The Health of Nations

“Only independence can fully guarantee Scotland’s National Health Service.”
– Nicola Sturgeon

I’ve been watching the twisty-turny passage of the NHS bill through the Commons and Lords, with horror mixed with relief. The devolution settlement means that the Scottish NHS is not subject to the same privatisation, and although as with other international struggles, I offer my solidarity to the people of England who are about to be robbed of their NHS, fundamentally I figured it wasn’t really my fight.

Only then it got personal.

This post on Edinburgh Eye points out that Scots travelling to England may not get emergency treatment on the NHS.  Indeed under the provisions of the bill, the clinical commissioning groups (CCG) are not required to provide the following services except to people who actually live in their area

  • Accident and emergency services and ambulance services
  • Services provided at walk-in centres
  • Facilities and services for testing for, and preventing the spread of, genitourinary infections and diseases and for treating and caring for persons with such infections or diseases
  • Medical inspection and treatment of pupils
  • Services relating to contraception
  • Health promotion services
  • Services in connection with drug and alcohol misuse

There has been some discussion over the exact provision of A&E  and it would seem that Clause 12 of the bill does cover emergency services to people living outwith the locale, however how “emergency” is defined is likely to be determined by the CCGs.

There are so many questions over this bill that it brings into question whether Scots travelling to England will require heath insurance to be assured that they will get the care they require should they fall in while travelling – will companies with an English presence have to provide health cover for their staff should they require them to visit or indeed work at one of their English operations?  What is the situation of pregnant women who go into labour while visiting England, or have health complications related to pregnancy – are these covered as part of routine ante-natal care, or excepted as a walk-in service.   Moreover there is the situation of English people travelling to Scotland: with waiting lists likely to be extensive for treatment unless you are prepared to go pay to go private, could we see an influx of the ill coming from the south to be treated from within our budget with no recompense for the Scottish NHS?

Within other countries in Europe there is a reciprocal healthcare agreement in place – whereby the health service of the country that the national of another is visiting provides treatment under similar conditions to the arrangements of their home country, charging the home country for the treatment.  Scots can travel throughout the EU with a E111 card, confident that should they become ill or injured they will receive treatment.  While we are part of the union however, the differences in provision between England and Scotland will be considered a national anomaly, and consequently not one in which the EU can intervene.

Within the Union we are placed in a situation where our revenue is being used to subsidise the profits of private companies making money out of the misery of the sick and injured of England, while we are left in limbo should we visit.  There is a damn good case for the Scottish NHS becoming a competitive provider of services in England.  At least then the profits made would be reinvested back into healthcare, however there is another risk with the NHS Bill.  Under EU competition legislation, companies could argue that the Scottish NHS is anti-competitive and demand access to that market.  This is currently being poo-pooed as pie in the sky, however exactly the same thing happened with BBC Jam; a scandal of monumental proportions which was completely hushed up.  I suggested at the time that such a ruling had a serious impact on the government provision of services – questioning whether BUPA could complain that the NHS is damaging its business – with a precedent set south of the border and within the same legal jurisdiction, the Scottish NHS is vulnerable to a similar legal challenge.

The NHS Bill must be stopped, not only for the people of England who are in the frontline, but also for the rest of the UK, who will suffer the fallout.

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  1. Bugger (the Panda) says:

    Could the author please post a link to the source article in the Edinburgh Eye?


    The Original (Govan) Scottish Panda

    1. bellacaledonia says:

      The link’s there – I have boldened it for the hard of seeing….

      1. Please make the links blue, this is the standard for a link. Bold just means emphasis. Noone shouldn’t have to meander around the page wondering where the links are.

        By the way, I completely agree with the article, but this isn’t a particularly Scottish issue – it affects everyone not in the local area. Raising it as a Scottish issue could backfire on Scotland unnecessarily

      2. Yeah – suppose you are right, in that it affects English people travelling outwith their own area as well. So a Geordie visiting Devon does not have the same rights to treatment as a national of a non-UK EU member state.

        That might well hit domestic tourism – if you can get healthcare visiting another EU country but cant within your own, why not go abroad. Might even see companies with multiple sites taking out health cover for their workers, especially peripatetic ones.

  2. Bugger (the Panda) says:

    Just a thought

    As I live in France I have a French E111 card so an independent Scotland would solve the problem at a stroke?

    1. burdzeyeview says:

      It would. But as Edinburgh Eye points out, health insurance and E111 wouldn’t cover Scots going to England. And they have the gall to claim that indy would erect unhelpful barriers!!

  3. Colin Dunn says:

    Um. Is it just me, or is this article repeated? Para two starts “I’ve been watching the twisty turny . ..”, and then half way down the page it starts again an repeats the whole thing.

    Could just be me, though.

    1. Dave Coull says:

      It’s not just you.

      The entire article has been posted twice.

      1. bellacaledonia says:

        It’s just you, you must be seeing things…

  4. Can anyone reading this article also read the article linked to which tells the sorry tale of BBC Jam. BBC Jam was a free service to schools which provided educational resources based on computer. The quality was excellent – well matched to the curriculum, lots of provision for disabled children. It was totally shut down, all the staff were laid off, small contractors waited ages for their money and the material sat lanuishing on a server.

    The big educational IT companies had mounted a legal challenge complaining that it was anti-competitive because it was free. If this NHS bill goes ahead, you bet your boots all the major companies will try exactly the same trick with our NHS. If this NHS bill goes through we have two years to protect our NHS without the tools to do so, before we can get the hell out of this toxic union

  5. Scottish republic says:

    “”””””””””””The devolution settlement means that the Scottish NHS is not subject to the same privatisation, and although as with other international struggles”””””””””””””

    Nicola Sturgeon said what I’ve been saying for a wee while now — nobody was listening — maybe they are now.

    If you cut the public sector contribution to the English NHS then that means they will do what they did with pensions (they cut the block grant by £100 million to reflect the ‘savings’) — they will cut the block grant eventually by 49% and it’ll be up to us where that funding comes for… that’s a large sum from the block grant. We’ll be forced to privatise against our will.

    That is NOT taking into account the Tories plans to privatise EVERY public sector service there is (‘put out to private tender competition’ — it’s inevitable).

    Tories of all colours are responsible for this — the Labourites just voted for the 49% — even though it’s supposedly lower than 49% but that’s just a hop, a skip and a bill or two to get to 49% (if they haven’t already done it).

    1. Yup I agree.

      I’ve been horribly complacent about the English NHS sell off, but its clear ours is under threat. If this goes through we have two years before we can get out of the union, enough time for them to sell ours off.

  6. John Souter says:

    So summing up – Life UK style 2012. Democracy is a sham – corporate capitalism and financial shamanism is king -the law is an Ass and the legislature and its statutes corrupt.

    Time I think to reaffirm a basic requirement for real democracy – when those representatives chosen to govern fear the people who appoint them more than those who would corrupt them.

  7. pmcrek says:

    Strange how all the scare stories in the press are about Scotland becomming independent and not remaining in the union. Yet, is there anything more terrifying than a Conservative Government constantly challenging Scotland’s democratic rights to provide free healthcare and free education?

  8. Dubai_scot says:

    If one was to stand back and look at this in the context of “internationalisation” it could be argued that this is in essence a rebalancing of wealth. The flow is from the rich western countries to the new family members, China, SE Asia, Africa etc So the pool of “profit” in the UK is no longer seen as sufficient by the financial elite of the world and the cash is now being freed up to be worked elsewhere for a better return. So privatisation of the NHS in England will see the tax payers receiving bills, and you can bet your bottem dollar that this will not be tax deductable. In effect the tax payer will pay twice, just remember TBlair and the Dentists.
    The English need to get a backbone, the Labour party have forsaken their electorate, time to wake up.

  9. Robert Peffers says:

    Very good article. We stand to lose quite a few other things under this Barnett Concequential’s thing. I would assume the SG would treat any loss of funding under this rule as they treat Higher Education fees. After all if we lose the funding the English visitor health funds have already been paid for by the Scottish reduced funding. So where we have agreements in Europe they get treated but the English pay. Like the University Fees it won’t stop them screaming, “Racial Abuse”, accusations.

  10. douglas clark says:

    Why are the English apparently completely unaware of this? There are lots of left wing newspapers and blog sites that ought to see this as a specific attack on the NHS. For goodness sake, they have commented on almost every other aspect of the reforms. But on this there is, it appears to me, complete silence. This is an attack on people, whether they are English or Scottish. The points raised deserve wider dissemination.

  11. Choices made in regards to English further education funding has led to a direct assault on the Scottish principle of free education. Now we can see clearly that choices being made to the English NHS will lead to a direct assault on the Scottish tradition of state provision of healthcare (and as Nicola Sturgeon highlighted at the conference on Sunday, the NHS has roots in the Highlands & Islands Medical Service which pre-dated it by some 35 years). I think we all know that the aim of these Tory NHS deforms is to provide a route to cutting NHS funding, which will launch another direct assault on Scottish principles.

    Quite simply, the union has long passed the point of being moribund, and is now an actual danger to Scotland. It is just not possible for two nations to follow completely opposing ideologies while chained together. The choice for Scotland is simple: do you want services privatised, or not?

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