NOT that we need reminding, but the recent General Election campaign brought into sharp focus the constitutional divide that now completely dominates Scottish politics.
Society has arguably become pretty used to this situation, and most of us accept that there are passionate and principled arguments on both sides. But the fact that the extent of this division could be having an impact on the NHS’s ability to move forward is a concerning development indeed.
A report by the respected health think-tank the Nuffield Trust has concluded that the polarised nature of political debate could make it increasingly hard for the Scottish NHS to take the sort of difficult decisions necessary to keep it afloat in the years ahead. The argument of the report’s authors appears to be that with the SNP government trying to build a consensus on independence at the same time as being attacked by opponents wishing to make political hay on the NHS, it is reluctant to propose necessary but controversial reforms. In other words, the SNP is shying away from serious and honest debate around issues such centralisation, for fear of losing core support.
It’s important to note, of course, that the SNP is not the only political party that could be accused of avoiding an honest debate on healthcare. Indeed, the allegation could be levied at the current Conservative Government that has failed, post-Brexit, to offer full residency rights to the hundreds of thousands of EU-born doctors, nurses and carers, who help keep the NHS running.
We must also acknowledge that the report is extremely complimentary about many aspects of the Scottish NHS, in particular how it trusts clinical staff to drive improvements to patient care, its ability to roll out change quickly and the continuity of policy over the last decade. Indeed, the authors urge other parts of the UK to learn lessons.
But these strengths could be put at risk in future, warn researchers, if the ability to make tough decisions is hampered, especially since Scottish health boards face making savings 4 per cent above the levels of their English and Welsh counterparts.
At the heart of the healthcare conundrum is demand versus funding: how do you treat more people with new and expensive treatments during a time of public sector austerity when so many of us are living longer and have higher expectations of the NHS than ever before? It’s this dilemma that frustrates health professionals, politicians and patients alike.
In light of this, the Scottish Government would be well advised to read the Nuffield report carefully and reflect on how their wider political strategy could be hindering NHS progress at such a crucial time for healthcare. And their opponents should do the same.
Wider society, meanwhile, should allow itself to see through narrow political rhetoric on the NHS and be brave enough to think about the bigger picture. After all, the very health of the nation depends upon it.
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