Staying in UK is healthiest option for NHS

I SUPPOSE it was to be expected that the NHS would become an electoral football, to be kicked about in the sad old “free versus private” game in the hope of picking up votes. Yet it never has been free and can’t ever be free: it’s paid for out of taxes and every pound spent on it is a pound less to spend on other services.

In the present age, health problems related to lifestyle choices absorb a large proportion of the NHS budget. It needs pointing out that the NHS, as presently constituted, is just an insurance scheme, with the premium compulsorily collected through taxation. But what rational insurance company would not penalise the bad driver or the careless householder, who repeatedly lodges claims?

My vote would go to anyone who recognises the urgent need to create a significant financial incentive for individuals to accept a greater responsibility for their own health and to dispel the notion that anyone needing medical attention has exactly the same moral claim to it as anyone else.

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The child with a genetically determined and incurable condition is not in the same category as the lads needing patched up after a drunken brawl on a Saturday night. The suggested treatment tax on alcohol suffers from the same flaw: the responsible drinkers fund the treatment of the irresponsible. We surely need to develop a sympathetic, supportive and constructive policy which places a significant part of the financial burden of care for lifestyle-dependent conditions directly on those individuals whose choices have contributed to their conditions.

No doubt poverty is a contributory factor, but it’s the causes of poverty that need tackled, not merely its symptoms. Higher real wages are needed and these can only come from increased industrial productivity – and a redirection of tax revenue (or a reduction in taxation) towards the achievement of that would be money better spent.

In the short run, those advocating separation should reflect on the fact that more than 20 per cent of English income-tax revenue is paid by those earning £200,000 or more (top footballers, university principals and the like), whereas in Scotland the share is less than half that (HMRC figures); in absolute terms that means the English tax take is about 25 times larger. Separation will mean losing a Scottish share of this revenue, so funding even current levels of public expenditure must surely mean higher levels of taxation on lower incomes to compensate. Or do we really want oil tax revenue to be squandered trying to fill the hole generated by the negligently ill?



Largs, North Ayrshire

“The Scottish Parliament has responsibility for the health service and that means we can protect NHS budgets.” It’s not often that I quote the SNP manifesto, but this says much about the advantages of devolution. More recent SNP distortions, however, suggest that NHS England is on the verge of “privatisation” and only independence can “save the NHS”. It is, however, clear – as with the pound being a “millstone” and European Union “legal advice” – that Alex Salmond has conveniently changed his tune to scrape up Yes votes.

A Freedom of Information request last week proved that even NHS Scotland has spent nearly £500 million on private services during the SNP’s tenure, a rise of 23 per cent during the period of power.

While this makes up only a small proportion of the total budget, it shows that outsourcing to private companies is not unique to “Tory” England. Neither does it mean compulsory healthcare charges at point of delivery. The coalition’s ring-fencing of English health budgets, whether spent publicly or privately, also guarantees that Scotland’s block grant is safe. 

Scotland receives around £200 per head more in health spending than the UK average due to differing health needs and lower population density. Given Scotland spends far more than we make in tax, this would have to be found elsewhere if we voted Yes. How exactly is turning away from this cash going to “protect” our health service? We may be a rich country, but Scotland does not have a bottomless purse – and becoming smaller can only make things harder financially. While we increasingly face difficult healthcare decisions, one easy choice is saying No Thanks to better protect our NHS – UK-wide.


Edward Drive