Like it or not, the NHS really has to take private cash

IF you stay in a hotel or a B&B in the Borders, the chances are that the sheets you will be sleeping on will have been washed, dried and pressed at the local hospital. It is one of the delightful quirks of this area that the Borders General Hospital runs the most efficient and most professional laundry service in the whole of the South of Scotland.

It has been washing and pressing linen for private customers for almost three decades. Last year, it made between £300,000 and £350,000 for the health board, enough to employ a couple of doctors and a ward full of nurses.

The hospital has an industrialsize laundry. It was already washing sheets, uniforms and bedding by the barrowload, so why not use its spare capacity to generate a little money?

It seemed a win-win situation for everybody. The health board got a bit more money, the laundry started operating at capacity and the local hotels got expertly cleaned and pressed bed linen.

But this little arrangement at one small hospital near Melrose is more than just a local oddity. It actually goes to the heart of the argument we should be having about the health service – yet it is an argument no one at Holyrood is brave enough to start.

Last week, Audit Scotland produced a report that sparked much moaning and gnashing of teeth at Holyrood.

It said health boards were struggling to cope and didn’t have enough money to meet the demands of patients and all those government targets they had to hit, such as cancer treatment lists and casualty waiting times.

The report also pointed out what we all already knew: we are living longer, but end up suffering from multiple conditions that need more complex treatments. We need more expensive medicines to get better and more advanced treatments to stay alive.

The health boards know this, the Government knows this, even the public at large knows this – one only needs to turn up at or try to book a GP appointment to realise how clogged the system is.

Not only that, it is going to get worse and worse as we live even longer and more expensive treatments are found for our ever more complicated medical lives.

Put bluntly, the NHS is a bottomless pit. The Scottish Government could throw all the money it has into that pit and it will never provide everything we want the NHS to provide.

As a result, choices have to be made. We have to decide what we want the health service to do and, crucially, how we are going to pay for it. We can muddle along as we have been doing, increasing the NHS budget bit by bit, demanding savings from the health boards and expecting them to scratch their way through, year to year.

That seems to be the approach all our politicians want to take, scared of really confronting the root of the problem. There is no doubt we can keep going down this road but, if we do, things are going to get worse and more fraught year on year.

Or we could actually have a proper, grown-up discussion about how we fund the health service.

That is where the Borders General Hospital comes in. Here is a hospital using a state-funded laundry service to make money from the private sector. It is using an NHS resource to generate extra cash, which is then ploughed back into patient care.

WHAT is the difference between using Borders General Hospital’s laundry to generate private funds and using spare capacity in a ward to do the same?

Why not start talking about treating private patients in NHS wards? If someone wants an ingrown toenail removed and is willing to pay for it to be done now, why not take their money and get an NHS surgeon to do it?

As long as this does not impede the care or treatment of any NHS patient, what is the problem?

Our NHS is rightly seen as a

THERE was some amusement at Holyrood last week when it emerged that Mike Russell, Scotland’s Brexit Minister, had been phoning a special ‘hotline’ to UK Brexit Minister David Davis for 36 hours, without success. As one Labour MSP put it: ‘If I had a phone on my desk and I knew it was Mike Russell on the other end, I’d probably hide it in a drawer too.’

sacred institution, bequeathed to us by our forebears. But that does not mean it should be encased, untouched, in aspic.

The NHS is supposed to be all about being ‘free at the point of delivery to all those who need it’. But as queues lengthen and resources dry up, that is not as easy to achieve as it once was.

Ask someone who has been told to wait seven months for a first appointment. Then ask if they would be willing to get a quicker appointment if they had to share the NHS with private patients. They would probably not care how the appointment came about; all that matters is the treatment.

I am not suggesting the privatisation of the health service or anything like it. But we have to start looking at other solutions, rather than simply sticking our heads in the sand and saying the NHS is unchangeable and untouchable.

We are not being honest with patients or health service staff if we are too scared even to go near this subject.

More than that, we are not being honest with ourselves – if not the patients of today, then certainly the patients of tomorrow.