The destruction of Scotland's NHS will spell defeat for the SNP

And the moral of the story is: be thankful for what you have, nurture it and don’t let greed and stupidity be your undoing.

We can only hope that Nicola Sturgeon, Humza Yousaf and John Swinney have at least a passing knowledge of Aesop’s fables. For right now, they appear to be a family of rather stupid farmers about to kill our society’s equivalent of the golden goose: the National Health Service.

Yesterday it emerged that NHS leaders in Scotland are discussing a complete abandonment of the founding principles of the health service. That’s how bad matters have gotten under the custodianship of the SNP Government.

In September, NHS Scotland health board chief executives discussed the creation of a “two-tier” system, with the wealthy paying for treatment. They also mulled over the end of some free prescriptions, sending patients home more quickly from hospital – which clearly involves higher risk – and pausing funding for some new drugs.

The meeting included an update from NHS Scotland chief executive Caroline Lamb. Executives were given a “green light to present what boards feel reform may look like”, and told “areas which were previously not viable options are now possibilities”.

A “billion-pound hole” exists in the budget. It’s “not possible to continue to run the range of programmes” on offer while “doing no harm”. Executives warned: “Unscheduled care is going to fall over in the near term before planned care falls over.” The Scottish Government is “divorced from [the] reality of life and purpose of service”, and there’s “disconnect from the pressure that the boards are feeling and the message from SG [Scottish Government] that everything is still a priority and to be done within budget”.

“Fundamental reform”, we’re told, “must be on the table”. The current model “no longer works”.

Nobody needs a rehearsal of the state of the NHS today – of waiting lists, ambulance times, A&E performance, GP and consultant appointments. People are dying unnecessarily because our health service is collapsing: that’s the real measure of our Government’s deadly failure.

Over recent months, I’ve spoken to a series of well-known doctors about the state of the NHS, and they were all clear that its collapse is the responsibility of politicians – and voters who elect them. There’s no real difference in the disastrous political mismanagement north or south of the Border. Regarding the NHS, the SNP is pretty much just as bad as the Tories – to say otherwise is sheer partisan nonsense, which simply puts the interests of a political party ahead of public health.

Arguably, though, Scotland is in a worse state than England, because the Tories don’t have the shield that the SNP does to protect them from much-needed criticism. First, the SNP endlessly abnegates responsibility by blaming everything on London. It’s true that London is the ultimate holder of the purse strings, but power means responsibility and the SNP has been in government for nearly a generation. If the SNP can’t take responsibility for the NHS what the hell is the point of it being in power?

Secondly, the SNP’s base – the hardline nationalist contingent – would quite literally let the party away with murder. The belief is that any wound to the SNP is a wound to independence, and therefore no criticism of the Sturgeon administration can be broached.

If the NHS is a benchmark, then the SNP is unfit for government. It’s becoming hard not to see the SNP as, in essence, an umbrella campaign group that simply wants independence, rather than a party dedicated to making the powers it has work as best they can.

So, tomorrow expect the SNP to talk endlessly of the Supreme Court’s decision on another referendum, not the NHS. A decent, caring administration would put constitutional obsessions aside, and get on with the business of government, given the heads of Scotland’s NHS are all but digging the health service’s grave.

This state of collapse isn’t consigned solely to the Scottish NHS, however. Education, policing and prisons – the key domestic pillars of state – are all creaking. What really works in Scotland anymore? What really works in Britain? We’ve two governments that have spent years obsessing over the constitution – be it Brexit or independence – at the expense of good governance.

The SNP and its cult-like base can argue until the cows come home that the state of hospitals, schools and policing is all the fault of wicked Tories – and there may be some truth in that – but the greater truth is that the SNP bears the biggest weight of responsibility. To deflect all blame is sheer transparent cowardice.

Most Scots aren’t partisan idiots who’d see the NHS ruined for the sake of a pitiful political party. Most Scots, like most Britons, cherish the NHS. So the SNP skates on thin ice. No party is indispensable. All governments eventually fall.

If the SNP had any sense – and often it’s hard to believe it does – it would open up an honest national conversation. It would be straight with us; and the straight truth is this: it’s either more tax, especially for the rich, or the end of the NHS. There’s no other choice. But the SNP fears using tax powers as it needs the middle-class onside for independence. Thousands, though, already go private if they can, leaving the poor to sink in an increasingly Darwinian world. This isn’t what a "progressive" party does.

So, the NHS could spell the end of the SNP. Perhaps we’ll see a reverse of the Golden Goose story: rather than the farmer killing the goose, it’ll be the goose who kills the farmer.

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Read more by Neil Mackay:

• The Scottish NHS is collapsing ... but are doctors right in blaming the SNP?
• Voters are to blame for crisis in NHS
• Brutal Tory budget is great for the SNP but grim for independence