You might think that since the Scottish Government has made it so clear that the NHS isn’t going to be privatised under its watch, we’d be safe. I wish I could say that was completely and irrevocably true.
After all, the Scottish NHS is devolved and we run it ourselves, so what difference could it make if the English NHS continues its privatisation journey?
It’s not that simple.
The way we in Scotland are funded is by the Barnett Formula. Basically, that means we get back from the UK Treasury a proportion of the taxes we pay in. In 2013-14, that total was £28,441million and it is being cut back each year.
There are lots of controls upon how the Scottish Government spends the money. Teachers, nurses, doctors, social workers, police, council staff, all have to be paid. Then we have to give back to the UK Treasury our proportion of the cost of building the Olympic stadium, the Cross-Rail line and the HS2 line to Manchester, maybe even as far as Leeds ultimately, but certainly not as far as Scotland.
After that, there’s the cost of our percentage of the interest on the massive UK debt and the running of all the Central Government departments, the Houses of Parliament, Inland Revenue and the rest. So as you might have worked out, the amount of the budget that the Scottish Parliament actually has total control of is not very large — some £6.2billion.
Our Scottish NHS costs around £14b a year. In spite of the austerity agenda, we have managed to protect that budget in real terms.
But now there are two separate attacking forces against us. First, because the NHS in England is privatising so much of its work, it is recording savings in its costs. The financial arrangements with Scotland mean that if England makes, say, 10 per cent in savings, our budget gets reduced by 10 per cent as well.
Because we’re determined not to privatise, that means we constantly have to do more with less.
The other attack comes from something called TTIP — the Transatlantic Trade and Investment Partnership. TTIP threatens the public ownership of the NHS. If it is implemented, all NHS contracts will have to be tendered and hospitals can make 49 per cent of their income from the private sector. There would be no exemptions.
Already the UK government’s own figures for 2013-14 show that more than £10b was spent on the purchase of healthcare from non-NHS bodies. If this continues, it is going to seriously undermine the capacity of the NHS to provide services in the future, leaving us at the mercy of the private sector.
So a Private Member’s Bill in the House of Commons was tabled and passed its second reading in a 239 to 20 vote. The purpose of the Bill is to pull back from back-door privatisation. The parts of the Bill that apply directly to Scotland would exempt the NHS from the TTIP threat to public ownership.
More than that, passing the Bill would mean that Scotland’s NHS could not be forced to open its doors to private healthcare providers.
While real control over our budget can only come with independence, the SNP MPs are seeking cast iron assurances from the Westminster Secretary of State for Health that TTIP will not impact on the Scottish Government’s ability to determine how NHS services are provided.
So it goes without saying that all six SNP MPs voted in favour of the Bill, and most Labour MPs were there to do the same. However, I note that Jimmy Hood MP didn’t manage to make the vote. The Bill was carried with a hefty majority in spite of those Labour MPs who didn’t bother to back their own party.