Sunday Column: It's time to have an honest conversation about NHS reform.

NHS Nightingale hospital (BDP)

By Derek W Gardiner

Stay at Home, Protect the NHS, Save Lives is the mantra applied during the first national lockdown in March and then again in this current lockdown. But this has led to many people asking why is it the public's job to protect the NHS when surely it is the NHS's job to protect the public. The early days of the pandemic saw a lot of ambition in the part of the government to expand the capacity of the NHS by building Nightingale hospitals in a week so the NHS would have the capacity it needed to take all patients who were in need of hospital care.

However, on January 4th the Prime Minister told us that there was a serious risk of the NHS being overwhelmed within 21 days so this was clearly an admission of failure on his part. There has been a trend in recent months to blame the public for the second wave of Coronavirus infections with such silly suggestions that it's because of people wearing masks under their noses (although studies show masks have limited impact) or due to people coming together for Christmas or going out for a socially distanced coffee and walk. In reality, the government has wasted the time it had over the summer to increase the capacity of the NHS by properly staffing the Nightingale hospitals, building more if necessary and cutting the bureaucratic process around hiring new doctors and nurses. They are now acting as if the NHS is has a fixed amount of resources which cannot be expanded upon and that is simply not good enough.

But it raises larger problems with the national health service, which many have described a new national religion now that Britain is no longer a Christian country so the public must be blamed because the NHS cannot be criticised. In recent years the NHS has turned into a bureaucratic mess, the NHS spends around £8 Billion of its £100 Billion budget on management and administration with around 31,000 managers, 350 of them earn more than the Prime Minister, costing the taxpayer £64 million per year, diversity and equality officers cost around £7 million a year. Form filling and targets, which often fail to be met consume time and money and fax machines are still in use. New recruits now need to fill in around 24 forms some for fire safety, diversity and deradicalisation before they can fill the shortages that need to be filled urgently. The government wastes Billions on outsourcing jobs such as catering, previously done in house to private companies, however, any criticisms of this will lead to accusations that the only alternative is an American style healthcare model where people sometimes need to sell their houses for life-saving operations.

I have long favoured a Swiss-style healthcare system where the government requires healthcare providers to provide insurance to citizens regardless of age or pre-existing health conditions and if a person's premiums are capped at 8% of their income with the government subsidising the rest. The Swiss healthcare system is one of the best in the world and the system was very able to cope during the pandemic.

While it will be difficult for any politician to attempt changes to the NHS, it could be as career-ending for a Prime Minister as the issue of Europe it must be looked at again so that it can cope in a future where COVID will still be with us.

Scottish Labour needs to get their act together for the sake of the union.

Gordon Brown (BBC)

The resignation of Richard Leonard is long overdue, he should have taken the hint 4 months ago when Jackson Carlaw resigned. Under his leadership Labour has lacked a clear vision of what it stands for, it seemed OK with an independence referendum before eventually adopting a resolution to oppose one and Leonard never struck a chord with voters, indeed many will react to the news of his resignation by wondering who he is. He occasionally raised good questions at First Ministers Questions but failed to land any blows, Labour has drifted further and further into the abyss since Leonard took over in November 2017. But the future of the union will require a strong Labour party as it's very unlikely the Scottish Conservatives will be able to form a government and unionist coalition may be the only way to get the SNP out of government.

So the question now turns to who should lead Scottish Labour. The two favourites are Jackie Baillie, the current deputy leader and Anas Sarwar, a former deputy leader, however, I do not think they have the necessary name recognition to lead Scottish Labour back from the dire polling situation it faces. Currently, the SNP are projected to win over 70 seats and the Scottish Conservatives will lose 14 seats potentially putting Labour as the main opposition party.

If as some have suggested, Gordon Brown was to return to frontline politics even temporarily as he did during the 2014 Independence referendum then he could put up a credible challenge to the dominance of the SNP and make a case for a prosperous future within the union. If he does then it's likely he can do business with other opposition leaders such as Douglas Ross and Willie Rennie to potentially build a unionist coalition.

Mandatory vaccines should not be implemented by the back door.

The announcement by the Chairman of Pimlico Plumbers that he will rewrite the contracts of his workers to require them to get a vaccination should worry anyone concerned about freedom of choice. This may be a violation of Article 6 of the Universal Declaration of Bioethics and Human Rights which states that "Any preventive, diagnostic and therapeutic medical intervention is only to be carried out with the prior, free and informed consent of the person concerned, based on adequate information. The consent should, where appropriate, be express and may be withdrawn by the person concerned at any time and for any reason without disadvantage or prejudice."

Many people, such as people with allergies, pregnant women and others will not take the vaccine for medical reasons and may have their rights curtailed by "no jab, no job" policies or their movement limited by "vaccine passports" which also raises all sorts of issues surrounding disability and gender discrimination. Demonising people for being "selfish" or demanding people make sacrifices for the "greater good" goes against the very foundations of British law which is to respect the rights of the individual against bouts of collective madness.