Even if Yousaf quits, NHS will still be dying in darkness

In the ancient world, our ancestors would sometimes look around for a guilty sort to pin responsibility on. If they found nobody suitable for a spot of misery, they’d take a goat and ceremonially transfer all their woes onto the miserable creature. Then they’d either send it off into the wilderness as an exile or slit its throat. Thus, the scapegoat.

We still do it. The 20th century was full of nations and ideologies choosing a group to blame. If you fancy a literary exploration of this dark need in humans to punish someone – anyone – then read Shirley Jackson’s remarkable short story The Lottery, about a village which selects one of its own each year to be stoned to death.

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The tale was so shocking when it was first published in The New Yorker in 1948 that readers cancelled subscriptions in droves. A good clue that Jackson hit a subconscious nerve.

Our society staggers under many ills today – too many to list in a single column – but it’s hard to argue that the collapse of the NHS isn’t the greatest stress facing us right now. In terms of what the state is there for, health sits at the pinnacle along with security and education. If a health system no longer functions, then it’s an indicator that a society no longer functions either.

In all four nations of the UK, the NHS is disintegrating. Here in Scotland, health secretary Humza Yousaf is the lightening rod for discontent. There are understandably – and rightly – calls for his head. As health minister, Yousaf has clearly failed. He’s presided over the ruination of the NHS.

However, while a quick political execution may make many feel good, or at least feel like something has been done and much-deserved punishment meted out, the hard truth is that simply sacrificing Yousaf would achieve precisely zero when it comes to saving the NHS.

There’s a grand irony here. Yousaf definitely deserves the order of the boot. How can anyone who’s ruled over this chaos be allowed to stay in office? What kind of lesson is that to the rest of us? That failure is rewarded, that life is consequence-free if you’re a favourite of the boss, or First Minister?

So Yousaf really should go. But if he goes, we may as well prepare to sack his successor and his successor’s successor. It’s not about the minister, or even the party. It’s about the system. You could select the wisest, most intelligent human on the face of the planet, yet if you handed them control of the Scottish, English, Welsh, or Northern Irish NHS, they’d fail.

Over the holidays there was a flood of horror headlines about the NHS across Britain. But let’s focus on Scotland, because really the problems that beset the NHS don’t differ greatly between the nations. The most startling headline came courtesy of Dr Iain Kennedy, chair of the British Medical Association in Scotland. “There is no way the NHS in Scotland can survive,” he said. “In fact, many of my members are telling me that the NHS in Scotland has already died.”

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On December 30, NHS Grampian put out an alert asking “for all available staff” on leave to come to work, as hospitals struggled with “an extreme level of pressure”.

On the same day, NHS Borders put out a call for staff, NHS Lothian warned it was “stretched beyond capacity”, and NHS Ayrshire & Arran said it was “under extreme pressure” and patients risked being “turned away” from emergency departments unless their condition was urgent. NHS Lanarkshire recorded its worst waiting times. Doctors urged NHS Greater Glasgow to declare a major incident over “grave concerns” for patient safety.

People are dying; they’re coming to harm. Folk are being treated in the open air, outside hospitals, as A&E units are full. Patients are waiting more than 40 hours on trolleys in corridors as there’s no beds. Ambulance waits are terrifying. Trying to get to physically see your GP is becoming an impossibility.

So this can’t go on, and simply dispatching Humza Yousaf won’t sort out the problem. However, it’s clearly untenable for Yousaf to remain in office.

Yet trying to tackle this problem from a solely Scottish political perspective is also pointless. Yousaf and the SNP, for all their many faults, are working within the boundaries and budgets set by the UK government. They’re also dealing with the consequences of Conservative destruction of the NHS over the last 12 years. Anyone who can’t see the connection between Tory austerity and the ruination of the NHS across the UK has either been asleep for years, or is a liar.

So let’s get some facts straight: the NHS is in crisis because the Conservatives battered the nation senseless with lunatic economics; however, the SNP can’t just blame London. The SNP is in power and must bear responsibility. That means, Yousaf should go.

But neither acknowledging Tory culpability nor sacking Yousaf will save the NHS. They’re both simply the only logical and just positions to take in the current moment. To resolve the crisis, we need to sideline politicians. It’s time for a national conversation – or national convention, or even judge-led public inquiry – into the NHS.

Some might say that establishing such a vehicle will take too long, or politicians won’t commit to findings – though they’d pay for that. However, anything is better than what we’ve got.

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We need a national debate about what’s gone wrong; why it went wrong; and who’s to blame. We need to hear from NHS staff who’ll tell us exactly what’s needed to run a health service of the quality we want. We need honesty when it comes to the cost.

Once that’s out in the open, then political parties can set out their stall accordingly and we can vote for whoever we think offers the vision we favour. Right now, the NHS is dying in darkness and lies.