The Scottish Government’s revenue rises and falls in a proportional relationship with rises and falls in English expenditure.
Therefore, although the Scottish Government may determine its own expenditure priorities in devolved policy areas like health, they must fit into a financial coat tailored to suit policies made for England by the Conservative-led UK government.
A straightforward example is that austerity for England means austerity for Scotland. However, there has also been significant policy divergence between Scotland and England on how to pay for public services that, without reform, will cause strain on the seams of Scotland’s hand-me-down coat.
The trend since devolution has been in Scotland to pay for certain public services from revenue, where the same services are paid for in England wholly or partly by the service users.
This goes across the piece, not just the NHS: prescriptions, eye tests, personal care, university degree courses. Furthermore, Labour peers have recently been suggesting for England the introduction of patient charges to see a GP.
It is perfectly reasonable for Scotland to adhere to the tradition of universal provision, rather than removing such services from all but the means-tested destitute, as is the trend in England. If we gathered our own revenue we could spread the cost fairly across all taxpayers and all revenue streams.
However, if we do not acquire powers to gather our own revenue, the consequence for health and other public services in Scotland is this: if the UK government takes a decision to fund a public service in England by service-user contributions, the Scottish Government must make the choice whether to follow suit or make cuts in that service or elsewhere.
In other words, the No campaign would cut Scotland to fit the Conservatives’ UK coat.
Alex Salmond, in attempting to convince voters that the NHS in Scotland is doomed unless we vote Yes, declared that “when the Westminster government privatises services and cuts state provision, those cuts are passed directly on to Scotland”.
This brings scaremongering to a new level. As he well knows, the use of private providers in England is funded by the NHS – and any increase in the use of the private sector does not result in any cut whatsoever to the NHS budget.
Indeed, it could be argued that providing NHS services through private companies is more expensive than that provided directly by the NHS.
The privatisation agenda in England started several years ago, and if his scare story is true, we should have seen a cut in NHS spending by now. Instead we have seen a steady increase in the NHS budget both north and south of the Border.
The Yes campaign scathingly refers to privatisation in England, and is trying to give the impression that the NHS in England will be dismantled and replaced by an American-style insurance system paid for by individuals.
There is absolutely no evidence for this, and indeed any political party which proposed this in England would be committing electoral suicide.
Devolution has allowed Scotland to run our NHS as we wish, unaffected by the different approach in England, and any suggestion that we can be forced to convert our NHS to a private system is utter nonsense.
(Dr) David Love
I believe Neil Finlay MSP (Letters, 19 August) wilfully chooses to distort the issue over NHS funding. The issue here is not whether a fully devolved NHS in Scotland can be forced to introduce wholesale privatisation.
The issue of what will be defined as public spending on the NHS in England and Wales with its implications for reductions in the block grant to Scotland through the Barnett consequentials is something we will only find out about for sure when it is imposed upon us by Westminster.
In my view, the real threat to the NHS and all public services lies in the swingeing cuts to general public spending which will be reflected in cuts to the block grant (following the 8 per cent cuts which we have already had to endure) which have been promised by the coalition and which Labour have promised to “honour”.
This is what will follow a No vote if we’re foolish enough to do so.