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| Scotland faces an NHS crisis – another reason the SNP needs a ‘successful’ Brexit Scotland faces an NHS crisis – another reason the SNP needs a ‘successful’ Brexit | |
| (2 months later) | |
| Audit Scotland has issued a strong warning about the state of the NHS in Scotland. It says the NHS is underfunded, has been unable to reform and faces unprecedented savings targets. Opposition parties have attacked the Scottish government for this, cutting into the SNP’s reputation for competence. Nicola Sturgeon responded at first minister’s questions by defending the SNP’s nine-year record (much of which with her as health minister) and suggesting that the NHS will always be in crisis until some fundamental changes are approved cross-party. | Audit Scotland has issued a strong warning about the state of the NHS in Scotland. It says the NHS is underfunded, has been unable to reform and faces unprecedented savings targets. Opposition parties have attacked the Scottish government for this, cutting into the SNP’s reputation for competence. Nicola Sturgeon responded at first minister’s questions by defending the SNP’s nine-year record (much of which with her as health minister) and suggesting that the NHS will always be in crisis until some fundamental changes are approved cross-party. |
| The row is likely to run on and on because it is about the NHS – no politician ever failed by posing as a defender of it. Sturgeon’s reaction is interesting because it suggests she is rethinking her own strategy on how best to provide care. As the health thinktank the King’s Fund reports, the UK as a whole spends less than many other nations on healthcare. The level is between 8-9% of GDP – it varies from year to year. The King’s Fund expects this to fall by 2020. Given the demand for more money from healthcare professionals, and reports such as that from Audit Scotland, it will not be enough. | The row is likely to run on and on because it is about the NHS – no politician ever failed by posing as a defender of it. Sturgeon’s reaction is interesting because it suggests she is rethinking her own strategy on how best to provide care. As the health thinktank the King’s Fund reports, the UK as a whole spends less than many other nations on healthcare. The level is between 8-9% of GDP – it varies from year to year. The King’s Fund expects this to fall by 2020. Given the demand for more money from healthcare professionals, and reports such as that from Audit Scotland, it will not be enough. |
| The Scottish government copied the UK in 2010 when the Tories promised to protect the NHS budget. This pledge resonates with voters, but is not wholly relevant – the point is the NHS needs lots more money. It is a need driven by demographics – we are living longer, and the last 10 years of our lives may well require intervention from the NHS. Other factors pushing up costs are the price of drugs and the effect of lifestyle decisions like bad diet and heavy drinking. | The Scottish government copied the UK in 2010 when the Tories promised to protect the NHS budget. This pledge resonates with voters, but is not wholly relevant – the point is the NHS needs lots more money. It is a need driven by demographics – we are living longer, and the last 10 years of our lives may well require intervention from the NHS. Other factors pushing up costs are the price of drugs and the effect of lifestyle decisions like bad diet and heavy drinking. |
| The irony in Scotland is that the SNP came to power in 2007 on a promise to reverse proposed NHS reforms. The health minister in the Labour/Liberal Democrat coalition government of 2003-2007, Andy Kerr, argued for the closure of community health units. One of Sturgeon’s first acts on succeeding him was to lift the threat to those hospitals. Hindsight says Kerr was right all along – Scotland cannot afford an unreformed NHS. Sturgeon’s “moment of truth” statement in the Holyrood chamber suggests she now recognises this. As she has changed, so has Labour, which is now accused of blocking reform plans set out by the Scottish government. | The irony in Scotland is that the SNP came to power in 2007 on a promise to reverse proposed NHS reforms. The health minister in the Labour/Liberal Democrat coalition government of 2003-2007, Andy Kerr, argued for the closure of community health units. One of Sturgeon’s first acts on succeeding him was to lift the threat to those hospitals. Hindsight says Kerr was right all along – Scotland cannot afford an unreformed NHS. Sturgeon’s “moment of truth” statement in the Holyrood chamber suggests she now recognises this. As she has changed, so has Labour, which is now accused of blocking reform plans set out by the Scottish government. |
| The issue gets to the heart of devolution. Holyrood’s founding father, Donald Dewar, echoed Irish nationalists when he said that Scotland’s new parliament should find “Scottish solutions for Scottish problems”. In the 17 years since it first sat in 1999, there has been very little in the way of original policy making. Social policy north of the border is dominated by people trying to protect existing institutions and self-interests. | The issue gets to the heart of devolution. Holyrood’s founding father, Donald Dewar, echoed Irish nationalists when he said that Scotland’s new parliament should find “Scottish solutions for Scottish problems”. In the 17 years since it first sat in 1999, there has been very little in the way of original policy making. Social policy north of the border is dominated by people trying to protect existing institutions and self-interests. |
| One of the great conservative forces has been the SNP. It is held back by not wanting to scare people away from independence and also a fear that if devolved powers are used to their maximum, people might think independence isn’t necessary. Traditionally, the SNP does not like to test voters, preferring to go with the popular. | One of the great conservative forces has been the SNP. It is held back by not wanting to scare people away from independence and also a fear that if devolved powers are used to their maximum, people might think independence isn’t necessary. Traditionally, the SNP does not like to test voters, preferring to go with the popular. |
| Sturgeon is from the party’s left and a genuine social reformer – her time as first minister has been spent flirting with more radical policies. The Audit Scotland report may prove the catalyst for real action. She knows that her predecessor left office with little in the way of a legacy apart from a university tuition fee policy which has since been discredited as a tool of social mobility. Sturgeon would not want to be the first minister known for failing the NHS. | Sturgeon is from the party’s left and a genuine social reformer – her time as first minister has been spent flirting with more radical policies. The Audit Scotland report may prove the catalyst for real action. She knows that her predecessor left office with little in the way of a legacy apart from a university tuition fee policy which has since been discredited as a tool of social mobility. Sturgeon would not want to be the first minister known for failing the NHS. |
| As with all things in Scotland, the determining factor is the constitution. Sturgeon says she is genuinely seeking a workable Brexit deal, and during her conference she rowed back from any automatic independence referendum if Scotland is taken out of the single market. The government has put out to consultation a new referendum bill, but that is not the same as wanting another vote. If Scotland gets enhanced devolved powers and a Brexit deal which the SNP can fudge into success, then all of Scottish politics will refocus on social policy, and the NHS in particular. | As with all things in Scotland, the determining factor is the constitution. Sturgeon says she is genuinely seeking a workable Brexit deal, and during her conference she rowed back from any automatic independence referendum if Scotland is taken out of the single market. The government has put out to consultation a new referendum bill, but that is not the same as wanting another vote. If Scotland gets enhanced devolved powers and a Brexit deal which the SNP can fudge into success, then all of Scottish politics will refocus on social policy, and the NHS in particular. |
| On the other hand, if Brexit rumbles on in the comedy manner it has adopted to date, and Scotland is seen to be irrelevant to London, then Sturgeon will be forced into seriously considering another vote. If that were to happen, she will not want to tell Scots that they either have to accept a diminished NHS, or pay higher taxes. | On the other hand, if Brexit rumbles on in the comedy manner it has adopted to date, and Scotland is seen to be irrelevant to London, then Sturgeon will be forced into seriously considering another vote. If that were to happen, she will not want to tell Scots that they either have to accept a diminished NHS, or pay higher taxes. |