Later this week Labour will hold a debate in the Holyrood chamber on health. 

In a press release ahead of the debate the quote given is from Public Services spokesperson, Jackie Baillie. She says that “It’s time we moved away from short term crisis management in our NHS to managing for the long term, building a health service fit for the challenges of the 2040s, not the 1940s.

She’s absolutely right that we need to move away from short term crisis management. But to do so we need to be realistic about what the NHS can do in meeting the challenges of, as Jackie puts it, the 2040s. 

But the fact is the NHS is required to do so much more today than was envisaged for it in the 1940s. So the question that springs to our mind is: are we having the right debate about the future of the NHS? 

Jackie also says that “now more than ever we need a health service free at the point of use based on clinical need, not the ability to pay.” 

This isn’t up for debate though. No one in Scottish politics is advocating for the private sector to play a role in healthcare in Scotland. This is despite health care spend in Scotland being over £12bn now or, put another way, over one third of the budget. For a little context, education spend is £3bn annually. 

So Wednesday’s debate will go ahead and Labour will criticise the SNPs record on the NHS during their eight years in power. Some of that criticism will be fair, some will be hyperbole. The SNP will defend their record. Some of that will be justified, some of that will be creative use of the the facts. 

But what we’ll not hear about is what the future challenges we face are, how much they’ll cost and whether it’s sustainable to keep funding them solely from the public purse. 

From a delivery point of view healthcare is all about outputs. And, when you look at it from that perspective, perhaps it’s time to start challenging our view that the state is the only provider of healthcare.