There was a bit of a seasonal pantomime spat in the chamber on December 12 when the Cabinet secretary for health and wellbeing introduced the SNP's action plan for NHS Scotland.
Nicola Sturgeon: "On a day like today, I am certain that great politicians such as Nye Bevan would look on this SNP administration with considerable approval."
Michael McMahon (Hamilton North and Bellshill, Lab): "He was never a nationalist."
The deputy presiding officer: "Order."
Nicola Sturgeon: "I am not sure why, but Labour members seem not to like the reference to Nye Bevan. I am certain that Nye Bevan would thoroughly approve of this SNP government."
So, as we head for the 60th anniversary of the NHS in 2008, has the new government become a standard-bearer for Bevan's vision? There has for a few years been much consensus among politicians of all persuasions in Scotland on the NHS's future direction, dating back to the excellent David Kerr report of 2005. Much of that coalesced around a vision of a distinctly Scottish health service, shunning the market ethos of the NHS in England.
"We set out a plan for a National Health Service based on the values of collaboration and co-operation, not the whims of the market. We affirm a unified structure in which decisions are made in the interests of the people we serve and not to meet the demands of internal competition. "(Nicola Sturgeon, December 12, 2007).
There has been a return to basics on prescription charges: "Next year, the NHS will be 60 years old. Abolishing prescription charges seems a fitting way to mark that occasion. Join the SNP government in ... restoring the NHS to its founding principle of care free at the point of use." (Nicola Sturgeon, December 5, 2007) The new government's view of capital investment also promised to crowd out the expensive use of private finance in getting us the NHS infrastructure we need in Scotland. However, an opportunity has been missed under the SNP's Futures Trust proposals to outlaw further the role of the private sector.
Bevan said: "Powerful vested interests ... compel the public authorities to fight a sustained battle against the assumption that the pursuit of individual profit is the best way to serve the general good."
The new government has not gone far enough in crowding out private profit. New PPP contracts could have been stopped, including all projects in the planning phase. Grants could have been offered for new capital projects, irrespective of the method of procurement. Health boards could be given prudent borrowing powers, and new procurement arrangements could have ensured that staff are excluded from transfer to the private sector. Non-profit distribution models retain higher borrowing costs, profit is still taken out of public services at the contractor level and the so-called risk transfer costs still apply, all leading to the same profiteering and inflexibility inherent in PFI.
Nye Bevan would be hard pushed to recognise his vision in England. He would, however, recognise and thoroughly approve of it in Scotland. The move to re-brand the NHS as the Scottish Health Service reflects the fact that all political parties and most other stakeholders see the NHS in a different light from their UK colleagues and that there remains a consensus around the public sector model. To that extent the Scots do remain standard-bearers for Bevan's vision.
John Gallacher is secretary of Unison's Scottish Health Committee and secretary of the Scottish Partnership Forum
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