The Scottish NHS is not just avoiding Lansley's free-market formula ? it is being boldly taken in the opposite direction
As the infamous "sick man of Europe" that continually tops obesity charts and comes bottom of life expectancy tables, Scotland clearly has unenviable health problems that stubbornly refuse to heal. Thankfully, however, what it doesn't have to deal with is a battle for the very heart and soul of the NHS.
Over recent weeks the future of the NHS in England has rarely been out of the headlines as Andrew Lansley's plans for GP consortiums and the extension of free-market economics in healthcare evoke the wrath of nurses, doctors, patients, charities, professional bodies and even his coalition colleagues. Discussion threads on the Guardian and elsewhere heave with anger and a sense of betrayal.
Many people living in Scotland observe this tussle with a mixture of relief and sympathy. Relief that devolution means Lansley's plans won't apply to them, and sympathy for family and friends down south who will take the brunt of them. Probe a little further and you may even find feelings of guilt.
The provision of free personal care, prescriptions, dental check-ups and eye-tests for all in Scotland has been part of the devolution debate for some time, and you'll often hear English folk only half-joking with Scots about moving north. What they may not be aware of, however, is the SNP minority government's strategic decision to move the NHS in the opposite direction to Tory proposals for England.
It will come as no surprise to prospective voters in next week's Holyrood election that neither Scottish Labour nor the SNP have plans to contract swaths of vital services out to the lowest bidder. But if the SNP is returned to govern Scotland next month, Lansley's Scottish counterpart Nicola Sturgeon will continue spending money on public health and eradicating any remnants of privatisation left behind by previous administrations. This work is already well under way.
Glasgow's Southern General hospital, a neurology and neurosurgery centre of excellence that takes patients from all over Scotland, is currently being rebuilt at a cost of �840m, every penny of which ? if Sturgeon has her way ? will come from the public purse. The SNP was one of the first mainstream political parties to air serious concerns about the long-term value-for-money of private finance initiatives (PFIs), the short-term fix where private companies build schools, hospitals, roads and government buildings, while the taxpayer is locked in to hugely expensive long-term lease agreements.
Obviously, �840m is a lot of money. But there aren't many Scottish taxpayers who would moan about their hard-earned cash going directly to build and equip a state-of-the-art hospital. Only this week, a patients' watchdog in Kent pointed out that the new �225m Pembury hospital, near Tunbridge Wells, will cost taxpayers �20m annually for the next 32 years.
You could argue that it was Labour who started this strategic shift in Scotland, despite an often confused stance on free-market healthcare policy nationally (for the record, Scotland also managed to dodge foundation hospitals). In 2002, the Golden Jubilee National hospital in Clydebank, near Glasgow, was bought for the NHS after it failed to attract patients in its previous incarnation as a private facility. It has since become a hugely successful specialist surgery centre, and the SNP hope to repeat this formula with Stracathro hospital in Angus, which has just been brought back into the public fold following a stint as a public-private venture.
On the ground, Scotland's public-public approach does appear to be bearing fruit. According to NHS statistics, in March 2008 there were over 2,000 Scots waiting more than 15 weeks for inpatient treatment; by November 2010 the figure had fallen to 58. Meanwhile, a new 31-day cancer waiting target set by the SNP government has been substantially met a year ahead of schedule, and a million more sweet-toothed Scots are now registered with a dentist.
Of course, there is far more to good healthcare than targets and waiting lists, and Scotland has its fair share of individual horror stories just like anywhere else in the UK. But perhaps these figures show that sticking with the seemingly old-fashioned idea that the government should run the health service can lead to improvements.
Appearing on a recent edition of Question Time, filmed in Liverpool, Alex Salmond wiped the floor with his three political rivals on the future of the NHS in England and urged English voters not to let the coalition or Labour "destroy your NHS". This may have been electioneering by a savvy nationalist looking to trounce the unionist opposition, but it could just as easily have been the voice of the English patient. For perhaps the first time in England, Salmond got the biggest cheer of the night.
Source: http://feeds.guardian.co.uk/~r/theguardian/commentisfree/rss/~3/nD_hDnSVmp4/scotland-nhs-snp-lansley
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