Scotland’s NHS has fallen behind the UK in spending – that must be reversed, argues Ruth Davidson
When I was five years old, I was run over by a truck. It wasn’t pretty.
My leg was broken, my pelvis fractured, the main artery in my leg was crushed and I had all sorts of internal damage, so much so that the bottom half of my body turned black.
The accident happened outside my house in Fife and I was immediately rushed to the A&E department in Kirkcaldy to be stabilised.
Realising the need for urgent specialist surgery, the doctors there transferred me to Edinburgh’s Western General who immediately passed me on to the Royal Hospital for Sick Children. Surgeons there spent hours in theatre working first to save my life, and then to save my legs so that – one day – I would be able to walk again.
It was a long road back. First, I had to have my leg put in traction – with bits of metal poking out from the bone and through the skin like three massive Meccano sets.
When that had done its job, I was back in surgery again to have it removed and was put in plaster from my toes up to my armpits.
Weeks later, it took a circular saw to break the cast off for the next stage of recovery, followed by intense physiotherapy. By the time I returned to school, many many months later, I was the only child who needed a zimmer frame. Large parts of my childhood were punctuated with trips back to the Sick Kids hospital for check-ups, to measure if my legs (now different sizes) had grown closer in height and to see if I could get the wasted muscles back.
Twenty years later, I ended up in a hospital bed again, unable to walk. This time I had broken my back during training with the Territorial Army. Three months in a back brace and another six of physio and I was – just about – back to my old self.
I have more reasons than most to be thankful for our NHS. I – literally – would not be here without them.
Today, there is rarely a week that goes by without the problems affecting our health service being highlighted. Over the winter, we learned that office staff were redeployed to help clean wards such was the pressure on services, while non-urgent procedures were simply cancelled. At the end of May, the latest figures showed that 16,000 patients in Scotland waited longer for inpatient or day case treatment than the 12-week “legal guarantee” – that’s around one in four people not being seen on time. And just yesterday, we learned that a third of NHS boards in Scotland do not offer full access to a life-saving technique to detect prostate cancer, the country’s biggest cause of cancer among men.
Money is not the sole answer to these failings. But there is unanimity that extra funding is required if we are to begin the process of making the NHS fit for the future in the face of the huge challenges to come.
At the end of last month, I gave a speech at Glasgow University backing the calls for additional spending. After ten years where we have (rightly) prioritised the reduction of both the deficit and the tax burden, I argued it was now time to prioritise the NHS over any further reductions in taxation.
I was therefore delighted to support the announcement by the Prime Minister on Sunday that an extra £20 billion will be made available to the NHS by 2023 in England. Thanks to the way the UK is funded, that means an extra £2bn will be made available to the Scottish Government. After nearly a decade where the NHS, like other public services, has had to contend with financial constraints, the extra cash provides the opportunity for the health service to take a deep breath and tackle the future with confidence.
That is – if the SNP does indeed pass on the spending it receives from Westminster. There is, of course, no requirement for the Scottish Government to do so. We know this because, since 2010, the SNP has increased total health spending in Scotland at less than half the rate of increases south of the Border. As the Nuffield Trust said recently: “This has not been caused by an overall squeeze on the Scottish budget, but by the priority choices of Scottish ministers.” The trust added: “The contrast between health spending growth over this decade in England and Scotland is striking”.
This must now end. Such is the squeeze on NHS funding in Scotland, it is now time the SNP reversed this trend. If elected in 2021, a Scottish Conservative government would guarantee that all the £2bn that will accrue to Scotland would be spent on healthcare. The SNP should make the same pledge immediately.
Crucially, the extra funding announced by the UK government is guaranteed until 2023. This marks a break from short-term settlements of the past, which have made it nigh-on impossible for NHS chiefs to plan effectively and with confidence. Providing the NHS with the certainty for the coming five years would enable them to put in place a programme for investment in technology and workforce. This is the way to answer the legitimate concerns of people who fear that the extra cash will only disappear down a public spending black hole. We can avoid that by giving the service the chance to plan properly and effectively.
And if there’s room to agree on the funding settlement of our NHS, I believe there’s room to agree on how we raise the money too. I have opposed tax rises in Scotland above those in the rest of the UK. My concern has been that, by making us less competitive, we only end up damaging the economy in Scotland, thereby reducing the overall tax pot on which public services depend. If we are to look at the tax system as a way to fund the NHS, my preference would be for a UK wide solution – such as national insurance. That will be for the Chancellor to decide over the coming months.
There is a real opportunity here to put our most cherished national institution on a firm footing. Like me, many people across Scotland will have their own personal stories to tell about how the NHS has supported them in a time of crisis. I hope we can agree on a way forward to ensure it is fit for future generations too.