Malcolm Chisholm: The Yes campaign scaremongering on the NHS

The big idea form the Yes Campaign in the first week of the short campaign was the big lie on the NHS . Those who have sanctimoniously criticised the No campaign for negativity showed  that they are in a class of their own  in the scaremongering stakes. The beauty of it from their point of view is that few people understand the complexities of Health systems, Barnett consequentials  and efficiency savings , with the Transatlantic Trade and Investment Partnership thrown in for good measure. So no doubt the scaremongering will go on but as a former Health Minister I have felt obliged  to rebut it on a daily basis and shall continue to do so.


The first deception is that privatisation implies a withdrawal of public money. That is not the purpose of creating a Health Market. Some people believe that creating a market involving private as well as public providers will increase choice and improve quality. I have never been persuaded of this but that is the route they have been going down in England and the motivation and effect have nothing to do with saving public money. Indeed all the evidence is that the traditional NHS is the most efficient Health system in the world and that the transaction and  other costs of a market make for a more expensive system.


The Scottish Government and many others  in the Yes Campaign have been going around talking about massive cuts from privatisation but  it is  interesting that Alex Neill at two successive Question Times has only been able to  mention one piece of evidence. The English Health and Social Care Bill had nothing about savings but the Impact Assessment on the bill, published in 2011, estimated efficiency savings of £1billion a year form the changes. There are three  points to make about  this.  Firstly, that is about 0.8% of the Health Budget. Secondly, as I said at Question Time on Thursday 14 August , the Impact Assessment   points out that the savings are “ highly problematic”. Thirdly, efficiency  savings are not the same as  cuts , as the Scottish Government  would be the first to point out since they impose efficiency savings of 3 per cent on every Health Board in Scotland every year.


None of this has stopped Alex Neill from saying two weeks in a row at Question Time  that the £1billion “cut” to the English Health budget would result in a £100 cut to the Scottish budget because Scotland receives roughly ten per cent of any changes to English Health budgets through  Barnet consequentials . I don’t  believe the notional efficiency savings will  materialise  at all because  of the transaction and other costs of the market but, even if they did, they would not result in a cut to the budget  any more than the 3 per cent efficiency savings imposed by the Scottish Government  result in cuts to Health  Board budgets. English Health budgets have been increasing, albeit by not as much as previously, and  the Barnett consequentials have meant that Health budgets  have gone up in Scotland too. There will of course be pressure on all budgets in the next few years , but not nearly as much as there would be in an independent Scotland, as I  evidenced  in the debate on Tuesday 12 August.


So the central piece of “evidence” from the Scottish Government  is completely untrue but ,even if it was true, it would hardly lead to the  biggest scare  of the Yes campaign that the Scottish NHS would have to be  privatised in due course  after a No vote. This has to be not just the biggest lie of the Referendum campaign but the biggest political lie of all my years in politics. There is no party in Scotland which wants to privatise the NHS and even the Tories are signed up to the Health system that we have here in Scotland. The NHS is fully devolved and only the Scottish Parliament can decide the future of the NHS in Scotland.


This however is where some in the Yes Campaign introduce another red herring, namely the Transatlantic Trade and Investment Partnership. This agreement between the EU and the US would allow US health companies to compete for business where there is a Health market such as in England. The UK Government refuses to exempt Health from this although Labour has pledged to do so if elected next year. Either way however, none of this would affect Scotland where there is no market and no Health contracts.  This has been made clear by Garcia Becero, the EU Commissioner with responsibility for TTIP, who has said that  Health services in Europe will be opened to private competition but only where privatisation is already established.


I have however made one slight  mistake in the last paragraph. I said there are no private Health contracts in Scotland but, irony of ironies, public expenditure in Scotland on private Health contracts has increased 23 per cent in the last year! That’s more than three times the notional cut to the Scottish Health budget trumpeted by Ale Neill two weeks in a row!  None of this however changes the fact that Scotland does not have, and I believe never will have, a privatised Health system. So the next time  you see that in a Yes leaflet , or hear it in the Parliament or on the doorstep, spot the lies but take comfort from the fact that they are in such trouble on the economy that lies are  all they have left.

Post Author: Alex Rowley