YOUR headline last week (November 28) read: “Care for sale: Firms invited to bid for 1,500 NHS procedures”, reporting that private contractors are being asked to “provide prices for more than 1,500 procedures including a range of operations such as heart, cancer and brain surgery "to support the NHS in Scotland", and that “health care support” could be provided abroad.

However, as in all things, context is critical. The proposed contract would mean on average 300 procedures per year. However, NHS Scotland does 270,000 operations, so private sector involvement is less than one per cent.

Moreover, only later in the article do we learn that the value of the contract is “£150m” over the “five years of the system”. However, in the current year, NHS Scotland’s budget is £15.3 billion, so spending on the private sector would be an even smaller fraction of one per cent than the number of procedures. If this is the “Scots NHS for sale” then there is a very long way to go before we get anywhere even remotely close to privatisation.

To be clear, I too would be utterly against the privatisation of the NHS, but the fact is that the NHS is under enormous pressure with a large volume of patients waiting for treatment since the Covid pandemic struck. Struggling to catch up, at the same time as more patients join the queue for treatment for their conditions, the Covid pandemic remains extant (and with the new variant very possibly going to set things back), does it not make sense to add to short-term capacity by involving the private sector on a time and cash-limited basis? After all, what is the alternative? Even if more physical infrastructure could be put in place, can the additional doctors (and nurses, and other essential staff) be recruited by the NHS in time? Almost certainly not.

Of course, in the name of ideological purity we could leave those patients, many of whom have waited too long in pain and/or their condition getting worse, to just wait some more and hope for the best. Or, should we not recognise that “needs must”?

Alasdair Galloway, Dumbarton.

* IT'S understandable that Scottish Government plans to invite private hospitals and other healthcare firms to bid for the provision of vital medical services normally carried out by the NHS should raise fears of the gradual privatisation of the NHS in Scotland. However, in the light of the fall-out from Covid, surely desperate times call for desperate measures.

Long before the pandemic, Scotland's NHS suffered from underfunding and understaffing with improvements to the health service being introduced in a piecemeal fashion and with very little improvement to meet rising demand. Farming out NHS services to private healthcare companies has always been with us but the impact of the pandemic has made the increased use of this facility almost inevitable.

I am sure that patients on long waiting lists for life-saving cancer treatment and pain-reducing surgery don't really care where the treatment comes from so long as it's made available. Keeping the NHS in public hands is a fight to be faced further down the road, but in the meantime hospital waiting times need to be vastly reduced by whatever methods are open to the Government.

Bob MacDougall, Kippen.

THERE IS MUCH MORE TO COME

A GOOD subtitle for your lead article on the NHS might have been: "You ain’t seen nothing yet".

For every £1,000 spent on the NHS in Scotland, only £2 finds its way to private companies. In England it is a quarter of the entire budget.

The rate of privatisation in England is such that Scotland is fast becoming an oasis of public health care within the UK. Unfortunately, this does not mean we can breathe a sigh of relief, safe in the knowledge that our better-performing NHS is safe.

The Internal Market Bill and relentless budgetary cuts will be used to force Scotland into ever-greater levels of privatisation. The pressure will be inexorable and cannot be relieved except with independence.

Jim Daly, Edinburgh.

STURGEON'S STOCK ANSWERS NOT GOOD ENOUGH

IT was interesting and instructive to watch Nicola Sturgeon when she was being interviewed on the Andrew Marr Show last Sunday (November 28).

She has ready fall-back positions that she turns to when challenged on deficiencies in our NHS. Her first line of defence is to say that, in a time of Covid, Scotland is doing no worse than others in the midst of this global pandemic. However, such replies do not cut any ice with relatives mourning lost members of their families. Rather, those grieving would prefer to hear what positive and constructive steps are being taken to eliminate the long ambulance delays and the long waiting lists which are having such an adverse impact upon the lives of patients caught up in those situations.

When confronted with the shortage of beds and the lack of spare capacity in the NHS, the First Minister pulled that tired old rabbit out of the hat that this had been the trend since long before the SNP took over the reins of government. What she did not reply was that her Government had been trying to buck that trend and reverse it. Instead she produced an anecdote about her granny having had her cataracts treated many years ago and having had to stay in hospital for days after her operation where today she would have been in and out in a day for the same treatment. And then she had the temerity to talk about bed blocking today. That story was irrelevant to the question posed and added up to no more than a smokescreen to disguise the difficulties current within our version of the NHS.

To give her her due, she is Scotland's most consummate politician, although that is to be damned with faint praise.

Denis Bruce, Bishopbriggs.

DEHUMANISED BY CONSERVATISM

CLARK Cross (Letters, November 28) asks: “Given that there is already a housing crisis in Scotland ... why add to the problem by housing pretend asylum seekers?” “Pretend”? I'd like to think that was a typo.

I ask Mr Cross: where do those refugees go, refugees fleeing the consequences of famine, destitution, climate change and war, some of these consequences caused by western actions and indifference? The UK must accept its fair share of these refugees, its partial responsibility for their plight. We registered a mere 5.78 asylum seekers and refugees per 10,000 inhabitants in 2020, compared with France’s 16.93 and Germany’s 19.52. Furthermore, around 85 per cent of refugees worldwide are camped in the poorest countries who can ill afford the responsibility.

I acknowledge, however, that it would be unreasonable to argue for global justice, no matter how justifiably, while ignoring the tragic consequences of a decade of pitiless austerity here in the UK.

The only way to prevent an ongoing recurrence of these consequences is for the citizens to dismantle, through the ballot box and other lawful means, the foundations of our unequal, fractured and consequently dysfunctional society. It is surely unacceptable that groups, not just refugees and the homeless but others including the obvious example of benefit claimants, are dehumanised by late 20th and 21st century Conservatism.

John Milne, Uddingston.

BRITAIN MUST STEP UP ON MIGRANTS

IT’S not considered scientific to talk about psychopathy or criminal lunacy, but UK asylum policy has stumbled into a lethal schizophrenia.

If you can cross the Channel illegally you’ll probably be granted asylum. If you perish in the attempt you are a solved problem, and better a still a problem with no name, never known to have existed.

Wise people have commented that the only solution is to solve the causes of refugee migration. That’s a bit late, because the causes are half-finished wars, from which we, the democratic nations, raced home as fast as we could. That’s left valiant people like Kurds and Afghans running for their lives.

Fortunately the victorious allies of 1945 didn’t trust each other and did not quit the smouldering rubble. If they had, Nazi stay-behind guerrillas would have sent streams of European refugees sprinting for cover. That’s what’s happening in Syria, Iraq and Afghanistan.

It’s not likely that democratic powers are going to re-engage to solve those particular problems, so we’d better get real about the people abandoned among the sand dunes of the French Channel coast. Some people will recognise the quotation "pray that your flight be not in winter".

French citizens act privately to alleviate as much suffering as they can, but why is this misery allowed? The great democracies of France and Britain have become giant and pitiless millstones to those who thought we would help them.

Britain or France must construct a place of shelter and assessment for these migrants, with a staff of UK immigration officials to decide the cases of those whose wish is Britain. That’s presumably all the migrants who have gathered on the Channel coast.

Tim Cox, Bern Switzerland.

OMICRON FOUR WERE VACCINATED

GORDON Brown claims that the lack of vaccines in poorer countries is to blame for the development of new coronavirus variants ("Brown blames lack of vaccines for new African mutation", November 28). Unfortunately he doesn't tell us what clinical research papers he's been reading, if any. He ought to know that the Botswana Government has made a press release admitting that its first four Omicron cases were all fully vaccinated.

Geoff Moore, Alness.