THERE is a lot of logic and common sense in the former health secretary Alex Neil’s analysis of the NHS. According to the MSP’s discussion paper for the Options for Scotland think-tank, the whole system across the UK is under severe stress and efficiency savings alone will not be enough to put it right. He also says the organisation of health and social care has to be radically streamlined as a matter of urgency.

But what should we make of Mr Neil’s more radical suggestion that the NHS needs a new ring-fenced health tax? Mr Neil says the tax – made up of rises in a range of taxes including national insurance and corporation tax – could raise up to £900million for the NHS in Scotland and £10bn for the UK as a whole and that earmarking the cash specifically for health and social care would allow taxpayers to see clearly what they are getting for their money.

It is certainly an interesting idea and we all know why Mr Neil has proposed it: demand on the NHS is outstripping the resources available to it. More specifically, the number of people treated in hospital is increasing rapidly because of our ageing population at the same time as the number of beds has dropped. It cannot go on for much longer.

In response, the NHS is doing what it can to bridge the gap – by reducing the time patients stay in hospital for example and exploring ever more sophisticated treatments. The Scottish Government is also quite rightly trying to shift spending away from hospitals into the community, although even this is not the complete answer as the new rationing system being developed for the new care boards demonstrates.

But eventually the debate about the future of the service comes back to the question Mr Neil has raised in his paper, which is how we pay for the NHS and inevitably - combined with an effort to ensure the money is properly spent - that will mean raising taxes to pay for extra investment. The need for a separate, ring-fenced NHS tax is yet to be proven, but what is clear is that we need to start talking about the reality facing our health service: it needs more money.