THERE is a lot of talk about the state of the NHS and what it needs. Some of this is hysterical scaremongering; others offer a reasonable discussion.

The systemic problems regardless of devolved administrations are dictated by and a direct consequence of the funding allocated by Westminster. A fact that most gloss over or do not take account of is that it is the high demand for health services that produces waiting lists and backlogs, made worse to an extent by the expectation that the NHS should be able to fix and treat every possible ailment.

The only way of reducing demand is to encourage more people to take care of themselves, which is why there is a focus on using pharmacies and other approved facilities.

The extent of waiting lists is only partially caused by people insisting on seeing their GP or A&E/ambulance, compounded by the well-discussed bed-blocking. To help alleviate this and aid the transition to community or home care there should be a reintroduction of halfway sanatoriums where people can be monitored as part of early recovery in a semi-clinical setting.

However, bed blocking also has a knock-on effect on staffing levels and the lack of staff to work through the backlog is the critical factor. There is of course no quick solution to this as it takes years to train people, so using semi-medically-skilled support staff in a non-hospital environment could help significantly.

If Westminster ministers and supporters actually understood the primary level arithmetic that only one person can do one job at a time, and it takes as long as it takes, we would be halfway to solving the crisis of their making. Continual reductions in earnings caused by austerity (tax cuts for the wealthy) then reduce the numbers of staff willing to take on the increasingly onerous tasks and results in more people doing exactly what the same Westminster ministers have been advising by going to a better-paid or alternative job.

Shifting the NHS to a private or insurance-based model will not stem the demand, which no-one can do anything about other than the antisocial and unacceptable practice of limiting health care to the wealthy. The demand would still be there, but controlled by a refusal to treat. And of course such a system would suffer from the lack of economy of scale and it would be far more expensive even for those who could afford it compared to now.

The biggest problem in health terms is that our so-called National Insurance, which should fund health and social care, is deemed to be part of general tax income and is therefore always at risk of direct political interference. Creating a proper insurance scheme independent of government would help alleviate this.

Any private solution to health will be doomed to eventual failure as the taking of profits directly reduces the amount of money available for service delivery, which like it or not requires a highly trained and sufficient labour force. Regardless of the funding model, the NHS requires people in wards, clinics and surgeries. No amount of tinkering around the edges can fix this.

Nick Cole
Meigle, Perthshire

REGARDING Friday’s story “LibDems claim refugee went back to Ukraine due to NHS GP waiting time”, the lack of any detail in Alex Cole-Hamilton’s statement other than the waiting time for a thyroid test somewhere in Scotland compared to in Kyiv creates possibly unnecessary worries for patients all over Scotland who require regular thyroid tests about access to the service.

Surely without breaching patient confidence the question could have included the length of the delay, the locality or health board area, when this incident happened and if it has or will be passed to the appropriate authority for action.

John Jamieson
South Queensferry