Pages tagged with "NHS"

Since the Brexit vote, Westminster has been determined to take back control - of Scotland. It wants to go back to an old version of the power relationship that predates the era of both countries joining the EU. It is tearing up the agreed legal framework that was established on the basis of the 1997 referendum where devolution was supported by 75% of voters. 

Without consultation or consent, the UK Government is making highly political and ideological changes. Instead of standing by the convention that it should not interfere in devolved areas, the Westminster government sees itself as the owner of Scotland’s sovereignty - and it regards the Scottish Parliament as having none. Therefore it can do whatever it pleases to Scotland.

Ten ways the UK Government is undermining devolution

#1 A hard Brexit was forced on Scotland without consent

The referendum on EU membership delivered an incredibly strong Remain result (62%) in Scotland. The four governments in the UK initially agreed a process that committed them to working together in EU negotiations. This could have provided an opportunity for the views of the Scottish electorate to be taken into account and for consideration of a compromise proposal, something like the Northern Ireland protocol.  In practice, however, the form of Brexit – with the UK leaving the European Single Market and Customs Union as well as the European Union – reflected solely the views of a hardline group of English MPs, the ERG who lead the UK Government. 

#2 The UK Government’s “Brexit Freedoms Bill” - means the freedom of Westminster to do whatever it wants to Scotland

Many of the laws we take for granted, from workers' rights to consumer protection are written into UK law as part of EU laws. The Brexit Freedoms Bill will tear those up - it will effectively give the UK Government so-called Henry the Eighth powers to amend these at will without the usual Parliamentary process for making new laws. It means there could be a race to the bottom with a bonfire, not of red tape, but of citizens’ rights. 

#3 The Internal Markets Act was forced on Scotland

The United Kingdom Internal Market Act 2020 made it illegal for any divergence between the different nations of the UK when it comes to trade. That means that even a small change by the Scottish Government - like putting a 10p deposit on glass bottles is automatically deemed illegal. It would require a specific exemption in the UK act for Holyrood to do that. The Act had to be amended last month to allow Scotland to ban cotton buds, which can end up in the ocean. That is a big change from the previous devolution settlement. Holyrood did not consent to this Act but it was pushed through anyway. 

#4 The UK’s increasingly-lax environmental standards and rights will be forced on Scotland

One example is the UK government is already planning to water down the regulatory requirements on key chemicals, and experts say the UK’s rules are now trailing the EU. One example is glyphosate - Roundup - which research suggests disrupts the immune systems of honeybees making them more vulnerable to colony collapse. It is likely to be banned in the EU but remain legal in the UK. Because of the Internal Markets Act, it would require a specific legal exemption by Westminster for Scotland to effectively ban toxic chemicals from being sold north of the border. 

#5 The UN Convention on the Rights of the Child was partly struck down

Another example is the incorporation of the UN Rights of the Child into Scottish law. This was passed unanimously by Holyrood. England doesn’t recognise these rights - in part because they would apply to child refugees. As a result, it took the Scottish Government to court and struck out several provisions of this internationally agreed convention. In the course of this case, the UK Supreme Court ruled that all of the sovereignty of UK democracy rests with Westminster - the Scottish Parliament has effectively no protection in the courts - despite the massive majority of Scottish people who voted ‘Yes’ to devolution. 

#6 “Leveling up” means avoiding the scrutiny of Scotland’s elected representatives

The UK Government has defined a series of “leveling up missions” covering devolved matters – such as education, health and justice -  without the agreement of the devolved governments and has indicated it does not intend to seek consent, or even consult them over its plans.  

The UK Government also took on new powers to spend money in devolved areas that had been removed from them in 1999. Scotland has received just 3.5% of all Leveling Up funding, despite having 8.2% of the population”. The leveling up funding being distributed by the UK Government fall far short of the funding streams Scotland received from the EU, for infrastructure, remote area support,  investment in science research and more. 

This is underlined by a “UK Infrastructure Bank”, being set up to bypass the devolution settlement

The UK Government’s legislative programme announced in May 2022 includes Bills for a UK Infrastructure Bank with powers to spend directly in devolved areas, without even checking  these decisions respect the priorities of the Scottish Parliament in areas for which it is responsible.   

#7 If the UK Government secures a trade deal with the US that may impact the NHS in Scotland

Ongoing trade talks between the UK and the US include access to health data. There have also been fears that US pharmaceutical companies are seeking access to the NHS in any deal. That could impact prices for new and old drugs. Holyrood would not have the power to say no to such deals and the gradual privatisation of the NHS will impact negatively on Scotland's health budget.

The UK Government has made it clear it will not hesitate to override devolution within the context of international trade deals. A clause protecting the NHS from being on the table in trade negotiations was removed from the Trade Act.

#8 Lack of protection for Scotland’s iconic food and drink brands in the UK government’s negotiated trade deals. 

The UK Government does not consult Scotland over the impact of trade deals on Scotland, even though Scotland is responsible for a third of the UK’s food and drink exports.  The EU recognises 15 protected geographic indicators for food and drink from Scotland - they are special food categories that belong to all the producers in a specific area - like “Shetland lamb” or “Scottish salmon”. Australia does not have these for food, though it has some for wine. Other legal ways to protect iconic brands, like Scotch whisky are expensive and complicated. The document produced by the UK Government on the Australia deal makes clear there is no current protection for Scotland’s food PGIs. This template will be rolled over to other countries such as the USA and represents a problem for Scotland’s high-quality food producers, who could be undercut by people piggybacking on the brand and any promotion. 

#9 The Elections Act 2022 demanding photo id to vote is being forced on Scotland 

The Scottish Parliament refused to consent to the Elections Act but nevertheless, it will cover the general election rules. The UK government's own research suggests that 9% of voters do not have eligible identification. It disproportionately affects those on low incomes. A report said the Act risks damaging trust in the UK’s electoral system, instead of protecting it. Legislation to create free voter id cards has been delayed.

The Wikipedia entry on the Act reads:

"The act was criticised for permitting as acceptable voter identification "an Older Person’s Bus Pass, an Oyster 60+ Card, a Freedom Pass", while not allowing 18+ student Oyster cards, national railcards, or student ID cards. An amendment in the House of Lords to list these as accepted forms of voter identification was rejected by the Conservative government.”

#10 The Vow to maintain the Barnett Formula is being broken

In 2014, the “Vow” that contributed to winning the referendum for the Union included an express commitment to maintaining the Barnett formula. Over time, Barnett gradually reduces Scotland’s budget share anyway. It is based on a per head population count and does not recognise the huge assets Scotland shares with the UK in terms of food and energy production, or the different costs of a more dispersed population in a large area, or the issue of peripherality for the Highlands and Islands, as the EU does.  But even that promise is being broken - the Scottish Parliament’s budget is being cut. Money such as the Leveling Up money is being unfairly distributed - Scotland’s share of that should be handed over to Holyrood. The Scottish Fiscal Commission confirmed in December that: “Overall the Scottish Budget in 2022-23 is 2.6 percent lower than in 2021-22. After accounting for inflation the reduction is 5.2 percent.”  That number will be significantly higher now. 

Conclusion

Far from the promises of the 2014 referendum campaign of ‘lead us don’t leave us’, the UK Government has embarked on a a very different course. Rather than consulting with Scotland’s elected representatives - be they in Westminster or Holyrood, the UK Government treats them with growing contempt. It does not recognise any sovereignty of the Scottish Parliament. Despite the fact it has a handful of MPs and relies on proportional representation to get less than a quarter of the seats at Holyrood, the UK Government intends to bend Scotland to its will. 

The UK Government published a Brexit Benefits Policies Document this week. It sets out a vision for the whole UK post-Brexit - which will not take account of Scotland’s unique situation or separate democratic voice. 

The glossy brochure mentions Scotland only in passing. The UK Government plans to legislate over the UK’s post-Brexit direction without consulting with, or gaining the consent of, the Scottish Parliament. The devolved governments were not consulted over this document or the “Brexit Freedoms Bill” that goes alongside it. 

The report is not honest about the issues the UK is facing as a result of Brexit - it slaps whitewash over the well-documented difficulties many are experiencing. There is no awareness of the different needs or views of the four nations that make up the UK. 

Some of the “benefits” the dossier claims the UK has already achieved are things that could have been done in the EU

• Blue passports - EU countries can have different coloured passports if they wish - Croatia does.
• Crown markings on beer glasses - these kinds of marks are allowed in EU countries 
• Freeports - many EU countries have freeports. 
• - the document doesn’t make clear that all but one are rollovers of deals that were already in place with the EU.
• The Turing system - this replacement for the EU Erasmus exchange programme is much more limited and doesn’t fund students and teachers to come to the UK
• Protected Geographic Indicators - the EU already protects food from specific areas. The report doesn’t mention that the trade deal with Australia doesn’t protect these. 

And some of the “benefits” are politically-motivated objectives

1 Replacing free movement with a points-based immigration system 

It has been well documented that Scotland’s food and farming sectors, care, hospitality, and health have all been damaged by the end of free movement. Crops lay rotting in the fields last year; care homes lost key workers; hotels had to cut their hours. 

An immigration points system designed in line with the needs and political colour of the south of England does not meet Scotland’s needs. 

Free movement also allowed Scots to live and work freely across Europe - the report does not mention this or the 90 day limit for visiting the EU. Neither does it mention the reintroduction of mobile roaming charges or the forthcoming charge for a visa to holiday in the EU. 

2 Replacing EU restructuring funds with the UK Shared Prosperity Fund

The EU focused restructuring money on areas at the periphery of the EU with high need. In Scotland, they partnered with the Scottish Government to decide how to use that money. The Brexit Benefits document says the replacement, the UK Shared Prosperity Fund, “will better align to our priorities”. These are the priorities of the UK Conservative Party, not the Scottish Government. 

It will be up to Westminster to decide where and how - and even if - to spend that money. The UK Government was accused this week of a “straightforward breach of its commitment” to spend the same sums as the EU, by Vaughan Gething, the Welsh economy minister. By convoluted accounting, the UK Government appears to be planning to underestimate what the EU spent, the FT reported. 

3 “Committed £180 million to modernise and streamline our import and export controls”

This is listed as a benefit of Brexit. But much greater sums will have to be allocated to mitigate the snarl ups and snafus caused at Britain’s borders by leaving the single market. Since new import controls were imposed on Jan 1, 2022, queues of lorries entering and leaving the UK have stretched for miles. Many small businesses are now unable to import or export to the EU and Scotland’s economy is suffering particularly, because of its strong food and farming sector. 

The document also lists “taking back control of our waters”. It doesn’t mention that many in the fishing industry feel they were mis-sold and the reality has been little change to fishing rights but much greater difficulty in exporting the catch. 

The report does not recognise the barriers to trade that Brexit has imposed on business. 

4 “£57 billion more for our NHS” 

The report controversially claims that a post-Brexit benefit is increased spending on the NHS. “We are spending more money on our NHS. By the 2024–2025 financial year our yearly expenditure on our NHS is projected to be £57 billion higher in cash terms than we spent in 2016–17, or over £1 billion more per week.” This is misleading. Talking in cash terms hides the effect of inflation. 

The Government plans to raise more money for the NHS budget from its new health and social care levy. It says that will help the NHS catch up with its Covid related backlog. This new money has nothing to do with Brexit - it is a tax increase. 

The document says the UK Government can afford to spend more on health because it doesn’t have to pay money to the EU now. But the loss of easy trade with the single market means that the UK economy is expected to shrink by 4% - that’s more than Covid and that means the Government gets less money in from taxation.

5 A bonfire of regulation

From “reforming and simplifying our public procurement rules”, to reducing driving licence standards for HGV drivers, to changing financial regulations for big mergers and freeing up international capital markets, to getting rid of the EU data protection for private citizens known as the GDPR, the document promises a bonfire of regulation. 

The UK Government plans to replace standards on the environment, animal welfare, chemicals, safety at work with its own regulation-lite approach. The document says the UK Government wants “Regulation only where absolutely necessary. .. This means making the best use of alternatives to regulation.” They want industries to check up on themselves. 

As Ben Chapman in the Independent pointed out: “If ministers want to understand how disastrous and counterproductive this approach can be, they should watch the Grenfell Tower Inquiry.”

Conclusion

The document is vague and lacking in detail. But in general terms it sets out a post-Brexit vision for the whole UK, in line with the values and ambitions of the government in Westminster 

Most of the changes it promises are unlikely to get consent from the Scottish Parliament. The report’s writers seems unaware that parts of this programme (such as the UK Shared Prosperity Fund) are already controversial in Scotland. They do not acknowledge any political differences with the Scottish Government. 

Over time, the approach of imposing unpopular laws on Scotland against the wishes of the democratically elected Government may lead to the sense that the UK Government is ruling without the consent of the Scottish people. That can only increase support for independence. 

One wonders if Alex Massie, a Scot, enjoys talking down his country. But then again, as a Spectator and Times journo, he’s paid to do so. It’s his confusion that’s more concerning. He writes “the present economic case for independence is non-existent” but in the next sentence says “Scotland is certainly not too poor to be independent.”

According to Alex, the reason there’s no economic case for us managing our own affairs – after all Westminster is doing such a smash-up job – is because we have such an enormous deficit. He then follows this with yet more confusion, saying Scotland is a wealthy part of Britain. Which is it, Alex?

Perhaps the IFS’ David Phillips, whom Alex selectively quotes, can assist. Phillips said that an independent Scotland’s economic growth “could more than offset the loss of fiscal transfers from the rest of the UK.” This is from a man whose research is funded by the UK Department for International Development. Phillips confirms that “despite devolution, the majority of Scotland’s tax revenues and a hefty part of its public spending is pooled with the rest of the UK,” adding that “there is no overall Scottish budget deficit or surplus, or accumulated debt.”

And that brings us to GERS, designed by Tories to show what an economic basket case Scotland is and how it couldn’t possibly survive outside the protective womb of the Union. David Simpson, founder of the Fraser of Allander Institute, not exactly a pro-independence think tank, has implored the Scottish Government to cease its publication. We understand David Simpson's reasoning but we think a better idea would be to publish the current UK-GERS report alongside a new report called i-GERs. This would be a projection of what Scotland's finances would look like as an independent nation, with a wellbeing economic approach. Then everyone could clearly see that all the economic arguments against Scotland's independence are just the UK Government's false accounting. 

Simpson points out that since by law Scotland's Government must annually balance its budget, it can’t have a deficit. The deficit Massie is so worried about is fake, assigned to Scotland through UK Government accounting practices, and concocted from what Westminster says it spends “for our benefit.” Among these “benefits” are nukes on the Clyde, helping Saudi Arabia lay waste to Yemen, unemployment payments because Westminster is rubbish at managing the economy, Truss’s private plane to Oz (costing £500,000) to negotiate treaties that hurt Scottish farmers, and paying London £4.5 billion pa to service a UK debt we didn’t create and certainly don’t benefit from.

On top of that, because 85% of social spending is reserved to Westminster, the Scottish Government has frantically tried to mitigate policies like the bedroom tax, miserly Universal Credit and state pension payments and chronic NHS underfunding.

GERS is what Scotland pays to remain in a Union that has failed us. It’s why the Tory and Labour parties are terrified we’ll leave. It’s why they will never concede that Scotland would prosper if we kept our own money, controlled our own resources and could make decisions in Scotland’s, not London’s, interests. And it’s why we must restore our independence.

Fears Are Growing for England’s NHS

Former Conservative PM John Major famously said that the NHS would be as “safe as a pet hamster in the presence of a hungry python” if Boris Johnson and Michael Gove rose to power after Brexit. New developments are causing many to fear that he was right and that bars are being bent on the hamster’s protective cage. 

How does this affect Scotland - surely health care is devolved?
At the moment, health care is devolved to the Scottish Parliament - but the UK Supreme Court has ruled that Westminster only ‘lends’ powers to Holyrood. The UK Government can overrule the Scottish Parliament whenever it wants. There is little that can legally be done to protect Scotland’s NHS without independence. 

FIVE recent developments are causing concern

#1 The Internal Markets Act mandates that any international trade deal the UK Government signs will cover Scotland

The UK Government has made it clear it will not hesitate to override devolution in regard to international trade deals. The Internal Markets Act, which became law a year ago, has the specific goal of ensuring that these deals automatically cover Scotland. 

The UK Gov announcement said the Act would protect businesses, jobs and livelihoods by ensuring there are no “harmful new barriers to trade between all parts of the UK”. It also said “world-leading standards” would be maintained after leaving the EU. However, they have been watered down in many cases - one example was the post-Brexit relaxation of rules on pumping raw sewage into rivers. 

As a result many fear that the UK Government will make deals, especially with US-based, privately owned healthcare providers that impact the NHS in all four UK nations. 

#2  A clause protecting the NHS from being on the table in trade negotiations was removed from the .

The House of Lords inserted a clause into the Trade Bill as it passed through Westminster which would have protected the UK's ability to provide “a comprehensive publicly funded health service free at the point of delivery”. The amendment would also have restricted “the sale of patient data” and protected NHS drug prices but those protections were rejected.

But 357 Conservative MPs voted to remove this amendment to the government's bill.  Trade Minister Greg Hands said: “We do not see the need for this amendment, as protecting the NHS is already a top priority in negotiations.” The Trade Act was passed last year. 

#3 The UK Government is trying to join the Trans-Pacific Partnership. 

After leaving the EU single market, the world’s largest trading bloc, the UK Government wants to make up for some of the huge loss of trade by joining another trading bloc at the other side of the world - the TPP.

To succeed in joining, it will have to sign up to the bloc’s terms and conditions, which include rules to protect drug companies’ intellectual property. These allow them to bloc generic drugs. That would affect the ability of the NHS to negotiate cheap prices for medicines.

Joining the TPP would be seen as a stepping stone to a trade deal with the US. US officials and businesses have repeatedly said that the NHS must be "on the table" in trade talks, with US pharmaceutical companies and healthcare businesses eyeing the UK health market as a source of profit.

#4 Trade deals are likely to give legal protection to trans-national companies’ profits, tying future UK Governments’ hands

When the Conservative Government enters into new international trade deals it signs legally binding contracts. These deals will enable companies to bid for contracts within England’s NHS “market” for services and products. 

The small print protects these companies’ business and profit - any future Government that wanted to get out of these obligations would find the trade agreements contain multiple obstacles and financial disincentives. This means they could incur massive legal costs and have to pay compensation.

5 The new health and care bill (England) allows private company reps to sit on commissioning bodies

The new health and care bill passing through Parliament is the latest in a series of Conservative reforms which aim to create a pretended free market within the NHS with private companies “competing” for public money which is “spent” by commissioning bodies.

This latest form of this allows people with an interest in these private companies to sit on the boards of the commissioning bodies. The rules and protections that were in place under EU procurement rules will no longer apply. The UK Government’s poor track record on public procurement in the pandemic has caused international comment.  Its lack of oversight of the loan scheme caused government minister Theodore Agnew to resign this week, which does not inspire confidence. 

It is difficult to predict with certainty what effect this will have on Scotland’s NHS. But the concern - which is shared by many in England - over the increasing role of private companies is profound. It may make the provision of health care in the UK more profit-orientated and less universal. While Scotland remains part of the UK it may be difficult to resist that pressure. 

Conclusion

There is a degree of urgency in taking steps to protect Scotland’s NHS. The UK Government under the Internal Markets Act has assumed the power to effectively sign Scotland’s name on international trade deals as it wishes. This could burden Scotland with legal obligations which are costly to escape. 

There are challenges for health care provision in the 21st century - dealing with an aging population; implementing new technology; increasing mental health support. An independent Scotland would be able to plan, budget and make policy decisions in line with its democratic choices.

An independent Scotland would be in a much stronger position to pursue its own course with confidence and clarity.  

It should come as no surprise that the mainstream media failed to cover another Scottish health service success - its outstanding patient safety record. In testimony before Westminster's Health Committee last week, Dr. Pelle Gustafson, leading European expert on patient safety and CMO at Swedish Patient Insurer, was asked which country he would hold up as an example on patient safety. He responded, “I would say I am personally very impressed by Scotland.” The Tory MPs’ sharp intake of breath was audible.

Dr. Gustafson praised Scotland’s equal provision of health services to all. “In Scotland you have a long tradition of working, you have a development in the right direction and you also have a system which is fairly equal all over the place. You have improvement activities going on. So I am very impressed by Scotland”. He concluded, “We in the Nordic countries have a lot to learn from Scotland." 

Scotland’s Patient Safety Programme, introduced in 2007, has reduced hospital and post- surgical deaths and complications such as pressure sores, sepsis, and wound infections.

Jeremy Hunt confessed that while Health minister he unsuccessfully tried to lure Scotland’s head of Patient Safety to England. Tellingly, Westminster has failed to introduce a similar patient safety programme.

Scotland’s health service outperforms England’s not only because the Scottish Government provides more funding per head but also because it remains under the control of 14 health boards, each responsible for the delivery of health care and services to the local population.

The Scottish Health Service is threatened by the relentless privatisation of NHS England, where funding, planning and provision of health services are disconnected from each other and from people in local areas. The UK health and care bill apes the US private insurance model where prescriptions, tests and treatments have to be paid for. Emergency services will no longer be provided for everybody in an area. For the first time since 1948, parliament will not determine to whom NHS services must be provided.

The bill will pass because so many MPs and peers have financial interests in the private health sector. Restoring Scotland’s independence is crucial for ensuring our nation’s future health and prosperity.

You can watch the testimony here:

https://www.believeinscotland.org/wp-content/uploads/2022/01/media-watch-socialmedia.mp4