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Salmond's NHS pledge is not enough to make me vote Yes

I was with a sick friend in the waiting room of a hospital cancer department recently.

A young woman was there too, wearing a hat, suggesting she'd had chemotherapy. A man in a checked shirt looked in and held out his hand in welcome. "So you're back," he said.

"That's the consultant," my friend whispered as the man chatted in a friendly, informal manner to his patient. I didn't listen to what he was saying. Instead I was focused on the transformation in her face: on how it lit up.

However ill she was, regardless of the struggles ahead, the consultant had already performed a healing act. That small moment of recognition and his few warm words articulated that she mattered; that she wasn't just a set of case notes; that he cared about her.

That's good medical practice. It's what I, and most others, want from our precious NHS.

Is the NHS a female vote-catcher? Most certainly it is. In recent days, it has become a crucial battleground in the independence referendum campaigns.

Yesterday, for example, Alex Salmond, accompanied by the Scottish Cabinet, went to Arbroath to make a new declaration. A Declaration of Opportunity, it was billed.

On the NHS, it was said, the opportunity of independence was to "protect our publicly-owned, publicly-run NHS forever from Westminster privatisation and cuts". The intended audience was women voters who have proved more reluctant than men to be converted to Yes. Will his declaration be enough to persuade them? Well, I don't think it will and I'll explain why.

Even in these days of equality, women are more likely to look after children or elderly parents. For long periods of their lives they are their family's primary carers. I knew a doctor who, before diagnosing a sick child, would always ask its mother what she thought was the matter because, nine times out of 10, she was correct.

At the risk of making generalisations, I think women are more interested in practicalities, in the quality of care, than they are by the political arguments around privatisation or future funding.

For example, on the day that Mr Salmond was effectively telling us that the Scottish NHS could only be safe under independence, the latest figures on cancer mortality rates were published.

Cancer Research UK revealed a 25 per cent decline in Scotland. So good news, then?

Yes and no. In England and Wales, deaths were down 30%.

A closer examination of the figures was concerning. For example, south of the Border mortality rates for prostate cancer had dipped 21 per cent over 20 years. The decline was only 11 per cent in Scotland. That's a long way behind.

If you were a man with prostate cancer or if your husband was suffering from it, on this evidence where would you want to be treated?

Scotland is also lagging in other cancers. Mortality rates for lung cancer have fallen 23 per cent in Scotland but 27 per cent in England and Wales.

For bowel cancer, the respective declines are 30 per cent here compared to 34 per cent there. A similar discrepancy can be found with breast cancer. In Scotland mortality rates are down 33 per cent. In England and Wales, the decline is 38 per cent.

Remember, every percentage point translates into real people losing their lives.

Isn't this the crux of the matter? For women, outcomes are more important than political grandstanding. They want to know that their child, their parent, their partner will receive excellent treatment this week, this month, this year.

They want them to have the best chance of surviving.

Instead of Mr Salmond warning about the consequences on the Scottish NHS of privatisation in England, shouldn't he be telling us how he intends to improve Scottish cancer mortality rates so that they equal or better those south of the border?

I know that's what I want to hear.

Also, I would like to hear something about government investment to make Scotland's cancer survival rates as high as those in Europe. The United Kingdom as a whole trails behind our neighbours across the North Sea.

Survival rates for prostate cancer in the UK are 80.6 per cent and in Northern Europe 85 per cent. For breast cancer, the survival rate in the UK is 79.2 per cent. In Northern Europe it is 84.7 per cent. I think that's enough of the figures, but you get the picture.

One of the benefits of living on an island with separate health services either side of the Scottish border is that we should be able to learn from the best practice of each country. That seems to have been forgotten in the referendum debate.

Instead we are treated to rival warnings, how public services including the NHS are at risk from independence or can only be secured by it.

To me - and I suspect to most women - rather than politics and finance and the configuration of the organisation of the NHS - what really matters is lives saved.

Health has been devolved, so why hasn't more already been done? I'm not unreasonable enough to charge one man or one party with responsibility for this country's health deficit.

There are, I know historic causes: lack of vitamin D, poverty, ignorance and obesity.

But England is not devoid of these disadvantages. And if I see its success in curing serious illness is higher than ours, I would rather our politicians would listen in and learn.

I think most women will feel the same way.

I'm told that women are less taken by great symbols and strategic vision than men are. We are not incapable of appreciating the first and devising the second. But we also have a firm grasp of the Monday to Friday of life.

By that I mean that historically men have fought over territory and, whether it has been won or lost we have made the soup, minded the bairns and bound the wounds. And although we now have political clout and careers, by and large we still deal with the home.

We therefore view the world from that intimate place. We are suspicious of rhetoric and speechifying as a remedy for a sick child or a threatened partner.

And the side that gets our vote is the one that, at that point, can offer the best support.

We will take a successful cancer treatment free at the point of delivery and, when it comes to the crunch, we'll mind less about whether it is the state or the private sector that has supplied it.

Right now, for cancer treatment, Northern Europe would get my Yes vote.

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Health

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