I was sweating, in pain, had a fever and was passing in and out of consiousness. My parents sat up all night with me and they were certainly very worried.

The discussed whether they should call the doctor. I thoght they should, but they did not do so. I do not know why.

To-day anyone would say that you were a bad parent if you did not call for help for a child in these circumstances.

There are many reasons why they may not have wished to call the doctor at night.

Had they paid the last bill?
Could they not afford to pay the next bill?
Had the doctor not rendered a bill for the last treatment because he thought my parents could not afford to pay it?
Was the doctor single handed?
Was he himself ill, or very old?
Couldn’t they be bothered going out to the public telephone?

I have seen good hospitals and bad ones, in the UK and other countries. I have been part of the management team that in 1974 was responsible for what was then officially recognised as the worst hospital in Scotland.

Last month my wife was taken in as an emergency in the middle of the night to the hospital staffed by the successors in the same GP practice that was not called to see me when I was a child.

I tried to think of any aspect of her treatment or the service provided by ambulance or hospital that was less than perfect and capable of being improved.

There was only one. The wooden front door of the hospital has seen some service. Often not fully opened because of the wind, it has been knocked about possibly for as much as a century by people passing through with walking aids, wheelchairs and stretchers. It could be replaced by one designed for a higher performance level.

Should I complain to my MSP? The last time I emailed him with a comment about the NHS he FWD’d it to the minister and other colleagues.

@NeilA – I guess your experience if the NHS must be limited. The issue at hand is that many managers are termed as such yet hold a clinical responsibility and are accountable for the effective dleivery of care. Thus its not a reasonable assumption that all managers have no patient impact as appears to be your assertion.

Lets be honest here, no private sector solution is suitable for the NHS, good bargaining power and efficient use of resources are what we must achieve. However RBS and Lloyds TSB are private and see what they’ve done for us. Thus capitalists keep out of the NHS as you will rue the day you let your chummies interfere and all you will be left with is a system for those who can pay – and lets be honest very few of us (you) would agree to paying for your mothers ten week hospital stay after a stoke…..

Pete B says that GPs, as small businessmen, are predominately sympathetic to the Conservatives. I do not doubt it, though I have met many exceptions.

Superficially, one of these observations must be inconsistent with an observed fact.

The last (UK) BMA conference was in Edinburgh and addressed by Nicola Sturgeon, the SNP’s Health Secretary and Deputy Leader. She got several standing ovations (four I think).

Now there were probably more than usual proportion of Scottish members present, and the BMA is much more than GP’s, but I think that this shows that it is unhelpul to assume that any political credo is driving these common sense changes.

Rather it demonstrates that you can get to be Scottish Politcian of the Year, and hugely popular, just by undoing impractical daft ideas which have originated in political philosophies in ignorance of practical issues in the real world.

You don’t need to do anything clever, such is the competition.

This might seem a pedantic point, but it does mean that is almost certainly false to say, for example, that Pulse surveyed 326 GPs on their voting intentions.

From political betting, a poster saying “S[ystem]3 for the Herald tomorrow has the Nats with a big lead for Holyrood 40-32 constituency and 37-29 list but Lab with a big lead for Westminster 39-25.”

Any more info?

That would be a mistaken analysis. She’s only chipping away at the margins of the things that don’t work. Not doing things, rather than doing them.

The NHS is, and can only ever be, a near monopoly, and it also has no choice but to provide a service to whatever kind of patient needs treatment.

A management philosophy of Left or Right is less relevant than the fact that these constraints are inescapable.

Pragmatism is the SNP’s USP because they cannot afford to lose pro-indpendance voters whether from the left or right.

They have now brought wholly into the NHS an privatised facility whch had no other customer. The Health Secretary said that they would save the profit element, but that’s only the half of it. There are many costs that will be saved also.

The response from the CBI was a predictable recitation of the free market Credo. It was of no practical relevance simply because there is no market.

Fundamentalists, religious, political or some other thing are the source of nearly all the worlds problems.

Any benefits of competition from the internal market in the NHS are debatable, possibly intangible and ephemeral. The cost in so-called “managers” and computer systems is clear and real. External economies of scale can be bought into by real managers without government direction or any political rationale.

The NHS which we have does not have the costs that insurance based systems do. Every paperclip and office building the insurance companies have is paid for by someone. So too is the fraud by doctors, patients and insurance companies.

The Scottish NHS, because of the success of the response to the 19thC Cholera epidemics, still has significantly higher funding than in England. The level of funding is comparable to Continental countries who have the additional costs of insurance systems.

The morbidity justification that is used to defend the difference is irrational, and not the reason it is there. Nobody can calculate the extra cost of serving sparse populations.

The Scottish NHS has enough money to provide an excellent service and can be better managed to produce savings. The focus should not be a hate campaigh against “Managers” but freeing them and motivating them to cut out useless processes while staff are reduced by natural wastage according to progress and not pre-selected targets

What will the incoming government do to remove this excess subsidy? Change the funding formula?

(Here’s a clue: there is an SNP government in charge of the Scottish NHS. Their main objective is to persuade Scots that independence is a good thing.)

For 17 years I ran the finance department of a small Health Board serving a declining population initially of 30.000. There were five hospitals, GP’s Dentists etc.

We also dealt with some staff records and data.

A couple of years after I had left, I was told that I had been replaced by “half a dozen” people.

I still don’t know if that was literally true.

Pete B

I’m not saying that Labour hasn’t made things a lot worse. I’m not a Labour supporter – I’m an alienated Conservative!