stuck in ambulances or die at home waiting to get to hospital. Then, once sick people are moved into an acute bed and start recovering, staff are often pressurised to send them home before they are ready to do so or before adequate care arrangements can be put in place. This often results in early re-admissions.
After the Covid pandemic and the creation of temporary Nightingale Hospitals there should have been a rethink and additional capital resources allocated to the NHS to increase bed capacity. While that wouldn’t remove all the pressures on NHS staff at times of high demand, sufficient facilities would make it much easier for them to continue to deliver high standards of healthcare and enable patients and their families to be treated with the dignity they deserve.
Instead, politicians, civil servants and NHS managers continue to be obsessed with the idea that if only every patient left hospital the moment they ceased to need medical attention we could get by with even fewer hospital beds. While “just in time” healthcare may work for much elective surgery, it works far less well for acute medicine. People who have been very sick often need time to recover, particularly when they are elderly or have underlying health conditions as many people in Scotland do. Successive Scottish governments have been trying to solve the problem of “delayed discharges” ever since the creation of the Scottish Parliament and we are still no further forward than we were 20 years ago. Perhaps it’s time to learn from the rest of Europe and increase bed capacity?
Doing so would not only improve the experience of people using and working in the NHS, it could enable adult social care to do its job and focus on how to support people at home instead of devoting a significant proportion of its resources into how to get people still needing large amounts of care out of hospital. That in turn might actually help the NHS by reducing the number of people who end up in hospital.
Nick Kempe, Convener, Common Weal Care Reform Group, Glasgow.
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This is down to the SNP
John Swinney’s excuses for levels of care in the NHS in Scotland reaching third world standards have been labelled ”preposterous” by opponents, with very good reason.
The FM cited the rising number of flu cases. When details are read of the disastrous state in which the staff and patients have to work and be treated, of people, some very old and infirm, being left in corridors for unbelievable lengths of time, waiting for a bed, hearts must sink.
No, Mr Swinney, it is not the flu to blame. It is 18 years of SNP misadministration that has led to this state of affairs. Eighteen years where the only items in the budgets given priority and maximum attention have been ferry fiascos, or fake embassies, or Saltire-waving nationalist jollies overseas for the boys and girls.
Begin by sorting out our priorities and take it from there. It will all fall into place.
Alexander McKay, Edinburgh.
Keep the Lords for politicians
We welcome that a fresh bid has been made to remove Church of England bishops from the House of Lords through the Hereditary Peers Bill. A different unhelpful amendment suggests adding other faith representatives: an equally divisive idea making for more religious interference in parliament. Why should the self-preserving and well-known illiberal and anti-scientific views of some religious leaders bring any more wisdom to the table than those of football team managers or gardening clubs?
It is only a matter of time before the privileged seats of this unrepresentative diminishing minority are removed along with those of hereditary peers.
Neil Barber, Edinburgh Secular Society.
A9 delay is disgraceful
I always think that if you become the butt of comedians’ jokes, you have really messed up. This is what has happened this week to Fiona Hyslop, the SNP Transport Secretary who rejected the recommendations of the A9 dualling. Fred MacAuley took to Twitter (X): “A9 Accelerating the project would lead to delay. A Scottish Government Minister actually said this out loud.”
While those of us living in the north wonder just how long it will take for the full A9 to be dualled, how many more people will lose their lives and how many more families will be impacted by crashes on this road while the SNP continues to offer such double speak?
If only the party spent as much time progressing this work as it does coming up with excuses, the A9 would have been long completed.
Jane Lax, Aberlour.
Get ready for waste crisis
A ban on the landfilling of untreated municipal waste in Scotland is due to commence at the end of this year. The ban was originally proposed for January 2021 but was postponed to allow the Scottish waste treatment sector enough time to develop the additional capacity needed to cope with it. However, progress in providing the additional capacity (mostly Energy from Waste plants) has been slower than anticipated, not helped by a later decision by the Scottish Government to stop allowing new EfW plants to be built.
As a result, it’s estimated that there could be a shortfall of 600,000 tonnes per annum of municipal waste that Scotland won’t be able to cater for by the end of this year. This material will have to be transported to England for disposal. It’s also expected that some of the existing landfills that currently rely on a significant intake of municipal waste for their financial viability will close. This will have repercussions for those of their customers who cater for the non-municipal waste sector.
In terms of the logistics, this could equate to 90 loads of waste per day going south, assuming that each truck can deliver a load from the central belt and get back within drivers’ hours regulations. For operators further north, a load per day isn’t feasible. There aren’t 90 articulated tractor units, nor the specialised trailers (or drivers to crew them) going spare in Scotland so this will mean additional procurement and recruitment issues.
It’s been argued that another postponement might be the answer but that could be unfair on those councils and companies which have already invested in measures to let them comply with the ban. Some landfills have already developed decommissioning plans. Another option might be to allow those organisations (including councils) which haven’t/can’t comply with the ban to pay a surcharge on the tonnages involved.
So it looks like a lot of additional vehicle trips and the associated carbon footprints will be generated by this decision.
And nobody seems all that bothered that the £75 million of landfill tax per annum associated with the 600,000 tonnes will now be collected by HMRC rather than by the Scottish Government, never mind that councils and businesses alike will be faced with increased waste disposal costs.
Whatever way it’s viewed, it looks like becoming yet another bourach and one has to wonder if those who advise the politicians are doing their job to the best of their ability.
John Crawford, Preston.
Reform of the insurance sector
Of course insurance fraud is not a victimless crime (“Insurance firms crackdown call”, The Herald, January 16). But at the same time why are the specialist insurance courts on The Strand at The Royal Courts of Justice so busy with insureds suing their deep-pocket insurance companies, sometimes also their brokers for negligence? Many of these claims are for multi-million-pound sums and insurers have access to billions to defend them.
Without what is known as after-the-event insurance many claims would not be pursued, putting businesses into liquidation with workers through no fault of their own losing their jobs.
Two thoughts for reform: insurance companies who “defraud” their clients with spurious declinatures and who are criticised by judges should have punitive and exemplary damages awarded against them, made an example of for bad practices and cheating the system.
Closer to home, NHS Scotland’s costs for medical mistakes is soaring. I don’t know if it’s an answer or not but Scotland’s political parties will be considering their manifestos for the 2026 Holyrood elections.
We cannot afford to self-fund or buy commercial insurance. I would like to see a progressive commitment from politicians to looking at a no-fault system obviating years of costly litigation with some people dying in the process.
Douglas McBean, Edinburgh.
How will we cope with the forthcoming ban on the landfilling of untreated municipal waste? (Image: Newsquest)
If Jesus returned
In the run-up to Christmas reader John Jamieson posed an interesting question, namely what would happen to Jesus if he returned to Earth now.
I think he would have a tough time of it. In the first place he would notice that the plight of the Jews had not changed much in the intervening 2000 years since he was last amongst us: generally vilified and discriminated against and with regular attempts at genocide, the latest of which was as recent as the 1940s.
He may have found himself once again born in a manger because not only would there have been no room at the inn but there may have been no inn at all given that so much of his homeland has been reduced to rubble by warring factions (including his own).
He might have become a social media phenomenon with half the populace seeing him as an influencer with the other half regarding him as the devil incarnate, such is the binary world he would have found himself in.
In any event his life would have been under constant threat unless he had been successful in teaching us the error of our ways and getting us to repent our sins.
Of course, there could have been an alternative history. His Father, taking a lead from the Terminator movies, may have sent him back with a more “Old Testament” brief to exact punishment and wreak his vengeance on us for all our sins.
One thing is certain, however. If he had retained his ability to turn water into wine, he would have always been welcome in Scotland.
Keith Swinley, Ayr.