MAGNUS Gardham is right that the health service should be at the forefront of the independence debate ("Health at the heart of our big debate", The Herald, July 19).
We all have a vested interest in having unconditional access to universal health care that is best when and where it is needed most. It is informative and enlightening to reflect on the changes to the delivery of health care in England, because this tells us something about the ideological direction of government and raises a vital question: is health care really regarded as a fundamental right?
There is growing anxiety about the state of NHS England from patient pressure groups, the BMA (whose incoming chairman has called for the repeal of the health and social care legislation) and the Royal College of General Practitioners, which has launched a petition highlighting the threat to the future of general practice. Clearly, in terms of real funding, the changes in NHS England have not made any tangible difference to the challenge of delivering health care in the community.
The integrity of any government is represented in its health and welfare policies; therefore it is also helpful to understand why there is a persistence of health inequalities when the rhetoric of the UK Coalition Government is about a fairer society. We now know that the scale of health inequalities is strongly influenced by inequalities in power, money and available resources in society. This is starkly represented in the average life expectancy of 74 in Glasgow, compared with 89 in Kensington, London. This is the biggest gap in mortality since 1880.
The NHS is value for money and is an efficient service but as the "core" NHS spend in NHS England is reduced as privatisation becomes the norm, then the proportion to Scotland also reduces. It will be financially impossible to maintain NHS Scotland in its current form with a reduced budget and without control of our full economic powers.
No-one working in the frontline of NHS Scotland would deny that there are many challenges to the NHS that will have to be addressed in the event of a Yes vote. A move away from the UK Government's neoliberal policies of low employment and few employment opportunities, austerity measures and welfare reform, low income and a widening gap in income between the top and lowest-earning workers is a step in the right direction and achievable with a Yes vote. This will ensure that health inequalities in Scotland are neither unavoidable nor inevitable and that NHS Scotland will have a realistic agenda of preventative health care.
Dr Anne Mullin GP (member NHS for Yes),
25 Rutherford Avenue,
Glasgow.
YOU report claims that co-operation on medical issues like organ transplants and blood transfusions between Scotland and England could be put at risk by independence ("Brown highlights the Scots getting crucial medical help from England", The Herald, July 21). This is not the case. The organisation which co-ordinates transplants in UK, NHS Blood and Transplant, has already stated that following independence for Scotland they will continue to work across these islands. Indeed, the chief executive does not believe there would be "any significant change" to the management of organ donation and transplantation.
Scotland's NHS is already independent and has formal agreements in place to allow patients to be treated in other parts of the UK, and also allow patients from other parts of the UK to be treated in Scotland, based on clinical need. That will continue in an independent Scotland.
Around 7,600 patients from outwith Scotland are treated here each year, and following independence we will continue to care for these people as our friends and neighbours.
Everyone in Scotland has the right to access healthcare in other European countries. No-one is seriously suggesting that doctors and nurses in England will be instructed to turn Scots away if they needed treatment.
By far the bigger danger is that, without constitutional change, we remain subject to Westminster cuts and their potentially debilitating effect on our public services - not least our treasured NHS.
Alex Neil,
Cabinet Secretary for Health,
The Scottish Government,
Holyrood,
Edinburgh.
David Torrance (" England is showing parallels with Scotland of the 1980s", The Herald, July 21) writes that I was wrong to suggest widespread English indifference to the Union. He says: "It simply isn't true, either in Lewes [where Mr Torrance had been speaking] or in the polls."
But for starters, look at the May 2011 YouGov poll of an English sample. This showed a small relative majority in favour of Scottish independence (36 per cent pro, 32 per cent against), and a "Neither" of no less than 23 per cent. Only nine per cent said "Don't know". That large, not-unfriendly "neither" can only mean: "We know, but we don't much care."
Neal Ascherson,
The Garden House,
Poltalloch,
Kilmartin,
Argyll.
IN the event of a majority Yes vote in the independence referendum, the only thing that would be guaranteed is Scottish independence. Nothing else is guaranteed. Everything is subject to negotiation.
Scotland's share of North Sea oil and gas, both finite and declining resources, is subject to negotiation.
Scotland's membership of the European Union is subject to negotiation, as is membership of the UN and Nato.
Scotland's share of UK assets is subject to negotiation along with its share of the national debt and RBS's debts.
The splitting up of UK agencies such as DVLA, the Maritime and Coastguard Agency, the Health and Safety Executive and many more is subject to negotiation.
It is only when these many and complex negotiations are complete, and there is no guarantee that the best deals for Scotland would ever be obtained, that the government of an newly independent Scotland would know exactly what its financial and physical assets really were.
Just how many of the numerous SNP promises could it actually afford to honour, especially when Scotland's budget deficit is taken into account? Alex Salmond's intention to set up an oil fund may be a non-starter. It is difficult to save and spend when there is a deficit of £12.3 billion to clear.
His aspirations on mothers returning to work, productivity, GDP and immigration are just that, aspirations. They are not guaranteed. And there is no guarantee that the people of Scotland, after negotiations were complete, would not be disadvantaged in any way compared with the citizens of the rest of the UK.
On the other hand, by Scotland's remaining as a key part of the UK, many things are guaranteed : pensions, welfare, access to NHS services across the whole of the UK, the security afforded by the UK's armed forces and intelligence services, the security of the lender of last resort, the Bank of England, the guarantees to savers of the Financial Services Compensation Scheme, the benefit of being a part of one of the largest economies in the world.
Why give up all of these and much, much more for SNP aspirations, assertions and promises that are in no way guaranteed?
Stuart Smith,
4 West Lennox Drive,
Helensburgh.
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