IT SEEMS nigh on impossible to write about Scottish politics at the end of 2014 without mentioning the independence referendum, so let’s get it out of the way. I promise to be brief.
If the great constitutional battle that dominated the year was about something more than hating David Bowie and shouting at BBC-owned buildings, it was about the kind of country we want to live in.
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Both sides, Yes and No alike, described their visions of how Scotland might be a fairer place. Despite disagreeing on whether their ambitions could be better achieved if Scots voted for independence, everyone said that a fairer Scotland sounded like a marvellous thing.
A key plank of that story about compassion was the NHS.
The SNP insisted that only a Yes vote would protect this great institution from the danger of privatisation. The party’s unionist opponents said health spending in Scotland was in a bad way, and accused the Nationalists of diverting cash away from the NHS.
Anyway, the referendum’s done and that’s that. We now know the constitutional settlement under which the majority of Scots would like things to start getting fairer.
The issue of the NHS, however, is most assuredly not dealt with and we can expect it to be a key battleground in the months ahead.
Scottish Labour leader Jim Murphy has – just as Labour’s UK leader Ed Miliband has done south of the Border – made the health service a campaign priority for 2015.
In his pre-Christmas reshuffle, Murphy promoted Jenny Marra to the position of shadow cabinet secretary for health, and we can expect her to have a high profile. Marra is close to Labour’s deputy leader, Kezia Dugdale, so we might even see a rare feat of joined-up thinking between senior Scottish Labour politicians.
The Labour party may boast of being the founder of the service but, since coming to power in 2007, the SNP has done a decent job of characterising itself as its custodian.
First Minister Nicola Sturgeon spent five years as health secretary, carefully building the story that the NHS was only safe in SNP hands, and her continuing success owes much to her reputation as a competent captain of that particular ship.
So there are good political reasons for the Labour party to go hard on the NHS. If the opposition can find ammunition here, then they may be able to undermine the First Minister.
The NHS in Scotland underwent extensive reform some years ago, when the oncologist Professor David Kerr was commissioned to examine the structure of the service.
But Kerr’s recommendations – including the creation of specialised centres for major illnesses – were implemented shortly after the SNP’s first election victory more than seven years ago.
Since then, the headline news on Scottish health has been “free” prescriptions (which aren’t free because nothing is free – the drugs budget has been plundered to the tune of £50 million a year to pay for this universal benefit) and free parking at hospitals, which is useful both for those visiting relatives and people on shopping trips.
An accusation levelled at Sturgeon is that her stewardship of the NHS was too managerial; that she preferred the calm of coasting to risking the potential political problems that might be thrown up by carrying through reform.
Some creative thinking from Labour on health, then, might fill something of an ideas vacuum.
Labour has to come up with more than headlines on the NHS. Polls show the SNP on course for unprecedented success in the next general election. An ICM survey published on Friday gave the Nationalists 43 per cent to Labour’s 26 per cent.
In order to combat this drop in support, Scottish Labour has to appear to be a party of real substance. A sceptical electorate will want to hear more from Labour than a few jabs about waiting times.
Marra has an opportunity now to draw up a new blueprint on health for Labour. This will be no easy task, but she’s smart and driven and well supported by the leadership team, so we should expect a new story in the New Year. As well as ideas for reducing waiting times and improving GP access, Marra will require a broader public health strategy, looking again at how we tackle Scotland’s appalling record on heart disease, cancer and strokes.
There is no doubt that the SNP’s soaring poll ratings make Labour’s task doubly difficult. A rush of new supporters to the Nationalists suggests that, for a great many voters, the constitution trumps everything. During the referendum campaign, evidence of a failure by the Scottish Government to invest in the NHS was dismissed by many as scare-mongering. Proof that health boards feared about the levels of service they would be able to provide in the face of falling budgets was just more “Project Fear” nonsense.
Some will, no doubt, continue to play that game, but Sturgeon, who will not be campaigning in 2015 on a pledge to hold another referendum, can’t afford to do so.
Labour’s argument in England and Wales is that the Tories are a danger to the health service.
Unfortunately for the SNP, that was their argument during the referendum. Although responsibility for health is devolved to Holyrood, the Nationalists made the case that the way the NHS was run south of the Border had a direct impact on services in Scotland. Vote Yes to save the NHS from Tory privatisation, remember?
Why then, Labour politicians might ask, is it worth voting SNP if it risks further Tory control of the health service.
Sturgeon’s current poll lead isn’t set in stone. She has to work to maintain that, obviously, and that will necessitate new stories, including one on the NHS.
The First Minister may have spent much of the year saying the health service was in danger because of the Union, now she has to convince us she knows how to make it better despite the failure of the Yes campaign.
The health service has played a crucial part in Nicola Sturgeon’s rise to power. Jim Murphy hopes it may yet play its part in her downfall. «
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