Balancing the costs

Professor Sir John Arbuthnott, chairman of NHS Greater Glasgow and Clyde, said the health service had to convince people it was spending money wisely.

Sir John, who designed the current funding formula for the service, said the debate should be "pretty bold".

His comments on BBC Scotland's Politics Show came ahead of the 60th anniversary of the NHS, which comes next year.

Sir John said the "substantial" health funding in Scotland since devolution - more than �65bn by the end of the financial year - had been well spent, adding that waiting times had dropped dramatically.

But he agreed it was now time for a national debate on the direction of the health service - including the role played by volunteers.

We actually can't deliver our service in NHS Greater Glasgow, or anywhere else, without fantastic cooperation from parents and patients and family and their carers and from the volunteers Professor Sir John Arbuthnott

"I think we should be pretty bold," he said.

"The service has got to convince people it is spending money wisely."

Spending watchdog Audit Scotland had been, Sir John said, correctly "chivvying" the sector from time-to-time.

"People pay tax and it is the fundamental basis of the NHS that the delivery of that service through taxation should be free at the point of delivery," he went on to say.

"That is an over-simplification, because we actually can't deliver our service in NHS Greater Glasgow, or anywhere else, without fantastic cooperation from parents and patients and family and their carers and from the volunteers.

"In Glasgow, we've got thousands of people who dedicate their time every week to doing that.

"Whether that ever gets to the stage of the total burden being realigned to some extent should be up for discussion in that debate."

Sir John also said that health bosses needed to take stock of the number of new drug treatments becoming available, some of which can be expensive.