This week waiting times in Scotland’s accident and emergency departments reached a new and painful record.
According to the latest official figures for the second week in September, only 63 per cent of patients were treated within the target of four hours. Nearly 10,000 had to wait more than four hours and 1,200 waited for more than 12 hours.
In one shocking example, given at FMQs on Thursday, the Scottish Conservative leader Douglas Ross mentioned a patient in Ayrshire who had waited 84 hours to be seen. Nicola Sturgeon said she would look into the case. It was unacceptable, she said, but at least waiting times, generally, in Scotland were not as bad as they were in England or Wales.
The NHS is not the only public service creaking towards collapse. Wage costs and energy costs and recruitment difficulties are afflicting care services, schools and colleges, council waste collections and railways. Workers is all these services have either been on strike or are balloting on strike action.
As we have emerged from the period of mourning for the Queen, we’ve had to face up to inflation at 10 per cent, interest rates starting at 2.25 per cent and energy costs doubling overnight. The new Truss government at Westminster has been forced to borrow £100 billion to soften the hammer blow of high energy prices for households and businesses. But it looks like austerity is to continue for the public services, with the Chancellor Kwasi Kwarteng’s “mini-budget” promising big tax cuts.
It’s true the health service has been given a token increase from time to time. But it only addresses the immediate crisis and there has to be a limit on how much can be spent on the NHS. At £18 billion a year, it already accounts for half of The Scottish Government’s budget. Any long-term fix is too frightening for the politicians to even mention.
For example, it seems that a major cause of the long waiting times in hospitals is that there are 540,000 bed days per year taken up by patients who could be discharged if there was a care system to handle them, either in their own home or in nursing homes.
A National Care Service has been promised, over and over again, by governments of various sorts. Indeed there is legislation going through the Scottish parliament at the moment which attempts to fulfil that promise. But none of them have faced up to the cost. Theresa May quickly withdrew her suggestion of people paying for their care from the value of their home after death. Labour’s Andy Burnham suggested a 10 per cent tax on each citizen’s wealth at the time of retirement. But none of these schemes have survived the popular press’ scorn and the politicians’ lack of courage.
And the same story of poor leadership can be told of many of the other challenges facing us: climate change, poverty, the cost of living crisis and the housing crisis. Politicians don’t talk about big solutions, like taxing air travel, or banning plastic packaging, or redistributing some income, wealth and welfare benefits from the majority to the 20 percent of households who really need it.
It could be that one of the reasons for the mass turnout at the Queen’s lying in state and the funeral on Monday is that people are yearning for some sort of long-term leadership. I’d like to see King Charles continue his campaigning on these major issues, persuading politicians and the voters to take them seriously, rather fall back into our usual short-term self-interest. He doesn’t need to prescribe solutions, just encourage us to get on with solving the problems.
King Charles has already been busy preserving the Union. As required he quickly organised a tour of the nations, travelling nearly 2,000 miles in the week after his mother’s death to meet crowds in Edinburgh, Belfast and Cardiff as well as London. The Queen, while appearing to be above politics, provided leadership over issues such as the Commonwealth, care for the less fortunate in society and the Covid pandemic.
Such leadership has to be a gentle balancing act between reminding people of the challenges and persuading them to respond. No one wants to return to the days of absolute monarchs, emperors, sheiks, caliphs, kaisers, fuhrers, tsars or other strongmen. We’ve seen what a mess they make of things, from the Stewart kings to Putin.
The Queen’s death and the arrival of a new King should give us pause for thought about the future. There should be dreams of a new world, of doing things differently. But as happened after pandemic, the new world began to look very like the old one. The arrival of Liz Truss as prime minister has set us on course for another round of right-wing economics – a dash for growth in which the rich get richer and the poor wait for some of the wealth to trickle down to them. It won’t happen, of course. And even if it did, it wouldn’t be good for the planet.
But even the attempt will further appall the Scots, just as Brexit and the shocking behaviour of the Johnson government did. The Union is heading for the emergency department but we don’t know how long we will have to wait.
