The First Minister can only claim to be the health service’s protector with policies that address the crisis identified by Audit Scotland, writes Euan McColm
When those at the top of the SNP eventually grew weary of life on the fringes of Scottish politics, they did two things. First, they ditched their relentless talk about independence. And second, they set about restyling their party in the image of Tony Blair’s New Labour.
This project – started when Alex Salmond returned, in 2004, for his second stint as leader – was hugely successful. Recent events stand testament to that.
A key part of the adoption of Labour’s robes was the audacious appropriation of the status of “defenders” of the NHS. The health service had been the great Labour totem; having established it in the aftermath of the Second World War, Labour would proudly – and justifiably – proclaim it to be its greatest achievement.
But after the SNP’s 2007 Holyrood election victory, the new health secretary, Nicola Sturgeon, was quite clear that only the nationalists could protect and nurture the NHS.
The electorate was ready to listen.
Just as it is obligatory for us all to revere those who work within the health service, it is obligatory for us to feel that they have been failed by politicians. The SNP, nine years ago untainted by power, was entirely blameless when it came to problems – real or perceived – within the NHS. Instead, the nationalists did a very good job of persuading voters that they had arrived in the nick of time to save it.
Sturgeon certainly gave the impression that she was in control of the health service, and streams of selfies with doctors and nurses gave depth to a picture suggesting that she was doing the right things to ensure the NHS would flourish.
And if things didn’t seem to be going well? If waiting time targets were missed or concerns were raised about staffing levels? Well, then there was always Labour to blame.
Sturgeon wasn’t a miracle worker, was she? But she was dedicated to putting right what Labour had got wrong. And Labour – she never tired of repeating – had got a great deal wrong.
In the NHS, the SNP had found a political sweet spot. The nationalists could claim credit for any successes and pass to Scottish Labour, or evil Westminster, the blame for any failings.
But nine years is a long time to get away with pointing the finger at others. Surely, at some point, a government must be accountable for the state of services under its watch?
Last week, the public spending watchdog Audit Scotland warned that the Scottish NHS is not keeping pace with demands made on it. Some health boards may be unable to balance their books. Unprecedented savings will be required in the year ahead. Furthermore, the report stated that performance on six out of eight NHS targets had declined over the past four years.
There should be nowhere to hide for the SNP when it comes to answering the charge that it is failing the NHS. As First Minister, Sturgeon can hardly say Labour was in charge four years ago, when things started to go south on three-quarters of targets, can she?
At First Minister’s Question Time on Thursday, Sturgeon valiantly attempted to throw blame back at opposition leaders. The health service in Scotland had been failed by the Labour-Liberal Democrat coalition defeated by the nationalists in 2007, the health service in England, under the Tories, was in even poorer health.
This shameless whataboutery might have been enough to gee up SNP backbenchers but it didn’t begin to answer the central charge that the nationalists have simply failed to keep their promises on the NHS.
The Scottish Government’s biggest idea on health has been the provision of free prescriptions for all. This is easily spun as evidence that the SNP cares deeply for the most vulnerable in society when the reality is it’s a policy that benefits the better off. Before the introduction of free prescriptions for all, the poorest didn’t pay, anyway. All the policy did was make prescriptions free for those who could easily pay for them.
The removal of charges for prescriptions means a dent in the annual drugs budget of more than £50 million.
This cheap populism undoubtedly helped the SNP gather support for independence (a subject it began talking about again after its second, decisive Holyrood election win in 2011) but it doesn’t stand up to scrutiny. It’s not a great progressive act but a bribe to the middle classes the financial implications of which are now playing their part in the health service’s crisis.
The prescriptions policy is only a small part of a bigger story. Sturgeon, confident and impressive on the political frontline, was seen by many in the NHS as too slickly managerial. Her rhetoric might have been radical but of true reform there was none.
Her successor as health secretary, Shona Robison, faces the same criticism, some of it coming from her parliamentary colleagues who, privately, share concerns about the government’s programme being more spin than substance. This, you may remember, was the charge laid at the feet of the Labour Party by the SNP.
As we look at what has gone wrong in the NHS, it’s important to remember that the SNP’s domestic agenda over the past nine years has been about clearing the path towards independence. This imperative has hamstrung ministers who fear taking big radical steps lest they stumble and harm the party’s chances of winning the constitutional battle (one thinks of former justice secretary Kenny MacAskill’s admission that a decision not to give the vote to prisoners was taken not because he thought it was right but because it might create damaging headlines in advance of the 2014 referendum).
The NHS is a great, unwieldy machine in need of repair. This will require the Scottish Government to be bold, to take risks.
If it fails to rise to the challenges it faces, the SNP’s responsibility for a deepening crisis will be clear for all to see.