Sandesh Gulhane dreamt of being a doctor since he was three years old.

But the Glasgow-based GP and shadow health secretary for the Scottish Conservatives now despairs over the “brutal” conditions facing the country’s NHS that has left patients frustrated and fearful over delayed operations and long waiting lists. He says he often encounters colleagues in tears.

“Receptionists are abused 15 to 20 times a day by frustrated patients and they want to leave,” he said. “Patients feel they have nothing to do but rant.” Gulhane said a patient he suspected of having a heart attack in December, when pressures on the health service were nearing their winter peak, stayed home overnight rather than wait at a hospital emergency unit. “I had to send her into hospital [the next day] because she still had chest pains,” he added.

Gulhane, whose Conservative party is in power in England where the health service is similarly in crisis, blames “negligence and mismanagement” by the governing Scottish National party for the problems north of the border. He often spars with his SNP counterpart, health cabinet secretary Humza Yousaf, a regular target of attacks by political opponents who have called on him to resign or be fired.

Health policy is devolved to Holyrood and opponents of the first minister, Nicola Sturgeon, have identified it as a key battleground to build an argument that her pro-independence SNP has failed governing Scotland after 15 years in office.

They hope that highlighting the problems facing the NHS and other issues, such as the SNP’s failure to deliver on a pledge to close the attainment gap in education between the richest and poorest Scots, will blunt the appeal of the party’s independence message to voters.

“Even those who are sympathetic to Sturgeon are beginning to voice more concerns about the way the SNP is governing,” said Adam Tomkins, professor of public law at Glasgow university and a former Tory member of the Scottish parliament. “People are beginning to wake up to the fact that there’s more to life than independence.”

Sturgeon plans to use the next UK election, which must be held by January 2025, as a “de facto” referendum on independence after the Supreme Court in London ruled late last year that she did not have the authority to hold a plebiscite. The SNP hopes winning at least 50 per cent of Scottish votes will force the UK government to negotiate. Political analysts point out that to get that level of support, the party needs to win over moderate voters, who are more likely to be critical of its record.

Yousaf told the FT that the SNP, which has been in government in Scotland since 2007, had “made good progress” in dealing with long-term health issues and partly blamed worsening waiting times in the run-up to Christmas on backlogs caused by the pandemic.

Yousaf said the NHS in other parts of the UK faced similar problems and, in contrast to England, the SNP had avoided the damaging strikes that are further blighting the health service south of the border.

The government in Edinburgh agreed a 7.5 per cent pay deal in December with unions representing the majority of NHS workers. This settlement was also imposed on other unions that did not sign up to the deal, including the Royal College of Nursing, whose members rejected it. Nevertheless, the nurses union has agreed to delay strike action while talks continue.

“You can look at the most recent strike action across the UK, you can look at the pay offer that we’ve put forward,” Yousaf said. “You can look at the vaccination programme for both flu and Covid . . . The A&E performance isn’t where I want it to be but continues to outperform the rest of the UK.”

Differences in methodology means it is not possible to directly compare NHS performance levels across the UK, although they were broadly similar, said Syed Ahmar Shah, chancellor’s fellow at the Usher Institute at the Edinburgh Medical School. “Overall, you can’t really say Scotland has done better than England, or vice versa,” he said.

But other longer term health trends show that Scotland is lagging behind England and other European peers, with the country having “one of the lowest life expectancies in western Europe,” according to a report by the Scottish Public Health Observatory.

Mortality rates were twice as high in most deprived areas compared to the wealthiest, National Records of Scotland  data showed, while the Health Foundation said life expectancy in Scotland had fallen by 4.4 years since 2013.

So far, negative perceptions of the SNP’s record in government have shown little sign of hurting the party at the polls.

An Ipsos survey last week found that only 22 per cent of Scots believed the party had done a good job of improving the NHS since the last Holyrood election. In contrast, 51 per cent of respondents to an Ipsos survey in December said they would vote for the SNP at a UK general election, six points higher than the vote the party achieved in 2019.

“When it comes to factors that shape voting intention, SNP supporters’ views on independence are taking priority,” said Emily Gray, Scotland managing director at Ipsos. “Almost one in five SNP supporters do not trust the party to deal effectively with managing the NHS in Scotland, but they nonetheless continue to say they would vote for the party.”

Yousaf said the polls consistently showed that Scottish voters retained confidence in the SNP’s management of the health service.

“If there was an election tomorrow, we would be back in power in Holyrood and make significant gains in Westminster,” he said. “That tells me when the NHS is such a significant priority for people, they still trust us with the stewardship of it.”

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