This week, Audit Scotland the independent watchdog for our public services handed the SNP Government in Edinburgh its report card for the running of our NHS.
It didn’t make pretty reading unnecessary cuts to our budget over and above what the Tories have made in England, key targets missed on diagnostics and waiting times and progress on reform stalling.
Of course, we don’t need the experts to tell us our NHS is under strain.
We already know NHS Tayside is having to borrow millions of pounds of extra cash for the third year in a row to meet the endless targets imposed on it by Health Secretary and Dundee MSP Shona Robison.
Now she is expecting it to make £27 million of cuts to our hospital services here in the city.
I think Shona Robison should explain to patients and NHS staff where she expects these cuts to fall without compromising the care we expect.
NHS Tayside is not in a good state at all.
For the third year in a row, the Tayside board has had to go cap-in-hand to the Scottish Government asking for loans to keep the budget afloat.
NHS Tayside blames the delayed sale of Ashludie Hospital. However, relying on the sale of the family silver is no way to run a public service’s annual budget and is a clear sign of financial and organisational problems.
Rumours abound of further closures and property sales but whatever decisions it takes, eventually the board will run out of silver to subsidise expense.
Particularly telling were the reasons the auditor identified for NHS Tayside’s projected overspend of £14m this year.
She was very specific in identifying the treatment time guarantee, primary care prescribing and staffing costs as the reasons for spending in Tayside spiralling.
The guarantee is fascinating as a study of how political targets can have perverse effects on public spending.
The SNP passed a law in Holyrood guaranteeing patients would have to wait no longer than 12 weeks for their operation or treatment.
That’s all well and good but to meet these legally binding targets, NHS boards are having to farm out some of this work to private health at exorbitant costs.
As one doctor in Edinburgh told me, the 12-week limit means the person who is having the mole removed from his foot, who can easily wait 14 or 16 weeks at no detriment to his health, can find his operation costs the NHS hugely inflated sums to have it done inside 12 weeks.
The truth is, the guarantee, as well as starting to cripple NHS budgets is being breached all the time anyway, as more than 17,000 patients across Scotland have had to wait longer than 12 weeks.
At the SNP conference last weekend, the First Minister Nicola Sturgeon challenged Scotland to judge her on her record. She may be reflecting on that this weekend as she reads Audit Scotland’s damning verdict of her government’s performance on our NHS.
Caroline Gardner, the auditor general, makes clear that workforce planning and staffing costs is one of the biggest budget challenges in the NHS.
The perplexing thing is the SNP has had nearly nine years to get under the skin of the NHS and run it efficiently.
Poor workforce planning that is coming home to roost today has to be laid at the door of the person who managed the NHS for five years herself Nicola Sturgeon.
Experts have been telling her for years that pressures on staff were growing. She is now presiding over a system where there is a chronic shortage of GPs. In the north-east alone, 20% of GPs are due to retire next year.
Why isn’t our NHS better managed so the exorbitant costs of bringing in agency nurses is minimised? When will the First Minister and the Health Secretary get to grips with that properly?
These problems won’t go away patient numbers are continuing to rise, our elderly population has more complex problems and the costs of drugs rise and rise. No one doubts the scale of the challenge but the SNP Government could start by accepting we have a real problem and take responsibility to get us back on track.
Caroline Gardner has said fundamental change is needed. Nicola Sturgeon cannot shy away from this and hide behind targets any longer.
I have offered to put politics aside and work with the Scottish Government where we can agree on the future direction.
Shona Robison is leading a national conversation on what people want from our NHS. She would be advised to talk seriously about bold and ambitious strategies that will help change the country’s health, improve efficiency, and give our doctors and nurses the resources they need to do their jobs.