We must change working practices if we are ease NHS crisis

Every winter we see the NHS in crisis, yet winter is no surprise, nor seasonal illnesses and complications, nor are demand spikes over public holidays. Every winter we see extra beds in wards, corridors, treatment rooms and a sclerotic treatment regime. Why is this so?

The answer is simple. If increased staffing and increased effective working time is provided, then these peaks would not be as dangerous to those unfortunate patients subjected to the constraints of existing treatment and care arrangements. It is logical that if this extension of staffing and working time is not provided even small increases in demand can lead to a geometrically progressive decline in performance levels.

What is critical is the rate of treatment, which is dependent upon staffing levels and availability of facilities. If no change is made then the more "emergencies" occur and fewer planned procedures take place. Since planned procedures are a more efficient method of treatment the whole system loses efficiency, meaning that patient wait times increase and necessarily more emergencies emerge due to increased wait times, a downward spiral of despair for patients and staff.

It follows that the capacity and working hours of the whole health system must be increased, or working practices that make more efficient use of the current facilities and staffing levels must occur if positive outcomes are to be achieved. Improvements to both would be the icing on the cake.

The Scottish Government has presided over this car crash of a service.

There is no scintilla of hope from the current array of "exhausted volcanoes" (thank you Disraeli) that fill the padded government seats at Holyrood who have presided over this wreckage for so many years of any change to "business as usual".

Gavin Findlay, Boghead.

Read more: Assisted dying: let's hope MSPs agree with the voters

Beware example of Oregon

UNLIKE Gordon Caskie (Letters, January 16), I am glad that MSP Sue Webber has changed her position on assisted dying. Mr Caskie suggests that there has been no "legislative drift" in Oregon. I would beg to differ because there has been some. For example, cancer was the main qualifying diagnosis, although this fell from an average of 80% in the first five years of the legislation to 64% by 2022. But since 2010, various other diagnoses have qualified, including non-terminal illness such as arthritis, complications from a fall, hernia, and anorexia nervosa.

I would also like to ask where the figure of 70% to 80% of Scottish people supporting the proposed bill comes from? Have I missed a referendum? I believe his statistics come from the report on the consultation document on assisted dying, which was a small sample.

I have great sympathy for people who are terminally ill and suffering, but as a country we should be looking and spending money on palliative and end of life care (both of which are seriously underfunded) rather than enacting a law which, despite the good intentions of Liam McArthur, will be challenged under equality laws as soon as it is enacted. Once we start making exceptions to the present laws, based on arbitrary criteria and emotional language such as terminal illness, the new law will become just a line in the sand, easily crossed and hard to defend. We only have to look as what has happened in Canada, Holland and other jurisdictions to see that the line has easily been crossed.

John Brown, Clydebank.

• GORDON Caskie is right to suggest that our MSPs should reflect the changing public opinion as regards the Assisted Dying for Terminally Ill Adults (Scotland) Bill, currently around 70-80% in favour. Sue Webber’s concern about the inability of Holyrood to scrutinise it is must be seen as an indictment of her fellow MSPs but surely not a valid reason not to vote in favour of the bill.

I think most of the public know that it is unlikely that there will be substantial additional funding for hospices, as suggested by her, given the current state of the health service and perhaps more importantly, it also ignores the principle of choice.

Jacquie Macintyre, Greenock.

A strange disparity

REGARDING Kevin McKenna’s article mentioning parents being first educators ("No wonder parents fear this ban", The Herald, January 16), it struck me what a strange world we inhabit.

If a child at school wishes to identify as a different gender, the school is not obliged to inform the parents, but if the child wishes to change or drop a subject, the parents must be informed.

Gender transitioning is therefore surely not considered important enough by the educators to inform parents about. So if it is not important, why is that ideology being promoted in our schools?

Irene Munro, Conon Bridge.

Read more: We would have fared better during Covid if UK had been in full control

Flunking the dunking

I HESITATE to take issue with such an authority as Dr Helen Pilcher, just appointed as McVitie’s first CDO (Chief Dunking Officer), but I am concerned at the photo in The Herald today showing her about to dunk what appears clearly to be a half-coated version of her employer’s famous digestive biscuit ("Dunking doctor", January 17).

I take my tea warm to hot, and while I am not averse to dunking a McVitie’s original digestive biscuit into it, experience has taught me not to dunk the half-coated version in view of the likely resultant mess as the chocolate melts.

Perhaps the good doctor shares my concern, as I note she has decided to use tongs to hold her biscuit. Whilst this will protect her against sticky fingers, from the look of them, the tongs must make it a bit awkward when she comes to trying to eat what’s left of her biscuit.

Alan Fitzpatrick, Dunlop.

Helen Pilcher, the dunking doctor (Image: PA)

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Cold case investigation

ANOTHER day, another freezing train journey with no heating: can the combined knowledge of Herald readers please explain why something seemingly so simple as heating a train is beyond ScotRail?

Stuart Neville, Clydebank.