Having worked as an anaesthetic colleague with Professor Mike Dixon for many years, I hate having to write and tell him he is wrong about the safety of the NHS after a No vote (Perspective, 9 August).
I agree that the NHS, particularly in Scotland, is a far better – and more cost- effective system – than that in the United States. However, there are still risks in a No vote.
First, the funding comes to the Scottish Government through the Barnett formula. A few months ago I heard that Westminster was planning to reduce the Barnett formula, though nothing further has been heard of this and presumably won’t be until after the referendum.
Even though I have retired, I remain a paid-up member of the National Health Service Consultants Association (NHSCA) and Keep Our NHS Public (KONP). Through their newsletters, I get information as to how the NHS in England is being dismantled. Through this I learn that the funding for the NHS in England is being reduced. This is likely to feed through to a devolved Scotland.
However, the greatest risk is coming from what is called the Transatlantic Trade and Investment Partnership (TTIP), the fruit of long- running negotiations between the European Union and the US over trade liberalisation. One of its fundamental principles is that services, including state services, should be open to private competition from US multinationals. According to Ignacio Garcia Bercero, the EU commissioner with responsibility for TTIP, health services in Europe will be opened to private competition, but only where privatisation is already established. In other words, where there is an existing state monopoly, foreign companies cannot sue the government in question for unfair completion.
The UK Health and Social Care Act opened the UK system to TTIP because it explicitly introduces a private market in health provision in England. After a No vote, private providers and insurance companies may argue that, since Scotland is not a sovereign state but a region of the UK, it cannot be exempted from competition for health provision. As the UK has made the NHS in England TTIP compliant, it seems highly likely that the Scottish system will be seen as an unacceptable anachronism in a unitary state.
This is the major risk to the NHS and I know that consultant members of NHSCA and KONP in England are reaching the depths of despair. I don’t want to se this in Scotland, which is the reason I will definitely be voting Yes and I would suggest that all medical people in Scotland who want to preserve our current NHS, with all its faults, should vote Yes.
Dr Evan L Lloyd