Several examples this month of NHS Scotland staff expressing their concerns over the pressures being placed on the service.
In the annual staff survey two-thirds of NHS staff in Scotland say they can't do their job properly because of staffing shortages. Just a quarter of nurses and less than a fifth of ambulance personnel felt there were sufficient staff to allow them to work well. Even senior managers believe the service is too stretched, with just 38% saying there are enough staff.
Of particular concern, the survey revealed 43% of NHS employees do not feel it is safe for them to speak up if they are concerned about quality or safety issues. 15% indicated they had been bullied or harassed by colleagues in the previous year.
These concerns are reinforced in three UNISON Scotland surveys.
Health and care staff involved in care integration said that while they support care integration, its delivery was being compromised by budget cuts. 68% believe it would get worse, not better next year.
In a separate survey Occupational Therapists had a similar message. An overwhelming majority (82%) reported increased workloads, 60% reported having to cope with reduced members of staff and almost half (48%) reported funding cuts.
Finally, hospital porters reported they are also under pressure and their workloads are going up while the value of their wages are going down. The report also concludes that their training is patchy and there are reports of lack of equipment to allow them to do their job properly.
The NHS budget may have had a degree of ring fencing from budget cuts, but that doesn't mean that the service isn't under real financial pressure. These voices from NHS Scotland staff make that very clear.