Leaders: Picturing the way forward | Life-changing hope

WRITING in this newspaper today, Michael Moore, the secretary of state for Scotland, spells out why the UK government of which he is a member will not get into discussions with the SNP now over how the break-up of the United Kingdom would proceed in the event of a Yes vote in the independence referendum.

He is well within his rights to do so, and it is the correct judgment. Not just because it is politically foolish for either side in this campaign to get into protracted discussions predicated on their side losing. But also because a moment’s thought about this subject would show the utter impracticability of a Scottish minister such as Moore involving him or herself in such a debate.

Let us imagine, for a moment, that Scotland had voted Yes. The resulting negotiations would be carried out between two sides that were defined not by politics but by geography. The Westminster side would be representing the interests of ­England, Wales and Northern Ireland. A Scottish MP such as Moore could have no role in representing this side. All Scottish MPs at Westminster would be in a curious kind of constitutional limbo during the negotiations. Moore’s political allegiances would switch, and he would have to resign from the government. All Scottish MPs would have their constituents as their primary responsibility, and would want the best possible deal for Scotland in the independence talks. Given Michael Moore’s inside knowledge of the workings of the UK government, he might actually be a very useful adviser to the Scottish negotiating team.

Such are the dizzying complexities and fascinating paradigm shifts a Yes vote would entail. Moore’s refusal to pre-negotiate independence is understandable, but that does not stop the rest of us embracing this debate. In fact, it is important that the likely process of negotiation in the event of a Yes vote is fully explored in the media, academia and the blogosphere, and serious thought given to where those talks might lead. Areas of contention need to be identified early, and then analysed to see with what ease – or difficulty – they could be unknotted. Exactly how would one go about dividing the assets and liabilities of the United Kingdom? How, in the first instance, would these be evaluated? How long would this take?

The language Moore uses today is interesting, describing the UK as a “family” and – although he does not use the word – likening the division of assets to a divorce. This is an echo of the Scottish Labour campaign against the SNP in the 1999 election that used the slogan: “Divorce is an expensive business.” Although unwilling to get involved in pre-negotiations, Moore will be more than willing to try to frame the debate.

It is important that Scots realise just what they would be taking on in the event of a Yes victory. Some may find this an energising and exciting prospect. Others may anticipate it with a feeling of dread. But we should have a clear-eyed picture of what it would entail, unclouded by wishful thinking either way. This newspaper will play a full part in that process. We will do so not because we anticipate a Yes outcome – it is far too early to predict what the referendum result will be. Nor will we do it because we favour one or other side – we will not be making a judgment until much nearer polling day. We will be doing so because it is important that Scotland, if it chooses to be independent, in so far as possible, is not taking a leap into the dark.

Life-changing hope

No-one can doubt that the decisions facing the Scottish Medicines Consortium are often fraught with difficulty. At a time when pharmaceutical companies are pushing back the boundaries of medical science, it is a simple fact of life that the NHS cannot afford to pay for all the advances that emerge. However, it is the SMC’s unrewarding task to weigh up the incalculable value of life against the all-too calculable cost of saving lives. So, when faced with a new drug costing an exorbitant £182,000 per person per year – which is the bill for the new cystic fibrosis drug Kalydeco – there have to be very good reasons indeed before its use is agreed.

In the case of Kalydeco, as we report today, the clinical case appears to already have been made. Short of a cure, it is the best treatment there is. And then there are the patients themselves; mostly children and young people. This is not a drug that offers the prospect of adding a short extension to life – as so much of NHS activity currently involves. It is a drug which, for as many as 80 young people around Scotland, offers the chance of health and a much longer and more fulfilling life.

In England, the National Institute for Health and Clinical Excellence has now backed the use of the drug. It must be hoped that the SMC will decide to follow suit tomorrow and offer Scottish children the same hope as children in England are already receiving.