Scotland's NHS outperforms the rest of the UK...but it is in danger

Healthcare spending in Scotland is £507 higher per person than in England

The NHS has been hammered by Covid, UK Government underfunding and staff shortages due to Brexit. Fortunately, Scotland’s NHS is managed by the Scottish Government. As a result, Scotland’s NHS possesses (per 100,000 people):

  • 95 GPs versus 64 in England and 75 in Wales
  • 1,191 qualified nurses and midwives versus just 654 in England
  • 61 dentists versus just 43 in England
  • 64 student nurses and midwives versus just 41 in England.

And:

  • Scotland was the only country in the UK to avoid strikes by NHS in 2023. Junior doctors accepted a pay increase of 17.5% over two years.
  • Scotland’s Patient Safety Programme has reduced hospital and post-surgical deaths and complications and is held up as best practice by Scandinavian countries
  • Scottish student nurses, midwives and paramedics in Scotland receive a bursary of £10,000 a year, double the UK average and Scottish students don’t pay tuition fees. 

Our NHS is in danger of being sold off

Jeremy Hunt, the new Chancellor, has co-authored a book calling for NHS privatisation. Under his tenure as Health Secretary, A&E waiting times skyrocketed, while cancer referrals and vital operations targets were missed. Despite his weak attempts to blame patients, staff and immigrants for his failures, public dissatisfaction with the NHS, infant mortality and life expectancy all shot up during this time period. Hunt has since fallen upwards into one of the most powerful positions in the UK Government. 

While Scotland has control over devolved healthcare policy, the UK Government still controls the purse strings. Cuts in funding have a real and tangible impact on both the provision of healthcare and the lives of people in Scotland. An investigation into the impact of austerity found that Tory cuts to the NHS lead to just under 20,000 excess deaths in Scotland between 2012 and 2019. 

The threat doesn't just come from the Conservatives. Former Prime Minister Tony Blair has also come out in favour of expanding the private sector role in the NHS. With Labour leader Keir Starmer backtracking on several planned reforms, there is nothing to say that he would be a major change in direction for UK health policy. Labour and the Conservatives are committed to Brexit, so they need a trade deal with the US, who will demand American health companies have access to all NHS contracts. 

Meanwhile, the UK’s new Internal Market Act would give Westminster the power to set up healthcare services and providers based on ‘market access principles’ without the consent of the Scottish Government. In theory, this bill is designed to make trade between the four nations that make up the UK easier after Brexit. In practice, it is a power grab that allows Westminster to bypass devolved legislation. Devolution alone cannot protect access to free health provision in Scotland. As long as the UK has control over budgeting and overall legislation, it has free reign to do whatever it wants. 

In recent years, the NHS has been stretched to its limit. Underhanded PPE deals during the coronavirus pandemic show how the NHS is in danger of being ‘privatised by stealth’, while surveys conducted by the Royal College of nursing show that over half of nurses working in NHS hospitals are considering leaving their jobs. Brexit has also had an impact, with the removal of European healthcare staff from the NHS workforce causing shortages in key specialist areas, including paediatrics and psychiatry. 

In a new paper published by the Scottish Government, protection of the Scottish NHS is incorporated into a plan for an independent Scottish constitution. Independence gives Scotland the chance to protect its NHS, which is as much its own institution as it is a British invention. Only independence can give Holyrood the powers to improve, staff and fund Scotland’s NHS properly and protect it from creeping Westminster privatisation.