NO matter how “impeccable” and authoritative (if you agree with its views) a report, in the way it is presented, such as that from Audit Scotland is regarded, it is capable of misrepresentation (“Targets culture blamed for holding back reform of NHS”, The Herald, October 22, and “NHS is a case for long-term remedies”, Herald editorial, October 22).

It is not acceptable to proceed on this without reference to the NHS situation in England, particularly regarding our funding which is predicated upon what England receives on the equivalent of its block grant. It appears that Audit Scotland has ignored the shortfall inflicted on us by the Barnett formula, just as another “respected” body, the Institute of Fiscal Studies did a few months ago when it reached a similar conclusion on growth in the NHS in Scotland.

If we are funded from Westminster on devolved matters at a 20 per cent per capita advantage over England, and we receive a year-on-year enhancement on a straight 10 per cent, population ratio of what England receives, then we lose out and that influences our available financial growth – if England receives £100, we receive £120; if their enhancement is five per cent they receive £5, and we also receive £5, but on our £120, that represents only four per cent and on a block grant of £25bm, we lose £250m. So, as half our money is spent on the NHS, it is £125m (one per cent) short.

That reconciles roughly with Audit Scotland’s claimed budget decrease of 0.7 per cent in real terms in 2014-15, yet that feature is not mentioned – and it is nothing new.

On almost every front, the NHS in England has similar adverse comments about funding and performance, however that is measured. It, too, is beset by recruitment problems; the word on the block is that newly qualified doctors and other professionals are emigrating to, chiefly, Australia and New Zealand. Now, that may not be within Audit Scotland’s remit, but it is material to the problems the NHS is encountering. What does Audit Scotland think should be done about that?

It is not appropriate to include capital commitments in current expenditure assessments – these are fraught by large fluctuations in incidence of occurrence, so they distort the picture.

In Scotland, we have the opportunity to raid other programmes for additional resources, but not even Labour’s public services spokesman Jackiei Baillie is ever able to identify options for that, yet its mantra when in power at Holyrood, and challenged by the SNP opposition for more expenditure on a favoured issue, was to ask the SNP to identify which area should be cut to provide the money. Our funding is finite, and it will remain so, expectations about increased tax proceeds are misplaced – under the new powers, these would be recovered from the block grant.

Also, the matter of employing agency staff (now, apparently referred to as “privatisation”) was a major issue when Labour was in power – I recall the case of a sister being employed at a cost of £800 per day. Isn’t it amazing how Labour can turn on a dose of selective amnesia on demand? Incidentally, it was Jackiei Baillie’s Labour party which introduced the Barnett formula.

Douglas R Mayer,

76 Thomson Crescent, Currie, Midlothian.

At the SNP conference, Nicola Sturgeon asked us to judge her on her record.

Yet, hard on the heels of us learning how the SNP has failed Scots in education and the emergency services, we have confirmation from Audit Scotland of deteriorating NHS waiting times. If targets are unmet when the weather is mild, what hope is there over the winter months?

No one is criticising hard- pressed hospital teams but rather the quality of SNP decision making and resource allocation. Plus we learn of a real- terms cut in our health budget under the SNP, compared to England where spending has increased.

It's inconceivable the First Minister is unaware of her party's lacklustre performance so why is she asking us to judge her on a track record of under-performance, especially with an election next year?

Could it be that the usually canny Ms Sturgeon is falling into the trap, as highly successful politicians sometimes do, of believing her own rhetoric? Margaret Thatcher and Tony Blair were certainly guilty of such self- deception as their popularity grew - and see how we regard those once powerful leaders today.

Judge you on your record rather than your rhetoric? Next May, Ms Sturgeon, we shall, rest assured, we shall.

Martin Redfern,

Royal Circus, Edinburgh.