Readers' Letters: Healthcare needs to be transformed, not reformed

Audit Scotland has added to the procession of deeply worrying data, detailing further aspects of the the cumulative dysfunction in the NHS by informing us that last year at least £440 million was spent in keeping people in acute and rehab hospital beds who do not have clear medical reasons for being there while the social care resources that may allow many of them home cannot be found (your report, 9 January).

Our multi-layered outrageously overpaid NHS exec and non exec corporate directors and their “partners” in the cabinet office, civil servants, various duplicated quangos, the vested interests of big pharma, big tech and and last but certainly not least “big law” are clearly not delivering the value for money tax-payers might expect from their increasing contributions

There have been repeated plaintive cries from the Royal College of Physicians, nursing leaders and rank and flie servants of the sick for an urgent “Health of the Nation” convention to effect reform in our health and social care which appears to continue to fall on the deaf ears of MSPs more concerned with culture wars and geopolitical distractions.

What is required is not “reformation” but “transformation” in our public services and commonweal .This could start with the NHS but not stop there. We need emancipation from a neoliberal Westminster and a rising imperative within Holyrood and within the hearts and minds of our compatriots to look after our own in all areas of life in a decentralised democracy.

A vision for the health of the nation in the coming decade is urgently required from the present incumbents before they dare ask for a vote in May. If Scotland need to be independent to heal this nation then let it be so!

Dr Andrew Docherty, Selkirk, Scottish Borders

Hard to swallow

With road safety and lower road casualties in mind the SNP government has unleashed narrower roads, due to no parking on the pavements, and slower speeds with the imposition of new 20mph zones.

This would be easier to swallow if the SNP really cared about the health and wellbeing of Scots but this same administration has presided over far more unnecessary deaths due to a meltdown in the GP service, ambulance service, A&E waiting times, hospital bed blocking and long waiting lists for surgery, cancer care and mental health issues.

Gerald Edwards, Glasgow

Policing epiphany

Police Scotland has been actively involved in training US law enforcement officers in non-lethal intervention programs and collaborations over many years.

A recurring theme among Scottish officers involved in the training is an epiphany moment when their US counterparts understand for the first time that there are alternatives to pulling a trigger to de-escalate flash points.

Regarding current events in Minneapolis, will US Ambassador to the UK Warren Stephens consider increasing Police Scotland’s capacity to Make America Safer?

Ian Macaulay, Cupar, Fife

Trans prisoners

You report (9 January) that the group For Women Scotland have objected to the Scottish Government suggesting that to require every trans woman prisoner to be accommodated in men’s prison may breach human rights law.

Trans women in prison are subject to a detailed risk assessment. Any with a history of abuse or violence against women are held in men’s prison. But some have no such history, and holding them in women’s prison reduces overall risk.

For Women Scotland claims that April’s Supreme Court judgment means that trans women must always be excluded from spaces designated for women. But there have since been two Employment Tribunal judgments which have concluded that it continues to be lawful, depending on the circumstances, for trans women to use the women’s toilets or changing rooms. No doubt there will be appeals and further cases – the legal situation is currently far from clear.

The Scottish Government is required by law to act compatibly with the European Convention on Human Rights. The European Commissioner for Human Rights, Michael O'Flaherty, wrote to the UK Parliament in October raising concerns that some proposed interpretations of the Supreme Court judgment could breach those rights.

So it seems entirely appropriate for the Scottish Government to ask the court to rule on the human rights compatibility of the treatment of trans women prisoners. Protecting women and girls, and protecting trans people, overlap and need not conflict.

Tim Hopkins, Edinburgh

Wrong priorities

The Scotsman’s front page yesterday headlined a £1bn budget black hole in Scotland’s finances for capital and infrastructure spending plans, yet what do I read on page 10? A “secret challenge” by the SNP to the Supreme Court’s ruling on the definition of a woman!

So they can find the money for this, but not the numerous things much more important to the “Scottish people” Swinney is so fond of. It’s an absolute disgrace.

Liz Towns, Edinburgh

Spending bias

There has been much comment about the proposal by Reform UK’s Malcolm Offord for a referendum in 2036. This would allow time for Holyrood to demonstrate its effectiveness in improving the lives of Scots and to produce a sensible plan for separation.

If you really think that more than 25 years (18 of them under the SNP), wasn’t enough, then that might appear to be a sensible approach. However, closer examination reveals some major flaws. Firstly, if devolved government is seen to be working, then why would Scotland want to separate. Secondly, for the next ten years the UK government would be faced with a dilemma over whether it should fund and co-operate on infrastructure, transport, trade, defence and industrial projects in Scotland if, at the end of it, Scotland has benefited sufficiently to want to walk away.

For the same reason, it would be unfair to ask the citizens of the rest of the UK who happily pay taxes to give fellow citizens in remote rural and island areas such as Cornwall, parts of Wales the Lake District and the Highlands and Islands of Scotland similar level of service to more densely populated areas, to keep doing so for a Scotland planning to leave.

An example would be renewable electricity subsidies (estimated by the Renewable Energy Foundation at between 30 per cent of all renewable subsidies and 10-15 per cent on all UK electricity bills, totalling over £25 billion per year), much of which is spent in Scotland.

As part of their manufactured “grievance” policy the SNP routinely, but falsely, accuse Westminster of a spending bias against Scotland. Let’s not create a situation where this becomes a reality.

Mark Openshaw, Cults, Aberden

Holy Loch lessons

The excellent article by Katherine Hay on the ecological regeneration of the Holy Loch in Argyll (8 January) misses several important historical facts.

When the US Navy exited Highland and Islands Enterprise (as was) injected considerable financial support to the area including environmental and ecological funds.

The strategy was largely recognised as being a major achievement for Dunoon and the Cowal peninsula and was fully supported by local residents and the business community. It was very much a hands-on approach aware of local needs. Some lessons could be learned as we approach our Scottish election in May.

DG McIntyre, Edinburgh

Risky business

Risk is the classic board game I remember from my youth: armies and dice-rolls were used to conquer continents, form alliances, eliminate opponents – and thereby achieve domination. I never imagined it as a blueprint for US foreign policy in 2026!

The evidence is clear: the US administration’s stated desire to acquire Greenland now complements the previously stated desire to make Canada the 51st state. Add that to the ambivalence of the US towards Europe and the war in Ukraine. And now, a new propensity to undertake high-risk military adventures in Venezuela, Iran, and elsewhere.

Polls show 90 per cent of Canada’s 45 million citizens would resist US overtures, as would 85 per cent of Greenland’s 56,000 citizens. Donald Trump will simply ignore majority public opinion and continue to drive a coach and horses through democratic institutions, whenever it suits.

As a result, widespread concern and anxiety continues to soar. Crazy or not, a worry for the First Minister must be that Trump wakes up thinking it a great idea to add the place of his mother’s birth to his expanding empire, namely Stornoway and the Outer Hebrides (population 25,000). And this for no other reason than that he cano.

Principled countervailing power from political leaders in the West seems all but neutered: only might is right – and hard power “trumps” soft power! It’s a truism to say things will change – and we all hope for the better. Meantime, God protect us from all autocrats!

Ewen Peters, Newton Mearns, East Renfrewshire

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