The NHS in the Union: from its cradle to its grave?

yes_nhs_dennisBy Fiona Bowman – Fiona is a nursing student based in the North East of England and is a former National Treasurer and Vice-Convener of the Federation of Student Nationalists.

Well doesn’t time fly! Only one month to go until Scotland votes on whether or not to become an independent country. One of the main discussion points at the moment is the future of our National Health Service, something I would like to touch upon here.

As a future NHS worker I do think there are real fears over the outlook of the National Health Service. Firstly, no-one can deny that all institutions need to continually evolve and face the modern challenges of the day. We should also recognise that conditions now are vastly improved from the decades and centuries past. But I live in England and when I sit in my local doctor’s surgery I’m baffled every time I see the prescription charge up on the pharmacy wall, which currently stands at £8.05 per prescription (due to increase to £8.25 next April). It makes me question the society we live in. I keep a quote from Aneurin Bevan, the Health Minister responsible for establishing the NHS, on my desk to remind me of the inequalities that still exist today. It reads:

‘My heart is full of bitterness. For when I see the well nourished bodies of the wealthy, I also see the ill and haggered faces of my own people.’

I like this quote as it gives me a constant reminder of one of the reasons why I wanted to be a children’s nurse; to give every child in our society the best opportunity of a healthy and happy start in life. After recently spending time in the community on placement, I have also developed an interest in public health nursing. It is here you get a real sense of the inequalities that exist in society, going from visiting families in privately owned new builds to mould-ridden council houses (which the NHS cite as a trigger of childhood asthma). But this is also where I’ve seen the ways in which government policies and investment can make a real impact on living conditions and wider social determinants of health, such as providing better housing and safe community playgrounds for children to play in. Government intervention can make a difference and I believe we can make more effective interventions in an independent Scotland.

No-one can promise that in an independent Scotland health and social inequalities won’t exist, but it is about reducing the ever-widening gap. Since the Black Report in 1980, successive Westminster governments have failed to deal with the widening health inequalities that exist. It is true, however, that health inequalities can not only be solved through improved healthcare. Indeed, the Marmot report in 2010 (commissioned by the Department of Health, England) put forward the argument that health inequalities emerge from social inequalities indicating that governments have a deeper-rooted problem to solve. Through these types of reports over the decades it has been asserted that there needs to be an overhaul of how inequalities are tackled and funding put in place.

This has not been happening in England while the union undermines our attempts to do this is Scotland. An independent Scotland would give us the opportunity to radically change how society deals with health and social inequalities. By having the constitutional and financial capabilities to commit to substantial transformation of health and social care provision, Scotland can build a fairer and healthier society.

This, in my opinion, cannot be achieved by staying in the union. Through the Barnett Formula, reduced public spending in England means reduced public spending in Scotland. This could directly impact on the health budget in Scotland resulting in cuts to services. More than that, I don’t believe that Scotland in the Union can withstand what will become a growing ideological pressure to follow the trend of privatisation south of the border. The collectivist ideology that may have existed within the Labour movement when Aneurin Bevan introduced free healthcare in 1948 does not exist today and shows no sign of returning.

An example of the routes being undertaken by the NHS in England includes NHS foundation trusts (which we don’t have in Scotland) competing against each other for services. This has been seen recently in the North East of England with children’s heart surgery services between hospitals in Leeds and Newcastle. I understand the need for specialist centres, for example Great Ormond Street, who can care for rare cases but I do not think reducing the availability of this type of surgery in regional areas benefits families. Major hospitals can already be a fair distance away from the family home, so to then make the family travel an extra 2-3 hours would be a detriment to their experience. Currently nursing focuses on two main approaches, holistic nursing and family centred care, and I believe that privatising the NHS and reducing availability of services it makes it harder for the NHS to deliver these approaches. By increasing travel time this may force families to be split up for lengthy periods, especially if the child requires substantial recovery times. Parents need to compensate for many things including work and childcare for other siblings. Scotland has an opportunity to protect the NHS from this reduction of services and privatisation. The level of free healthcare currently provided in Scotland can be guaranteed, but only by the inclusion of this principle in a written constitution of an independent Scotland.

Protecting the NHS in Scotland is only one reason I believe in an independent Scotland. The other key reasons for me include removing nuclear weapons from the River Clyde, returning a government that Scotland votes for through a proportional voting system – not the out date first past the post Westminster system – and having control over our own finances and ultimately our own destiny.

Hopefully this is not new to anyone but it is important to emphasise that this referendum is not solely about the NHS, currency or even Alex Salmond and the SNP. It is about each and every individual voter questioning what kind of country they would like to live in. Vote for the country you would be proud to live and work in. Vote for the country you would be happy to bring your children up in. Vote for the country you would be proud to call home.

I’ll finish on one of my favourite and inspiring slogans of the campaign:

If not us then who? If not now then when? Vote Yes on 18 September 2014.

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Vote No to Foodbanks, Trident and Platitude – Vote Yes for Independence

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By Stephen Bowman

Dan Snow annoys me on multiple levels. For one, he is a TV presenter masquerading as an historian. I’ve still not recovered from reading his article on the BBC website back in February in which he set out to ‘debunk’ ten ‘myths’ about the First World War, and in which he made the mundane and mildly offensive argument that some soldiers enjoyed taking part in the conflict. I’m sure some did, but presumably not those who were cut to pieces by machine-gun fire.

Be that as it may, he’s annoyed me this week by leading a love-bombing campaign of Scotland by some well-known and not-so-well-known celebrities opposed to Scottish independence. Don’t go, they tell us in an open letter published on Thursday. They love us too much. We’ve achieved so much together (presumably including fighting and dying in imperialistic wars). The signatories of this letter include such Scottophiles as David Starkey, who loves the country so much that he’s previously labelled it – along with Wales and Ireland – as ‘feeble.’

In fairness, I’m sure other of the signatories of the open letter – most of whom appear to be based in England, including Scots like Ronnie Corbett – are genuine enough in their affection for Scotland. My main problem with their letter, then, is that it entirely misses the point. Scotland doesn’t feel unloved or disrespected. It doesn’t want to be told how much it will be missed by other parts of the UK (as if it’s actually going anywhere after independence). Despite the content of an article written by the Telegraph’s Tom Chivers, Scotland doesn’t need to be reminded that it has impressive scenery (which most people can’t afford to work or live near to in any case) or a good ferry network. This is all mundane, trivial and platitudinous.

No, the rest of Britain needs to realise that the referendum is not about identity nor about how we want other parts of the UK to think about us. Nor is it really about Anglo-Scottish relations, even if the UK Government and the main Westminster parties seem intent on making it about that through their intransigence on the currency union question. No matter what the Unionist press say, Salmond is correct to argue – as he did in last week’s televised debate with Alistair Darling – that the pound belongs to Scotland as much as it does to the rest of the UK. Scotland can and will use it as it pleases. To argue differently is to argue for a very one-sided conception of Anglo-Scottish union.

Moreover, to argue against a currency union is to argue against economic stability in both England and Scotland post-independence. While I fear that some in the English electorate will welcome the UK Government playing hardball with an independent Scotland, it would be in nobody’s interests if it did so. Not only would Scotland refuse to take a share of the UK debt, but the disruption caused by cross-border transaction costs in the event of a veto on a currency union would damage businesses in England and in Scotland. In which case, the UK Government would be entirely to blame.

So the time may yet come when Scotland does indeed feel unloved by the UK, though I hope it doesn’t come to that. It remains likely that the UK’s opposition to a currency union will disappear in the event of independence. Regardless, the real essence of the independence debate is about policy and democracy. Scottish independence is about how Scots want Scotland to be run. For me, this comes down to three things.

Firstly, the UK Government’s ideological assault on the welfare state. This is something that has resulted in a massive increase in the use of foodbanks and is not something that Labour will reverse if (and it is a big ‘if’) it forms the next UK Government. Scotland needs to leave a Union that is failing utterly to help the poor.

Secondly, Trident. Independence will mean that these weapons of mass destruction will be removed from Scottish waters, and will force the UK to rethink its commitment to keeping nuclear weapons.

Thirdly, EU membership. If Scotland stays part of the UK it will be voted out of Europe against its will when the UK holds a referendum on EU membership in 2017. This will be a disaster for Scotland, as it would threaten its ability to trade with, and receive investment from, Europe. It would also make it more difficult for Scots to travel freely across the continent.

We’re now very close to the referendum. The Yes campaign has had to compete with a hostile and biased press, yet increasing numbers of Scots support independence. The press on Wednesday morning was never going to report that Salmond ‘won’ the debate with Darling. The mainstream media doesn’t like Salmond and it doesn’t like independence. That’s why it totally ignored the snap poll taken after the STV debate which showed a 4% swing to Yes.

Independence will not be won by newspaper editorials, press releases, celebrity letters or TV debates, but by the very real grassroots movement that is leafleting, canvassing and discussing its away across Scotland every day of the week. If you’re undecided, and I know some of you are, please really try and question what’s being written in the press. Chances like this don’t come around very often. Vote Yes.