FORMER finance secretary Kate Forbes has warned against the "ridiculous suggestion" of privatising the NHS as she backed calls for a "national conversation" on the future of the health service.

The SNP MSP – who also criticised proposals for a National Care Service in Scotland – said “without urgent interventions there might not be an NHS to reform in a few decades”.

She said only NHS workers kept the health service from “keeling over” in 2023 and despite their “herculean efforts” patients are “waiting too long for almost every service”.

Writing for the think tank Reform Scotland, she said NHS staff were “plumbing new depths of fatigue and pressure”, adding that she knew doctors and nurses who work over their hours every shift.

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The Skye, Lochaber and Badenoch MSP supported the idea of a “national conversation” about the service and its funding, but stressed it must lead to results.

But in the piece she said claims by politicians that privatisation would solve issues was a "ridiculous suggestion" and said the NHS must not be "a cover for politicians to promote their favoured policies without proper accountability". 

Forbes wrote: “In principle, who could disagree with the need for a frank debate? But only if it leads to results. We’ve heard talk of reform in the NHS for years – but without urgent interventions there might not be an NHS to reform in a few decades.

“The greatest risk, however, is the wrong diagnosis of the root causes, which will be inevitably followed by incorrect treatment.

“Everybody can list the symptoms: waiting times; a shortage of workers; bed blocking. The problem comes when politicians and commentators immediately jump to conclusions and suggest certain treatments which would almost certainly exacerbate the symptoms.

“You hear some insist that it’s the public sector to blame – if it were privatised it would become more efficient. Others condemn the shortage of money – if every penny of the devolved settlement was expended on the NHS, we’d wave away the problems. Both are ridiculous suggestions.”

She set out four parameters for the conversation: “zero tolerance” of moving away from the founding principles of the NHS; a focus on patients and need for government to take “tough decisions”; no extra bureaucracy; and the need for “simpler changes” regardless of structural reform, such as freeing up management money for frontline staff.

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Forbes said carers deserve a higher wage and better terms and conditions with or without a major overhaul of the care sector.

"Let’s not rearrange the deck chairs while the ship sinks," said Forbes.

"Major structural reform might be required, but it will inevitably distract from the simpler changes that could be made and will need to be made irrespective of structural reform.

"That’s self-evident in the proposals for the National Care Service. At the end of the day, carers deserve a higher wage and better terms and conditions with or without a major overhaul of the care sector.

"The same principle applies to the NHS. Free up resources in the deep recesses of management in order to employ more frontline staff, and you probably don’t need to put everything on pause whilst you redraw the NHS."

Dr Iain Kennedy, chairman of the British Medical Association (BMA) in Scotland, previously warned the NHS in Scotland may not survive the next 25 years without a national conversation. 

Former NHS Scotland chief executive Professor Paul Gray has also called for a conversation on the NHS – leaving open the possibility that some services could become paid for in the future.