Dear Editor,

I read with interest the comments by Dr Lewis Morrison on the current state of services within the Scottish NHS. He has stated correctly, that services are stretched just now due to financial constraints. His solution to this problem appears to be ‘centralisation’ or reduction of facilities to a few key locations and accuses the SNP of being dishonest in its aspirations to keep service local.


There are two elements that need to be separated here. Is the drive towards centralisation because the present configuration of services is not suitable for patients’ needs or is it because financial pressures, especially PFI debt, are making it necessary? If the answer is the latter, then I would argue that the SNP are correct in insisting on maintaining local services and forcing the issue on the servicing of debt.


Over the past few years, local councils and health boards  across Britain have borrowed a total of £11 billion to build new schools and hospitals. In return £66 billion has to be paid back to private consortia. This is barely being discussed. In my own area (Lanarkshire) we have shut nursing homes, day hospitals, continuing care beds and mental health facilities to feed this monster.


There are various ways that this problem could be tackled. The Treasury negotiated a voluntary code with consortia that they should pay back 30% of the profit on the refinancing of PFI loans. This has been more honoured in the breach than the observance, but now that Westminster owns 70% of the  Royal Bank of Scotland and is in effect lender, shareholder and payer in these deals, there is no reason why it cannot enforce this code.  Lowering or abolishing the capital charge (a tax on NHS buildings and property  of  approximately 4% per annum) could also help. But throwing our services down the black hole of this debt is not an option. If we do that, we will still have the debt and we will have no health service. We cannot allow private consortia to hold the NHS and the future of our country to ransom.