Scotland's NHS shouldn't be a factor in the General Election. But it is.
The pressures on A&E in Scotland's hospitals are the latest political storm in the lead up to the General Election in May. The next government – whatever its colour or colours – will face some serious challenges on how to create sustainable change for the health of its citizens.
But although the debate will rage across the country, those elected in May will be making decisions of no relevance to the day to day running of Scotland’s NHS. Health is fully devolved, and Scots will find themselves voting for MPs who will have an important say over the English NHS, but none over Scotland’s version.
The subject is a source of frustration for UNISON Scotland's Head of Bargaining & Campaigns, Dave Watson. “We understand why it’s an election issue for our colleagues down south and why Labour’s majoring on it. It’s entirely understandable. What’s happening in England is absolutely shocking, and they’re right to make an election issue out of it. The point in Scotland is in terms of the operational side of it; those issues unions and others will campaign on in the election down south do not apply in Scotland,” he says.
It hasn’t stopped the political parties wading in however. The SNP has argued their MPs will intervene on the English NHS, claiming the increase in private providers of healthcare in England poses a threat to the Scottish Government’s budget. Labour, meanwhile, has been focused on the NHS, with new Scottish Labour leader Jim Murphy pledging to recruit 1,000 more nurses than whatever the SNP pledges, using funds raised from a UK-wide ‘mansion tax’, and with additional money already raised through the Barnett funding formula to invest £100m into a ‘frontline fund’ to ease pressure on the NHS.
Watson says the fact the NHS has become an election issue in Scotland has been met with “some bewilderment” by people who work in the Scottish health service.
While politicians and policy professionals understand the difference, the general public are left with media reports of national debates on the subject, he says. “The most astonishing statistic I saw in one poll was 65 per cent of people in Scotland thought welfare was devolved to Scotland. Firstly, the Scottish Government should be grateful they haven’t blamed them for the bedroom tax on that basis! It does demonstrate the fact not everybody understands the differences.”
This presents a difficult position for politicians in Scotland, he admits. “It’s very difficult, if that’s the news buzz the public’s getting, to then say, ‘hang on, that doesn’t apply here in Scotland’. I can understand that particular issue.”
“Sadly, the NHS has a long history of being used as a political football by all political parties across the UK"
Part of the news buzz in recent weeks has been around Labour leader Ed Miliband, who allegedly told a BBC reporter he was going to “weaponise” the NHS in the election campaign. David Cameron called them “disgraceful remarks” when trying to deflect health questions at Prime Minister’s Questions. Whatever the equivocation, the NHS remains a key battleground in the General Election, and has traditionally been a vote winner for Labour.
The coverage has been met with disappointment by Dr Peter Bennie, chair of the BMA in Scotland. “Sadly, the NHS has a long history of being used as a political football by all political parties across the UK,” he says. The size of the budget spend on health makes its profile in debate inevitable, he argues, “but often this can be at the expense of coherent, consistent long-term policy making. There is also the strong personal connection each and every one of us has with the NHS. We all have a story to tell about our experiences with the NHS, whether that be good or bad. But it’s when these stories are picked up, not for the purpose of improving healthcare, but for political point scoring, that I find it particularly sad.”
Exchanges at PMQs in the Commons or First Minister’s Questions in Holyrood frequently centre on who is to blame for pressures on A&E, but Bennie says these are misplaced.
“What’s important is not who ‘caused’ the problem but who can show leadership to overcome these challenges,” he says.
If you were taking a non-political, policy analysis perspective, we would have said 1,000 home-care workers would have been a better pledge than 1,000 nurses
Watson believes politicians are in a “chicken and egg” situation where a lack of public understanding about the relationship between health and social care makes them focus attention on short-term fixes. “With the Barnett consequentials from the Autumn Statement, John Swinney wasted barely seconds before he announced the money from NHS consequentials would be applied in Scotland. Now I think that reflects a political judgement, not a balanced public spending judgement,” he says.
For Watson, funds would be better spent on social care, if ‘bed-blocking’ is to be addressed. “It’s like Jim Murphy’s 1,000 nurses. If you were taking a non-political, policy analysis perspective, we would have said 1,000 home-care workers would have been a better pledge than 1,000 nurses,” he says. “They’re playing to the same narrative and the same public perception. The issue is we do need to do a lot more to explain to the public healthcare is more complicated than simply always focusing on the NHS. Don’t get me wrong, we could do with 1,000 nurses, we could do with filling the current vacancies, for goodness’ sake, that would be wonderful, but I think we do need to have a dialogue in Scotland to understand [that] if we’re going to address demographic change then it’s a more complicated picture.”
For more on the future of the NHS read the latest issue of Holyrood magazine