In poor health

With less than 50 days to go till the referendum I went along this week to a meeting of my local Yes group to offer support. Suddenly, a weekly blog doesn’t seem enough. Like many other people I’ve spoken to, I now have a horror of waking up on September 19 to the thought that perhaps I could have done more.

This grassroots group is just one of hundreds that have emerged spontaneously all over Scotland in the last few months – unfunded and largely unsupported except for a pile of stickers and some pens. There were 14 people present, representing a mixture of ages, occupations and interests. There were English accents in the room as well as Scottish ones. There were SNP members and Greens and people with no particular political leanings. All were there to give freely of their time and energy.

Looking around, it struck me what a spectacularly ordinary group of people we were, the kind that gathers every weekday night in houses and halls the breadth of the land for more reasons than you can begin to imagine. Except, of course, that there was nothing ordinary about our agenda: to play a part, however small, in the single most momentous opportunity for change we will have in our lifetimes.

I think it would be fair to say that every word spoken in that room was motivated by the same two emotions, which happen to be on opposite sides of the same coin. One, a palpable excitement at the prospect of a Scotland free to be the country it would like to be, an energised country that stands proudly among its peers, that speaks with its own voice and is responsible for its own mistakes, that exploits its own resources, trades with the world on its own terms and looks after its people the way they want it to.

The other, a deepening revulsion for everything Westminster stands for, a real fear of remaining shackled to a system governed by a party which has cast aside any last shred of sheep’s clothing with the recent cabinet reshuffle and is now loping towards some kind of isolationist, plutocratic hell where it vies with UKIP to demonise scroungers, immigrants and anything that begins at Calais.

These two emotions are deeply felt by most people who support independence and have made the conscious effort to become informed about it, and there is plenty of information to be had once you start looking. But that kind of conviction doesn’t spring so readily if your only source of information is the mainstream press which, with one single exception in the whole of the UK, the Glasgow-based Sunday Herald, is pro-Union.

For example, there is a quite widespread misperception that independence is a threat to Scotland’s health service – and that is among people who understand the current arrangements, let alone those who, we heard at the meeting from someone who had been out canvassing, believe that the NHS in Scotland is just part of the English NHS. The truth is that Scotland’s health service has been independent from England for a long time and resolutely retains its public service ethos, while the English NHS is being further dismantled and privatised as every week goes by.

So the real threat to Scotland’s NHS, it transpires, is not from independence but from remaining in the Union. Although we run our own health service, the way Scotland receives funding from the UK Treasury means that cutbacks in England are effectively mirrored in Scotland. This, as I understand it, is how it works: all the tax raised in Scotland (VAT, income, corporation and all the rest) goes to London and a slightly smaller amount (which for the last 33 years has made Scotland a net contributor to the UK economy, thus demolishing the myth that we are dependent) is then paid back to us, though not as a lump sum which we can use as we wish, but rather according to different defined areas of spending.

So as privatisation in England grows apace and public health spending continues to be cut, proportionately less money would make its way to the already-stretched NHS in Scotland. In time, here as south of the border, the pressure would fall more and more on GPs to commission services from private providers, on the basis of decisions which are not necessarily in their patients’ best interests.

Sarah, my wife, although half Scottish (and half Irish), was born and brought up in France, spent 20 years in London, and had never lived in Scotland till I dragged her back here nearly a quarter of a century ago. Initially she was very uncertain of her loyalties. Gradually she has come round to Yes, not because of anything I have said, but because, among other things, she is a counsellor who practises two days a week within the Scottish NHS and has a passionate desire for it to remain what it began as, a truly public health service, free at the point of delivery.

That alone seems a powerful reason for a Yes vote – and there are many others. I’m struck again and again by the seriousness with which people are approaching their decisions. I know that whatever the outcome on 18 September I will feel proud to have been part of a campaign which is overwhelmingly honest and decent and motivated by simple human, rather than political, considerations.

For a senior Scottish doctor’s view of the situation, watch this short YouTube clip.

About Jamie Jauncey

Author, writer, blogger, facilitator, musician, co-founder of Dark Angels and The Stories We Tell
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4 Responses to In poor health

  1. With you 100% on this Jamie

  2. The biggest problem facing the NHS is not one of ideology. Rather, it is that demand is outstripping resources in ways its creators could/would never have envisaged. On average, we consume 90% of our individual cost to the NHS in the last six weeks of our lives.

    That fact alone tells you that, as we improve our ability to keep the sick alive, the burden on the NHS will only get bigger. And that is not to factor in the burgeoning costs associated with our constantly developing ability to fight previously fatal diseases.

    Free at the point of delivery still has to be paid for. At the moment the UK pays total tax (including VAT and NIC) that constantly hovers around the 40% mark. In France, the equivalent figure – as it is also in most Scandinavian countries – is 60%.

    So, as consumers of public services, we have a choice. We can swallow a 50% hike in taxation or find other ways of keeping certain costs outside of public funding.

    You know I hate to disagree with you Jamie. I really do. It upsets me.

    But if, as a recent survey suggested, 700,000 tax paying Scots plan to leave the country in the event of a Yes vote, and several large employers relocate, Scotland would find it impossible to raise the taxation required even to keep its current levels of public service afloat.

    I much prefer your poetic, romantic and emotional support for a Yes vote. The politics, the arithmetic and the purely pragmatic are all against you.

  3. Me and a large number of other people, Paul – many of whom would not be averse to a tax rise if it meant a country that worked better. You’re right, I prefer to make the emotional case, but it also feels important to try and counter some of the nonsense that’s being dished up in the name of the Union – including, dare I say it, the 700,000 would-be emigrants. I hesitate to say this to you of all people, my wonderfully hard-headed friend, but believe that and you’ll believe anything!

  4. Graham Leicester says:

    I too hate to quibble, Jamie… but the financial relationship is a bit more complicated than you suggest. For example, the ‘block grant’ allocated to the Scottish Government each year does not represent all public spending in Scotland and – as the name suggests – is in fact a lump sum which can be allocated in any way the Scottish Government wishes. But it is true that it is calculated on the basis of English spending decisions which are departmental (the Barnett formula – not a simple beast either). I also think ‘privatisation’ might need some unpacking with respect to the NHS – particularly the distinction between ‘privatising’ costs (eg introducing user charges) and ‘privatising services’ (eg introducing non-state providers who nevertheless take public monies). NHS ‘privatisation’ will only reduce the English health budget if it is indeed found to be cheaper than keeping services in-house. The US experience suggests that privatising services is more likely to increase costs in the longer term. And, whether we try to limit demand or innovate the financing of supply, healthcare spending continues to rise unsustainably across the developed world – so something will have to give, even in Scotland (see the Costing an Arm and a Leg report here – ). Saving the NHS is indeed a challenge – but we will not save it for long simply by playing with the financial models. Former President of the Royal College of GPs Iona Heath scopes out a very different and more ambitious agenda in her ‘Can Scotland Save the NHS?’ talk here: Sadly I hear no hint of this level of thoughtfulness on either side of the referendum ‘debate’ – at least in public.

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