WINTER is always the time of year when the NHS is under stress, as flu season hits, however this year it is particularly bad. A combination of an early and particularly bad flu season combined with Covid, an NHS reeling under industrial action and dissatisfied staff, and an energy crisis that has left thousands of vulnerable people unable to heat their homes. All of this comes on top of an NHS which has suffered years of Conservative austerity and has combined to create a crisis for the health service which is worse than it was at the height of the Covid pandemic.

In England, the situation is truly dire, with warnings that the NHS is close to collapse in many areas. Today a group of doctors have accused the Prime Minister – who refused to comment on whether he uses the NHS for himself or his family – of being “delusional” after he insisted that the NHS had the money it needed to deal with the extra pressures caused by the surge in demand for health care in the winter and denied that the NHS was in crisis.

There is no single NHS across the entire UK, the health services in Scotland, Wales, and Northern Ireland are under the control of their respective devolved Parliaments, however, the stresses currently being experienced by the NHS are present in all the nations of the United Kingdom. This suggests that there is a bigger issue here which is beyond the ability of devolved governments to deal with.

While the NHS in Scotland is performing better than its counterparts in England or Wales, that is not a huge consolation to Scottish patients forced to wait for hours in over-stretched A&E departments or left waiting weeks or months for a vital appointment. Scotland too has its problems in the NHS, with some calling for the resignation of the Scottish Health Secretary Humza Yousaf, even as they admit that his resignation and replacement would not actually address the root cause of the problems which assail the NHS in Scotland, far less across the UK as a whole.

The key problem for the NHS is a systemic and decades-long lack of proper funding. Although the NHS in Scotland and Wales is devolved, the overall budgets for the devolved governments are set by Westminster, and there is only a limited extent to which the Scottish or Welsh governments can rob from other budget priorities in order to boost NHS spending. For decades, Holyrood has been putting a sticking plaster on an open wound.

SNP MP Dr Philippa Whitford has warned that the current crisis in the NHS is so bad that it warrants a Cobra-level response from the British Government. She noted that: "You've got Brexit, 12 years of austerity, and then you’ve got Covid. You've got lots of things that are structural, political, and policy decisions that were made – often in Westminster – that then impact the NHS. Of course, across England but also in the devolved nations.”

It suits the anti-independence parties to cry that the NHS in Scotland is devolved and to heap all responsibility for problems in the NHS in Scotland on the Scottish Government, but this ignores the bigger picture and the reality that services in Scotland, even devolved services, must operate within constraints imposed by budgetary and policy decisions made in Westminster. The genesis of the current crisis in the health service lies in a decade and a half of Conservative austerity.

The problems in Scotland's NHS cannot be solved without an increase in funding from the Westminster government which jealously guards the purse strings, or unless the Conservatives in Westminster agree to allow Holyrood greater borrowing powers. Neither of these things are likely to happen. Instead, the NHS in Scotland will continue to struggle and Labour and the Conservatives will continue to put all the blame on the Scottish Government while turning a blind eye to the bigger picture. This form of political opportunism is particularly crass and opportunistic on the part of a Conservative Party which presides over a far more serious crisis in the NHS in England and whose budgetary and policy decisions in Westminster lie at the root of the crisis.

Unfortunately, as far as a wake-up call comes, we are still only in early January and except for a single cold snap, this winter has so far been unusually mild. But chances are that things will only get worse as we head into the remaining winter months and we can only pray that our NHS weathers the storm.