Boris Johnson and the NHS

By Vince Mills

One of the enduring ironies of the referendum campaign is the extent to which the ‘Yes’ camp has attacked the ‘No’ camp for using negative tactics and scare stories and then used precisely the same tactics themselves. What is worse, is that in the process concerns that we on the left share and would want to analyse are subjugated to the simple Yes/No binary, closing down the space for a serious discussion.

The most important area for consideration here is the NHS, but before we look at that, let us consider the issue of Boris Johnson. Enough has been written about the mop top with prime ministerial ambitions to fill a wilderness of dustbins, but not enough of that has focused on the reactionary core of the man’s politics – his elitist upbringing, neo-liberal instincts and social prejudices.  Politically there is probably little to separate him from Cameron except that he has managed to develop a populist appeal based on what is seen as ‘personal authenticity’ which disguises the awful consequences of the politics he espouses – food banks, a working poor and a trade union free economy, a precondition of the first two evils.

In Scotland the possibility of Johnson’s accession to the prime ministership focused less on the swarm of political plagues that would infest Britain should he succeed and more on what it might mean for further powers for the Scottish Parliament. Here is the Scotsman:

“The London mayor stated his opposition to devolving greater tax responsibilities to Scotland as a poll showed he had opened up a big lead over his rivals as the politician the public would like to see replace Tory Party leader David Cameron.

Nationalists last night seized on the intervention to warn that Mr Johnson’s comments offered a “grim insight” into Scotland’s future devolution prospects in the event of a No vote and a Johnson premiership.”

This of course entirely contradicts the implications of Scotland voting ‘Yes’ that its supporters are wont to promote.  The SNP has offered endless assurances that negotiations over the currency and Trident and the myriad of other matters will be a walk in the park given the desire for agreement on the part of the rUK government they insist will follow the acceptance of a ‘Yes’ vote. If Johnson wins, according to their interpretation, we will have a politician with a popular base who appears to be hostile to concessions, thereby increasing the risks to getting a settlement on issues the SNP consider core, like the currency. Admittedly this is less of an issue for those in the ‘Yes’ camp who support an independent  Scottish currency, but that takes us back to the issue of who is actually calling the shots in the independence campaign and like it or not it is not Jim Sillars and Dennis Canavan

The obfuscation of serious socialist dialogue evident in the Johnston case is magnified when it comes to the question of the NHS. In fact the NHS in Scotland has been a considerable success, certainly in comparison to its travails in England and it therefore demonstrates the effectiveness of devolution in delivering Scottish solutions for the Scottish context. As Dave Watson on Unison noted in June in the openDemocracy site:

“Since devolution, the NHS in Scotland has taken a very different path to that of NHS England. It has embraced co-operation rather than competition. And new figures show that Scots reckon that it delivers for them.”

Not that it has saved the Scottish NHS from PFI/PPP and the left certainly needs to discuss how, for example, additional borrowing powers for the Scottish Parliament could help address that issue.

But that is not the discussion we are having at the moment, however.  Instead in language every bit as ‘scary’ as the scaremongering the ‘No’ campaign is accused of, leading ‘Yes’ politicians predict the end of the health service in Scotland as we know it. Here is the BBC website:

“Earlier this year First Minister Alex Salmond warned of a “growing threat” to the Scottish NHS from an agenda of “privatisation and fragmentation” at Westminster.

“Under the Westminster system, cuts to spending in England automatically trigger cuts in Scotland,” he said. “So if private money replaces public funding in England, our budget will also be slashed no matter what we want or need.””

The argument being pursued here is that because the Barnett formula works on increased funding going to Scotland based on an increase in England, then a spending cut in England as a consequence of privatisation will mean less money will go to Scotland.

What is really egregious here is the failure to explain the full horrors of privatisation.  The private sector is not coming into the market to take money and offer care to patients who might otherwise have used public services – that form of privatisation is peripheral.  The point is that services are subcontracted out to the private sector, like hip replacements funded by public money!

Consequently the amount of public money going into the Health Service in England is not falling. It is, according to a report produced by the Charity the King’s Fund which looked at a number of projections, increasing and according to the Treasury’s official Red Book for the 2014 Budget spending on England’s NHS was scheduled to increase from £105.6 billion in 2013/14 to £110.4 billion in 2015/16.

In light of this what are we to make of the Sunday Herald’s Panelbase poll on 17th August on the NHS.  Here is the question that was asked:

“Does the prospect of an increased role of the private sector in the NHS in England having an adverse effect on the Scottish budget which funds NHS Scotland make you likely or unlikely to vote for an independent Scotland?”

If it were true that the increased role of the private sector in the English health service would have such an impact on the Scottish budget then yes, that would be of concern. But as we have seen there is no such reduction. The ‘poll’ therefore was a cheap exercise in propaganda rather than an attempt to help understand attitudes to an area of national importance in both England and Scotland. Despite, or perhaps because of  the questionable wording of the Panelbase poll which the accompanying article claimed showed the NHS was the key to winning women voters, only 42% women said they likely to vote yes on that basis, 38% were unlikely and 20% women were undecided – hardly a ringing endorsement. 

Of course, and rarely mentioned by independence supporters, ‘we are doomed’ if Cameron and the right can win the next election. The UK polling site puts labour ahead in the polls by 36% to 33% which translates, using their methods, into a 32 seat majority for Labour.

I hope that if, as the polls suggest, there is a ‘No’ vote the Left can devote its energies to exposing the damage and the danger that Cameron, Johnson and their ilk pose and discuss radical alternatives including what additional powers a Scottish parliament will need to underpin successes like the NHS.

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