Since the introduction of the original 24-month waiting time limit in the 1990s to the current 12-week waiting time guarantee the NHS has used a combination of private sector providers, charities and the expansion of directly provided NHS.
However, the philosophy behind the use of the private sector is now different across all four parts of the UK.
Over the seven-year period highlighted in last week’s letters page may have been £0.485 billion it only represents 0.6 per cent of the total NHS budget in Scotland in that period of just under £78 billion.
Locally NHS Grampian spent £6.3 million in 2012-13 and is now reacting to this by spending £16 million in expanding theatre capacity in Aberdeen.
In England shadow health secretary Andy Burnham, who among his last acts as health secretary privatised the Hinchingbrooke Hospital, recently highlighted that private sector spending has gone through the £10 billion barrier.
The Department of Health confirmed that when Labour left office spending in England on the private sector annually was 1.6 per cent of the annual budget but now under the Liberal Democrat/Conservative coalition government this now stands at six per cent.
In contrast in Scotland the previous privatisation under the stewardship of Liberal Democrat/Labour coalition government of regional treatment centre at Stracathro Hospital run by Netcare UK was brought back in to full NHS control.