Johnstone’s View - Salmond has lost the plot

In the last two weeks, Alex Salmond, motivated primarily by an intense desire to save his own political skin, has launched an unprecedented attack on the ethos which lies behind our National Health Service.

By his choice of argument, his choice of words and choice of target for his attack, he has demonstrated that he has no understanding of what the NHS is or what its primary function might be. He has lost the plot entirely.

First of all, he has almost entirely stopped using the term ‘National Health Service’, choosing to use a new term of his own invention by calling it instead, the ‘Public Health Service’. This comes along with promises that, “in an independent Scotland,” the health service will be publicly owned and run by the government on behalf of the people. Not only that, this commitment will be enshrined in a written constitution. Problem is that this is not how our health service is, or ever has been structured.

Let’s look at the facts. If you make a visit to your GP at your local health centre, chances are that you are visiting a private business which is acting as a contractor to the local NHS trust for the provision of health care in your community. If you go to the dentist, he or she too will most likely be a private business who is able to provide you with NHS care through a similar contract.

If your doctor provides you with a prescription, you might take it to your pharmacist to be filled. That pharmacy will be a privately-owned business providing that service as part of an agreement with the NHS. The drugs which you might receive, may well have been developed by a multi-national private conglomerate which may have invested a £billion budget in developing the myriad of new therapeutic substances which continue to help us live longer, and more comfortably, than we ever did before.

Furthermore, if you are injured in a road accident or in some other accident for which insurance cover is in place, our health service may well claim the cost of your treatment through that insurance cover. In other words, your care might be privately funded. You may also find care being funded through travel insurance in some cases.

Now let’s look at the health service in Scotland and see how it provides the treatment we get in our hospitals. Because of the protection of NHS spending by the UK Government, NHS continues to rise while difficult decisions have had to be made elsewhere. Scotland’s share of that money is guaranteed under the Barnett formula. Scotland’s health has even seen a £1.3 billion increase as a result of UK budgets being increased beyond that projected in previous budgets.

Then there is the practice of, when the NHS is not able to provide care, buying these services in from the private sector. Spending on private healthcare by the NHS in Scotland rose sharply last year to a total of £83,478,000, up from £68,767,000 in the previous year. For all the SNP’s talk about private healthcare, they themselves have spent more than £400 million on it since coming to power. On a per-capita basis, this figure is higher than that in England and Wales.

The political commitment to provide health care, free at the point of delivery not a commitment to government ownership of the means of delivery. The National Health Service is a system which enables the best of healthcare, regardless of what economic model lies behind its provision, to be made available to the public, free of charge. If taxpayers’ money is used to provide free healthcare but the medium for that delivery happens to be one of these private contractors, then this is NOT privatisation; it is anything but.

Our National Health Service has served to draw together all the talents, whoever they might be, and gives us all access to the best of provision. It is a partnership, a co-operative, a commonwealth run for all our benefit.

So what is Alex Salmond’s vision? What exactly does he mean when he talks about a “Public Health Service” in Scotland? He has already made it clear that this will mean state ownership. I can only assume that this will facilitate a dramatic shift in power from NHS Trusts to Ministerial decree. Aggressive outbursts against ‘privatisation’ indicate his hostility towards private contractors, in spite of his own current dependence on them to plug the gaps in his own devolved NHS.

So, from a National Health Service which brings together the best that healthcare has to offer, we will move to a Public Health Service which will drive a wedge between the public and the private, leaving patients to receive only the care which government decrees they need, in the facilities which they can afford, and where the only choice is, ‘take it or leave it’. No Thanks.