IT MAY turn out to be the spoonful of sugar that helps the medicine in the Autumn Statement go down, but the Chancellor’s intention to free up £500 million for spending on Scottish capital projects is welcome nonetheless.
Of course, this is not a Treasury handout. This is money already in the Scottish Government’s budget, albeit allocated to areas that currently preclude its use for capital projects. Any transfer into “shovel-ready” building or engineering schemes will have to be at the expense of other areas of public spending that are already feeling the pinch.
This does, however, allow the Scottish Government much more leeway to prioritise its spending to meet Scotland’s needs. It will not make the process of choosing winners and losers any less difficult, but it will allow a degree of flexibility in the process that was hitherto lacking.
At the weekend, George Osborne admitted that the process of dragging Britain out of the economic crisis was taking longer than he envisaged. Admissions of this sort from the Chancellor are rare, so this was a significant concession. Indeed, his freeing up of cash for public sector capital projects can be read as a sign of the failure of his key strategy.
Mr Osborne, after all, tried to convince us that private sector entrepreneurialism would step into the breach left by cuts in public spending, ensuring the economic activity necessary to provide the fuel for recovery. This simply has not happened to the extent the Chancellor promised.
Much more of the burden of restoring the nation’s health must therefore be shouldered by old-fashioned Keynesian public spending, with the hope of a multiplier effect of sufficient oomph that it can provide the kickstart the economy needs. There are signs that this thinking will be a major theme of today’s Autumn Statement.
The news from the Treasury is an opportunity for John Swinney, as Scotland’s putative chancellor, to demonstrate some imagination and dexterity in how he deploys this cash. But the transfer from current to capital spending also poses political problems for the SNP and the Scottish Cabinet. Capital projects may be good for the economy, but the benefits are intangible, certainly in the short term. Cuts in current expenditure, on the other hand, are all too immediately tangible.
The cold truth for Mr Osborne is that public spending – however well targeted and cleverly focused on the sectors that can make a difference in a short order – cannot in itself save the country from the dreaded triple-dip recession. The recovery can only happen if the private sector steps up and delivers – and that cannot happen until its customers have some money in their pockets again. Will today’s Autumn Statement provide that spending cash, and instil in the public a degree of confidence that will allow them to spend it? The mark of Mr Osborne’s success or failure will be the ringing of cash registers.
Disquiet over Scottish NHS
IN RECENT years there have been some encouraging snippets of good news from Scotland’s medical and scientific
communities on how the nation deals with cancer.
After a concerted effort by Scottish governments of different political persuasions, there were signs that our frankly appalling record on cancer outcomes was finally being tackled. Instances of many cancers were down, and the process of diagnosis and treatment improved in some important ways. Pioneering work by Sir David Lane in Dundee
allowed us to raise a tentative hope that a scientific breakthrough in cancer treatment might not be far off.
All good, one might think. In fact, it seems we may have been fooling ourselves. Evidence from specialist oncologists to Holyrood’s health and sport committee paints a very different picture. Not only does Scotland offer “an inferior health service”, it is at risk of losing its global reputation for biomedical research.
If supported by evidence, as seems to be the case, this is disturbing news. It is particularly disturbing when the criticism centres on the cancer drugs available to doctors in treating their patients. Evidence to the committee suggests drugs that could and should be available to sufferers are being withheld for cost reasons, but it is the doctors in the
Criticism of the Scottish Medicines Consortium, which advises the Scottish NHS about new drugs and treatments, is becoming a recurring theme in discussions about our health service. This organisation needs to be scientifically authoritative and organisationally nimble. Ministers need to ensure we stay at the forefront of cancer care.