On Thursday NHS consultants in England went on strike, the first time that senior doctors in the NHS have taken industrial action since the 1970s. Strike action in Scotland has been avoided, thanks to an improved pay deal offered to doctors by the Scottish Government, which has shown a willingness to engage with and negotiate with the BMA, the organisation representing doctors, which is in marked contrast to the hard line macho attitude adopted by the Conservative run Department of Health, which oversees the NHS in England.
The NHS is in crisis everywhere in the UK, thanks to many years of Conservative austerity and budget squeezing on NHS England which has had a knock on effect in the block grants from Westminster upon which the budgets of the devolved governments are based. Although health is devolved, and each is ultimately the responsibility of the governments of Scotland, Wales, and Northern Ireland, with only NHS England being run by the Westminster government, the fact that all four of these separately managed health services are in crisis points to deeper structural issues related to UK-wide financing for the NHS. It is therefore not merely facile and simplistic, but downright misleading, to lay all the blame for problems in NHS Scotland at the door of the Scottish Government.
The Westminster government decides how much it is going to spend each year on NHS England, this figure is what is used as the basis for determining how much the Westminster Government pays towards the running of NHS services in Scotland, Wales and Northern Ireland. If the Conservatives squeeze the funding of NHS England it has a knock on effect on the funding allocated to the NHS services under the aegis of the devolved governments.
Although the devolved governments can choose to spend more on their NHS services than the amount allocated to them for this purpose in their respective block grants, they can only do so by cutting back on other areas of expenditure in their budgets. NHS Scotland remains dependent upon NHS England via the devolution settlement’s umbilical cord of funding. This acts to throttle any potential growth In NHS Scotland that might be seen as desirable by the government elected by the people of Scotland.
Should the Scottish Government attempt to boost spending on the NHS by trimming other aspects of its spending The resultant cuts then inevitably lead to the Labour and Conservative parties denouncing “SNP cuts” even as they refuse to say what other areas of Scottish Government expenditure should be cut back on in order to make up for a Conservative squeeze on NHS funding which has been going on for thirteen years. These are the same anti independence parties which steadfastly refuse to countenance allowing Holyrood substantially greater tax raising or borrowing powers. In a very real sense the devolution settlement operates as a mechanism for transferring the blame for Westminster Conservative austerity on to Holyrood.
However it is a Scottish success story that despite the stringent restraints placed by Westminster on the Scottish budget, the Scottish Government has been able to avoid the strike action by nurses, ambulance staff and doctors which have assailed the NHS in England. Of course you’d never know that from BBC Scotland. BBC Scotland consistently goes for the simplistic and misleading take, completely ignoring the budgetary constraints placed upon the Scottish Government by the devolution settlement and presenting the NHS in Scotland as being utterly independent of any funding decisions made by the Conservative Government in London.
But while BBC Scotland is quick to blame the Scottish Government for all that ails NHS Scotland, it does not devote even a fraction of the time it gives to attacking the Scottish Government for failures in NHS Scotland to giving the Scottish Government credit for things going right. Junior doctors in England went on a five day strike last week, a strike which was averted in Scotland thanks to a Scottish Government which negotiated with and engaged with the BMA, the organisation representing doctors. This was in stark contrast to the macho intransigence of Conservative health ministers in England which has created an almost complete breakdown in trust and goodwill and has caused repeated strike action which has caused thousands of appointments to be cancelled or postponed.
The situation in Scotland is very different, yet this success by the Scottish Government was not mentioned at all on BBC Scotland’s “news where you are” and merited just a passing and grudging sentence on Reporting Scotland that evening. Instead BBC Scotland found something else with which to attack NHS Scotland, and by extension the Scottish Government, leading with a story about the shortage of applicants for nursing posts.
Today hospital consultants in England start a two day strike, the first strike action by senior medical staff in the NHS since the 1970s, again Scotland is unaffected, and with its usual dreary predictability, BBC Scotland chose to ignore the success of the Scottish Government in avoiding strike action, and instead found yet another negative NHS story to attack the Scottish Government with.
Before I had even seen the news on Thursday, I said to my other half that because there’s a hospital consultants’ strike in England which does not affect Scotland, BBC Scotland is going to headline some other story which paints NHS Scotland and the Scottish Government in a bad light. And to the surprise of absolutely no one, that is exactly what they did. Today’s lead story in the “bad Scottish news where you are” unlit basement of the BBC is a tale of woe about problems in NHS building projects in Scotland.
New building projects always have a list of problems highlighted by inspectors. It’s called a ‘snagging list’. These snagging lists are routine because such snags are inevitable in any building project. BBC Scotland is presenting it as unusual and another failure that can be pinned on the Scottish Government. But any port in a storm when it comes to distracting from the Scottish Government’s success in avoiding the industrial action which is crippling the NHS in England. Mind you by reporting this the BBC is inadvertently telling people that the Scottish Government is actually building new hospitals, unlike the Tories in England who just lie about building new hospitals.
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