So, I wrote a little piece about the economy a few weeks ago. I said then that I’d write something about “It’s The NHS, Stupid” so here it is…. I’m not sure if anyone is reading what I write (actually I am ‘coz the WordPress stats are err, empty…) but here goes anyway.
Writing about the NHS is relevant because it’s maybe the most obvious area where a no vote will have huge impact in the future for Scotland. I sincerely believe everything I am about to say is accurate and can be verified should you wish more details.
1. NHS Scotland and NHS England/Wales have always been separate organisations. They were created by different acts of parliament.
2. All matters relating to NHS Scotland are currently devolved from Westminster to the Scottish Parliament. This is by Westminster’s permission, which if they so chose, they could withdraw.
3. NHS England was subject to the “Health & Social Care Act 2012”. NHS Scotland was not. This act completely changed the way the way NHS England operates internally. It was the biggest change since the NHS was founded. In effect, it created a competitive price driven market for services within NHS England. It gave funding to buy those services to GPs and created “Commisioning Bodies”. There are many analysts who agree that this was in effect the privatisation of NHS England. It is still free at the point of use, however the model which has been adopted is remarkably similar to the American model for healthcare. There are now multiple commercial companies competing to provide services to the NHS. Services like Plasma Resources UK (an important part of the Blood Services) – which has been sold to a Venture Capital firm owned by Mit Romney
4. NHS Scotland remains a single service (it’s not perfect, it needs to change and evolve in line with our population and needs, but it is still true to the founding beliefs)
5. The pressure on NHS Scotland following a No vote will come in two ways – firstly, as overall UK Government spending on NHS England will go down as a direct result of it’s privatisation, the direct consequence will be a reduction in the money made available to Scotland through the Barnett Formula. This reduction in the “Block Grant” will in most analysts views the Scottish Government to have to reduce the spending it can make on NHS Scotland. The second, not so obvious way there will be an impact – and this one is far more serious – is through a little discussed legal framework which the UK Government (and the EU) are currently negotiating with America. It’s called The Transatlantic Tade and Investment Protocol (TTIP for short). To summarise this thing, when it’s signed/agreed it will give fully legal power to large Corporations to sue Governments for loss of profits, if the Government has passed a law which the Corporation deems is causing it to lose profits. (Think about the way Monsanto is currently suing the EU over various herbicides) is The court which will adjudicate on any such cases is in America. How does this impact on NHS Scotland? Well, as NHS England is already privatised, so a Corporation could sue the UK Government for the profits it is not making from NHS Scotland. Thus, making the break up and privatisation of NHS Scotland far more likely. (This could also apply to Scottish Water, as it too remains a national service where the equivalents in England are private). As I understand it, the only way to avoid a TTIP challenge to the national services in Scotland will be if Scotland is no longer part of the UK. ie there is no comparable services which are already privatised in the Nation.
I’d be happy to be corrected if I have fundamentally mis-represented what is happening to the NHS in the UK. I’m not a politician, just a guy who sees what’s happening in England is really worried about what those changes will mean for my children and their children.