Leaders: Scotland’s health | Sir Jonathan Mills

WE SCOTS have become so used to grim research about our nation’s poor health – whether it is obesity, life expectancy, late-onset diabetes or cancer rates, to name but a few – that we are in danger of becoming inured to their message.

Picture: PA

The temptation is simply to accept the appalling picture they paint in a way that nods to our cultural Calvinism. This, we may be tempted to think, is just the way it is. Then along comes a news story like this newspaper’s front page splash today about levels of sickness benefit in Scotland compared to England that demands a response that amounts to more than a resigned shrug.

Given the current state of Scottish politics, this Stirling University research will inevitably become a political football in the referendum debate. But whether it aids or diminishes the independence argument should – for anyone with a deeper and longer-term interest in Scotland’s future – be its least interesting aspect. Instead, our focus should to be to seek answers to the searching questions it asks of Scottish society. And to do this we need to look as much at Scottish culture and the Scottish psyche as we do at the public policy response.

Sign up to our Opinion newsletter

Sign up to our Opinion newsletter

As the researchers suggest, it is far too simplistic to conclude that the solution to having too many people on sickness benefit would be to throw more money at the NHS. Scotland has enjoyed significantly higher spending per head on health for many decades. Experts in the field instead believe resources would be better targeted at improving the work skills, employability and “functional ability” of those claiming these benefits.

The implicit question here, given the higher level of claimants in Scotland compared to the rest of the UK, is an uncomfortable one. Are Scots on sickness benefit less likely than south of the Border to have the personal and practical skills that would allow at least a proportion of them to overcome poor health and move themselves from welfare to work? And if they are lacking those skills, is this a consequence of the unavailability of opportunities to obtain these skills? Or does it suggest that among a disproportionate number of Scots on sickness benefit there is a lack of motivation or willingness to obtain these skills? Here we are into the realm of what has become known as “the Glasgow effect”. Cities elsewhere with a similar social and industrial heritage do not seem to have the same problems to the same degree. So, what is to be done about it?

Scotland is ill-served by both Westminster and Holyrood governments on welfare. While there is a broad acceptance that the benefits bill needs to be reduced, Westminster continues to pursue with undue relish a programme of ill-conceived and punitive cuts that include such Dickensian atrocities as the Bedroom Tax. Meanwhile in Holyrood, Scottish ministers’ only interest in the subject appears to be an eagerness to give assurances that benefits will be protected after independence. There does not seem to be a simple acknowledgement within the SNP government that Scotland has a problem with welfare dependency, let alone a coherent plan to tackle it. This is the kind of difficult issue that requires politicians to be brave, to be bold, and to do the right thing – with little expectation of an quick and easy result to brandish as a victory. A national problem like this requires a national – and cross-party – response, with the aim of a cultural shift that will, if it happens, take a generation to achieve. But first we have to acknowledge there is a problem.

Room for change

For most of the past week Sir Jonathan Mills, director of the Edinburgh International Festival, has been trying to play down comments he made to one of our reporters last weekend. In those comments, Mills made it clear that next year’s International Festival would take no account of the independence referendum scheduled for September 2014. “My planning hasn’t coincided or been influenced by that event,” he said. “I’m not anticipating anything in the programme at all.” The question many people have been asking in the days since is: “Why ever not?”

Writing exclusively in today’s paper, Mills tries hard to limit the damage. He insists there is no “ban” on referendum-linked material, and goes on to claim that issues of “nationalism and nationhood” will be addressed in the festival’s authorised themes – the Commonwealth and the centenary of the First World War. This is disingenuous. If nationalism and nationhood are legitimate subjects for the festival in a referendum year, then why not commission something that directly addresses these topics? Why are the issues inherent in Scotland’s referendum only to be addressed when they arise as accidental grace notes within pieces about other nations and other nationalisms? Mills says “so much can change” before he publishes his programme for 2014. We certainly hope so.