Health

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FOR THE UNION FOR INDEPENDENCE

Scottish NHS past and present

Pro-unionists claim that Scotland's devolved healthcare system is illustrative of the success of the UK. Scotland is already in control over its own healthcare services within the union.[1] The Better Together campaign argues that, as part of the UK the NHS in Scotland gets the best of both worlds. Decisions about healthcare are made here in Scotland, and the investment in our NHS comes from taxpayers across the whole of the UK.[2] Further to this, Scotland currently profits from its UK representation within the World Health Organisation[3]. Scotland’s spending in healthcare is above the average for elsewhere in the UK. Staying in the union remains beneficial to the financial health of its NHS[4].
Between 2002–03 and 2009–10 real-term health spending per person grew by 29% in Scotland compared with a 43% increase across the UK as a whole[5].

NHS after Independence

Funding for the NHS, if outwith the UK, would be too uncertain to ensure a stable future for Scottish healthcare[6].

On 15 September a leaked paper for senior NHS managers revealed they were planning to have to deal with a £450m shortfall over the next two years. Sweeping cuts would be needed to fund the shortfall. Alistair Darling, head of the Better Together campaign, said: "...they've known that these cuts are coming along, but we weren't going to be told about it until after the polls had closed.[7].

Privatisation

The Scottish NHS does not have to make more use of private sector providers just because the English NHS is (and indeed, it hasn’t been)[8]. And the Scottish government decides how much money to allocate to the Scottish NHS from the overall block grant it receives from Westminster.

Cross-border Healthcare

The Better Together campaign asserts that leaving the UK could complicate the current systems in place for cross-border healthcare, causing greater inconveniences for patients requiring specialist care.[9] The British Medical Association has pointed out that the General Medical Council, the regulatory body of medical professionals in the UK, currently runs as a UK-wide institution. It would therefore require a re-establishment of regulations in an independent Scotland.[10]

References

  1. http://www.bbc.co.uk/news/uk-scotland-scotland-politics-28183860
  2. [http://bettertogether.net/blog/entry/say-no-thanks-to-separation-to-protect-our-nhs Better Together: Say No Thanks to separation to protect our NHS 6 July 2014 (retrieved 6 August 2014)]
  3. [https://www.gov.uk/government/uploads/system/uploads/attachment_data/file/271794/2901475 Scotland analysis: EU and international issues para 2.40]
  4. http://bettertogether.net/blog/entry/say-no-thanks-to-separation-to-protect-our-nhs
  5. Institute of Fiscal Studies: The Scottish NHS - more financially secure outside the UK? 11 September 2014 (retrieved 14 Sept)
  6. http://www.bbc.co.uk/news/uk-scotland-scotland-politics-28183860
  7. "Guardian: NHS leak fuels campaign clashes 16 September 2014
  8. Institute of Fiscal Studies: The Scottish NHS - more financially secure outside the UK? 11 September 2014 (retrieved 14 Sept)
  9. http://bettertogether.net/blog/entry/say-no-thanks-to-separation-to-protect-our-nhs
  10. http://bma.org.uk/working-for-change/policy-and-lobbying/scottish-parliament/scottish-independence

Scottish NHS past and present

The Yes campaign uses the existing devolution of Scotland’s health service as evidence of Scotland’s ability to function as an independent state.[1] The Scottish Government argues that it has improved the Scottish NHS since 1999.

NHS after Independence

The SNP claims that the day-to-day running of the NHS will be unaffected by Scottish independence, the way patients access healthcare will remain as it is.[2] With Independence, the Scottish Government can continue to tailor Scotland’s NHS to the country’s specific needs, tackling root causes of poor health such as smoking, alcohol abuse, and obesity. As well as take greater control of the regulation of tobacco and alcohol.[3] The SNP stresses the importance of Scottish independence in order to continue to protect Scotland’s NHS from Westminster spending cuts, which if the country remains in the UK, could be unavoidable in future[4].

On the September 15 leak about a £450 million shortfall in the NHS budget, Nicola Sturgeon insisted the leaked document strengthened the case for independence, because those cuts were identified as part of the spending squeeze imposed by the UK government's austerity programme, "making our case for us because [we] don't have control over our own resources[5].

Privatisation

The Yes campaign claims that it has successfully safeguarded it from privatisation, something which has begun in the rest of the UK, and has had a negative effect on the social equality of healthcare[6].

Sir Harry Burns, former Chief Medical Officer, wrote on 14 September[7]:

"In the UK, we are facing increasing privatisation of the NHS and there is very little anyone can do about it in Scotland so long as we remain part of the UK. The UK government is a member state of the EU and the European Commission is currently negotiating with the US a free trade agreement of unprecedented scale which will affect Scotland's ability to control its NHS. This is the Transatlantic Trade and Investment Partnership (or TTIP). Once it has been ratified by the European Parliament, its implementation will be mandatory across all countries, including Scotland if it remains in the UK. If agreed, TTIP is likely to give transnational companies such as American healthcare providers the legal right to bid for all government spending, including spending on health where private companies are already running those services. This is the case in England.
Those promoting TTIP say that health will be exempt from the treaty because it is a public service. However, in the context of free trade agreements, the term "public service" usually refers only to those services that are not supplied on a commercial basis, or are not in competition with other service providers. Since the passing of the Health and Social Care Act (2012) in England, the NHS in the UK does not conform to this description."

Cross-border Healthcare

The Scottish Government intends to build upon the already established cross-border healthcare system in place. It will ensure that Scottish citizens continue to receive healthcare throughout the rest of the UK, and vice versa.[8] The Scottish NHS will continue to work with other countries in the UK, where high-quality, specialised care may be based.[9] The SNP also plans to leave its use of the England-based Medicines and Healthcare products Regulatory Agency (MHRA) unaffected.[10]

References

  1. http://www.yesscotland.net/answers/what-about-nhs-independent-scotland
  2. Chapter 4: Health, Wellbeing and Social Protection, Scotland’s Future, http://www.scotland.gov.uk/Publications/2013/11/9348/8
  3. Chapter 4: Health, Wellbeing and Social Protection, Scotland’s Future, http://www.scotland.gov.uk/Publications/2013/11/9348/8
  4. http://www.bbc.co.uk/news/uk-scotland-scotland-politics-27555849 24/5/14
  5. "Guardian: NHS leak fuels campaign clashes 16 September 2014
  6. https://archive.today/xL9YB from the blog of Marcus Chown (retrieved 14 Sept 2014)
  7. Herald: UK faces increasing NHS privatisation and there is little Scotland can do if we remain in union
  8. Chapter 4: Health, Wellbeing and Social Protection, Scotland’s Future, http://www.scotland.gov.uk/Publications/2013/11/9348/8
  9. Chapter 4: Health, Wellbeing and Social Protection, Scotland’s Future, http://www.scotland.gov.uk/Publications/2013/11/9348/8
  10. http://scotreferendum.com/questions/how-will-an-independent-scotland-access-services-from-the-medicines-and-healthcare-products-regulatory-agency/