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NHS scare story is a convenient distraction

WHY is Alex Salmond trying to suggest the NHS in Scotland is under threat?

Why has he changed his mind?

In September last year, Mr Salmond was certain "the Scottish Parliament has the power to keep the NHS in public hands".

The SNP's White Paper on Scotland's Future was equally reassuring. "Independence will not affect the day-to-day management of the NHS in Scotland nor how people access NHS services."

No hint of any threat to Scottish health service then. So what has happened between then and now?

The stark truth is that the Scottish NHS is no more under threat this year than it was last. Health responsibilities in Scotland are devolved completely and will remain so.

What has happened, however, is that Mr Salmond has failed repeatedly to say what plans he has for currency in an independent Scotland. He cannot or will not say what he will do if his plan to establish a currency union doesn't work. And it may just be possible Mr Salmond is wrong.

The question won't go away. Using the NHS to change the agenda, to turn the spotlight from currency to health care, is a cynical ploy by the SNP. No matter that the premise of his argument is not true.

New contracts to provide NHS services in England have been awarded to private companies. Mr Salmond claims this is evidence of the NHS in Scotland being under threat. Yet under Mr Salmond's stewardship of the Scottish Government, the use of the private sector in the health service in Scotland has increased.

Whether increasing use of the private sector is either desirable or wise, whatever happens within the service in England need have no impact on the health service in Scotland.

At present the health budget in England has increased, so the corresponding allocation to Scotland has increased. But even if that situation changed in future, under the 2012 Scotland Act the Scottish Parliament has the power to raise the shortfall.

Throughout the UK, the NHS provides health services, free at the point of delivery, based on clinical need and not ability to pay. There is no appetite anywhere for that to change. The mainstream parties have never argued against the fundamental principles of the NHS. During next year's General Election campaign they will be more likely to try to outspend each other.

Throughout Scotland the vast majority of health boards use private hospitals to help meet their targets, they borrow rather than buy equipment from the private sector and employ the private sector to deal with aspects of mental health and addiction. Scottish health boards spent £14 million on bank and agency nurses.

In 2006/2007, the year before the SNP took power, the spend on private healthcare provision was £58.67m. In 2102/2013 it was £80.26m, a rise of 37 per cent. And it is worth recalling that GPs have operated in the private sector ever since the NHS was established in 1945.

Mr Salmond's latest wheeze is to enshrine public ownership of the health service of an independent Scotland. That there was no mention of this "fundamental part of Scotland's national identity" in the Scottish Government's draft constitution published only two months ago heightens suspicion of a last gasp for headlines. Policy and politics determine health priorities - they are not for constitutional experts to decide.

How the health service is delivered is a matter of legitimate debate, and throughout the UK arguments rage over health care provision. While successive governments have used the private sector in the NHS, Andy Burnham, Westminster's shadow health spokesman, now insists an incoming Labour government would order NHS managers to review all health care contracts in the pipeline.

Mr Burnham's writ stops at the Border so he could not make the same commitment for Scotland. But even Labour admit that whatever the scale of privatisation in England, there has been no impact on the Scotland's budget. Anyone arguing otherwise can rightly be accused of scaremongering.

Contextual targeting label: 
Health

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