A blog from Chris Bartter, trade union writer and communications expert in Scotland,
This blog is a small contribution in opposition to the right-wing consensus in the media, and will. hopefully, campaign for working people and public services.
Any comments on this blog to firstname.lastname@example.org please.
Sunday, 14 September 2014
Our NHS. Why the Yes campaign must destroy a UK-wide service
With the polls coming together as the referendum approaches, it
would seem a good time to analyse the importance to that debate of the
controversial claims around our NHS
This is a difficult issue for the Yes campaign. Firstly the NHS
is that rare thing, a UK-wide institution that is both respected by experts and
valued and supported by people across the UK; obviously the complete antithesis
of what Yes campaigners want to see. Secondly, it is funded as part of a system
(Barnett) that makes at least some attempt to recognise differing demands of
different parts of the UK and fund them accordingly. Again an example of an
UK-wide positive process that would be killed stone dead by a Yes vote.
In short and in principle, the NHS is a good example of what
Better Together should be trumpeting. Sharing UK resources so that anyone in
any part of the UK can receive treatment free at the point of delivery,
wherever they need to receive it. Why BT hasn’t done so enough, we'll deal with in a
Are the threats real?
The Yes campaign have to deal with the inevitable break up of our
NHS that their aims predicate. To invent a back story for this split, a) they
have tried to create an image of an irreparably damaged NHS South of the
border, and b) argue that the only way out is to pull up the ladder, and
abandon the rUK NHS. To do so they risk the claim that they will cut the
'hassle free access to specialist clinical facilities in England, Wales and
Northern Ireland' that doctors put so much importance on, and abandon the
collective creation, involvement and resourcing of our UK NHS.
So, if a successful UK-wide institution delivering services to us
all is so clearly a problem it has to be denigrated. And not just for failings
in England, but if possible how those failings will eventually reach across the
Eleanor Bradford of the BBC
So the targets picked on by the Yes campaign were Barnett and how
it is threatened by English privatisation, and - when it quickly became clear via
that privatisation itself threatens Barnett in no way - the overall impact of
lowering levels of service in England and the knock-on damage to Scotland's
What did SNP MPs think?
However, Yes have another problem with the 'impact of NHS
privatisation on Scotland' argument. As is well known, SNP MPs do not (as a
matter of principle) vote on legislation that has no impact in Scotland. But
obviously, the Health and Social Care Act 2012 (the main coalition legislation
opening health care up to private commissioning) DOES impact, doesn't it?
Everyone from Dr Philippa
Whitford to Alex Salmond has
Dr Phillippa Whitford
told us so. However you'll look hard to find
the SNP MPs voting against that bill (neither in the second nor the third
reading!). Surely they couldn't have been under the impression its impact on
Scotland would be non-existent (twice)? Hopefully, if a Labour government
committed to repealing that law - as both Burnham and Miliband have committed
to do - is returned in 2015, they won't make the same mistake again.
However, no matter what SNP MPs might think, the Yes campaign’s
point about the privatisation of England's NHS does have an impact on Scotland
and Scottish patients. Currently - although the NHS is run differently either
side if the border - all UK patients are entitled to get the most appropriate
care for their condition in the most appropriate venue. In some cases that
means English specialist hospitals. That has been made clear by Sir Leonard
Fenwick, the chief executive of the North East NHS foundation when he replied
to Dr Whitford's bogus claims about cancer surgery in his area. A number of us
also remember the emergency airlifts of Scottish patients suffering from swine
flu, to a hospital in Leicester. The prospect of these areas of specialism down
in England suffering because of the introduction of profit-driven,
resource-undermining privatisation is very much something that we in Scotland should
be concerned with. And we should be campaigning with our fellow NHS supporters
across the UK to ensure that privatisation is stopped in its tracks and the
Health and Social Care Act is repealed.
It is disappointing that Better Together seem to have been a) hypnotised
by the 'Barnett myth' and b) hamstrung by the presence of parties representing
the architects of this privatisation, and failed to highlight the REAL dangers
to Scotland’s patients, but at least the Labour opposition at
Westminster has made a clear commitment to repeal the odious Act.
Campaigning for the NHS across the UK
External support, or joint
We could still campaign in support of the English NHS in an
Independent Scotland, of course, although we would a) then be offering
solidarity to campaigners in a different country with a different healthcare
system, and b) no longer have a right and a stake in a UK-wide NHS. Not
impossible then, just unnecessarily more difficult.
And this leads to another objection that the Yes campaign has to
challenge. The right of us all as patients to use the NHS across the UK would
cease. Now, it is possible, even probable, that arrangements would be
negotiated to allow continued access, but they would have to be created via
some financial bargain, as Scottish and rUK populations would no longer be
contributing to one cross border system.
Plus, of course, the real cast iron danger to any redistributive
effect (however small) that exists in the Barnett formula doesn't come from
English privatisation, or even from 'revenge plots' by Westminster politicians,
but from a Yes vote! Separation of the nation, means separation of national
healthcare systems, and separation of the tax and spend arrangements that fund
them. So – no Barnett, no redistribution from a bigger pool to a
Our NHS, Our Campaign
So, while no one underestimates the danger to the NHS from
privatisation, it is surely more likely to be defeated by working and campaigning together
as part of our NHS, than by striking camp and stealing away into the night? An
argument that can also, incidentally, be applied to many other pan-UK struggles
And ultimately this is why the break up of our NHS is quite so
crucial to the Yes campaign. It is not just a successful practical service, it
is also a symbol of a UK success with input from us all, and access for us all.
Let's keep it that way. Vote No to continue and increase the campaign to defeat
privatisation of our NHS - wherever that is threatened.