Let's hear it for NHS staff

They save the health service on a daily basis. We - state and society - owe them effective structural reforms that guarantee its sustained survival

“Workers are exhausted and demoralised.” “Scotland’s NHS is at breaking point.” These comments by Jackie Baillie, Scottish Labour’s spokesperson on health, are commonplace and echoed by professionals and patients across the country – and the UK as a whole. They are pushing Rachel Reeves and Keir Starmer reportedly to inject a further £30bn into the NHS in the June 11 spending review.

We can all recite several bleak facts: waiting lists (in Scotland) of more than 52 weeks up at 106,000; almost 10,000 Scots waiting for a social care assessment or care at home package as proposed legislation to mitigate the problem is scrapped; poorer Scots denied access to dental care; nursing vacancies up 22%, overall NHS staff vacancies up 19% in Scotland. Yet personal experience of the service, including my own, can belie this unrelenting gloom and doom.

Sure, I had to wait five months for an appointment with a vascular surgery consultant and the ensuing consultation lasted all of ten minutes, with several of these devoted to what it’s like being a foreign correspondent and despairing Scotland soccer fan. I had shorter waits for COPD and cardio consultations which ended up with repeat pills prescriptions and proposed lifestyle changes already underway.

But last month I experienced an efficient, effective and empathetic NHS at its best and emerged from a 60-hour stay at Edinburgh’s Royal Infirmary for my first-ever OP with huge respect for the dedication, hard work, professionalism and caring of its staff from cleaners to consultants drawn from around the world.

Saving my/our NHS

I never reached my favourite Italian wine bar with my wife and brother-in-law. Instead, I briefly collapsed halfway across the street, regaining consciousness after less than a minute to find myself lying on the tarmac surrounded by anxious family and passers-by (including fortuitously a couple of off-duty A&E doctors). Eventually, an ambulance came and sped me on my way to RIE, blue lights flashing and wheels bumping in and out of myriad potholes.

Here began my assessment and treatment course, with the ace young paramedics swiftly and initially diagnosing the likely cause of my fall with a series of tests and questions. Handed over to an A&E team headed by a Dutch doctor with a name like that of a striker for Ajax Amsterdam, there followed more tests, including a CT scan. I then spent a few hours in a noisy waiting pod before being admitted to the Acute Medical Unit in the early hours and later one of the cardio wards. I already knew then via the senior cardio consultant that I was going to be fitted with a pacemaker, probably in the following week.

In fact, again very fortuitously, I was offered an early OP the next day and was indeed whisked down less than 24 hours later by good-humoured porters to the operating theatre. Then more friendly, reassuring chats with nurses, some liquid Valium as local anaesthetic, a consultant surgeon cutting open my left chest and gently prodding the pacemaker and wires to the heart into place…Electrical (conjunction) problem causing a complete heart block over-ridden (for now at least)…Two weeks later I’m filled with even greater admiration for all the staff I came across.

There was little sense of the oft-cited demoralisation. Instead, a love of the job and commitment to patient care. Plus, a wary, critical attitude towards executive and political management. Two of the porters I met had come from long careers in professional life, including management, to do a less stressful job they liked. A central European care assistant freely discussed the prospects of getting her overseas qualifications recognised and moving on to a more senior, better-paid post. Senior doctors/consultants told how they planned to stay with the NHS despite the pull of Canada and Australia (double the pay for many fewer hours).

My experience was privileged not in the sense I could afford to pay for it but that I suffered none of the delays and botched decision-making that plenty of others, including my nearest relatives have suffered. (My first wife was misdiagnosed and died of a grade 4 brain tumour a few months later.) (My late mother spent considerable amounts of time in distress waiting in hospital corridors before a bed became available).

A cogent view is that the NHS is excellent at acute/emergency medicine/treatment, not so good at handling chronic conditions like cancer which can put a strain on resources and often require long-term care. Some commentators believe such conditions might better be treated in the community or even at home. This requires a national debate on NHS reform that works. We have just under a year to Holyrood 2026 to go beyond kickstarting it. And then starting all over again.

Reform options

There are plenty of laudable ideas around but, as Audit Scotland recently reported, a key one is to improve governance, with auditor general Stephen Boyle urging reform of delivery services if the NHS is to remain “affordable and sustainable.” Scottish Labour proposes slashing the number of health boards as part of its DOGE agenda (adopted before Musk’s demise) while the SNP is promoting its proposed “NHS renewal framework.”

Most experts agree on a greater emphasis on and investment in primary care, preventive and/or personalised medicine, digitalisation (in a country not exactly awash with reliable, up-to-date data), innovation, and, of course, more money but money that’s better spent and linked to improved productivity (the age-old British problem). After living for many years in mainland Europe, I also favour an insurance-based funding system. This has nothing to do with Reform UK’s predilection for a US-style, HMO-based system but one built around contributions to mutuals (mutuelles/gemeinschaftliche Krankenkassen) albeit there are few takers so far for this proposal…

What’s certain is that we owe it to the near-200,000 NHS staff in Scotland to reward their hard work and dedication to patient care by putting into practice as many of these proposed reforms as we can. Enough of seminars and workshops. On with effective policy-making and implementation.