A HERALD reader who recently spent two periods in a Scottish hospital counted five or six different nationalities among the staff who attended to her. On leaving for home she reflected, as many before and since have: where would our NHS be without people from overseas?

Modern Scotland has absorbed huge numbers of migrants from England and much further afield: India, Pakistan, China, Africa, Poland. By and large, they've been accommodated into Scottish society without any of the turbulence, or the provoking of widespread native grievances, that have made immigration such a sensitive subject in certain cities in England.

Research conducted by Migration Policy Scotland and published three months ago suggests that most Scots – 59% of those surveyed – believe that immigration has had a positive impact on Scotland. Forty-eight per cent believe it has had a positive impact on their local area.

Scotland has distinct issues relating to an ageing population and declining fertility, while net migration, the main driver of population increases in recent times, is forecast to ease in the coming years, not least because of the end of free movement from the EU. Several sectors of the Scottish economy are feeling the pinch, with the Scottish Licensed Trade Association reporting that 72% of businesses are struggling to fill vacancies.

Migration is an issue reserved to Westminster, something that Scottish ministers are keen to terminate, arguing that Scotland will benefit from a tailored approach to immigration policy. Westminster has resolutely rejected such requests, an approach echoed by the Scottish Secretary, Alister Jack, on November 29. To attract more workers from abroad, he concluded, the SNP-Green administration needed to lower taxes to make Scotland more attractive to them.

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Mr Jack knows what he is doing when he deflects blame in this way. Consider the reaction of many Conservatives to the news that net migration to Britain in 2022 was at a record high, with 745,000 more people arriving than leaving. The right-wing New Conservative group of MPs fears that the consequences of failing to tackle immigration could be "catastrophic" for their increasingly dysfunctional government. The issue was "really do or die for our party", they said. Douglas Ross's support for the Rwanda bill is a reminder of his lack of seriousness.

The Conservatives have had 13 full years in which to address both legal migration and illegal migration and it is to their lasting shame that they have still not got to grips with the issue. The endless row over the Rwanda policy – its erratic formulation, its rejection by the Supreme Court, and now its hastily drawn-up emergency replacement, to say nothing of backbench unrest and Suella Braverman's squalid grandstanding – is a forceful reminder of immigration's reliably toxic nature so far as the Tories are concerned.

The attendant publicity, moreover, obscures the fact that Scotland is not England when it comes to immigration. Policies designed for the south of England don’t necessarily work for Scotland, particularly when they are cynically designed to shore up the Tory vote in advance of a general election.

A case in point is Home Secretary James Cleverly's announcement that overseas care workers will be barred from bringing family dependants and that the salary threshold for skilled workers will be hiked to £38,700. The SNP leader at Westminster, Stephen Flynn, was right to say there was no rational justification for the new threshold, which is higher than the median gross annual salary for Scottish full-time workers. The public and private sectors, he added, badly need migrant workers.

Scotland has distinct needs that struggle to be met. The ending of free movement has had a disproportionate impact on our rural areas already hit hard by depopulation. As mentioned above, the ageing population and the declining birth rate are challenges that could be met partly by migrant labour. We need workers for our care homes and our hospitality sector, and top technical workers for the life sciences sector.

Scotland could do more to get its army of youthful NEETs ("not in employment, education or training") into work or apprenticeships, and to further encourage people who have dropped out of the workforce to return. But these measures, on their own, will not address the shortage.

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Scotland needs control over migration to Scotland but the Conservatives betray little sign of listening, let alone obliging. A recent Scottish Government paper speaks of a post-independence migration policy, replete with new "Live in Scotland", "Sponsored Worker" and "Scottish Connections" visas. Given the diminishing chances of there actually being a second independence referendum any time soon, and the Tories' hostility towards the idea of Scottish control of migration, it seems a pity that Scotland will continue to be hampered by Westminster indifference and by immigration policies geared towards an English electorate.