Aug 292014

Eilidh Whiteford

With thanks to Dr Eilidh Whiteford MP.

Nobody likes to go to the dentist – least of all me. But the only thing worse than the dentist is not having an NHS dentist when you need one, which was the situation for thousands of people in Scotland, including the north-east, until just a few years ago.

One of the early steps taken by the Scottish Government in 2007 was to open a new dental school in Aberdeen and significantly increase the numbers of trainee dentists and increase the level of NHS dental provision across the country.

Just this week, figures were released showing that there’s been a 30% rise in the number of NHS dentists since the SNP came to power, and that over ninety per cent of children are now registered with an NHS dentist, compared to 67% in 2007,  and 84% of adults compared to just 46%.

One of the big questions being asked in the independence debate over the past few weeks has been the future of our health service following either a Yes or No vote.

While NHS Scotland is entirely devolved, spending decisions made in England determine the amount of money allocated to Scotland to pay for public services.In Scotland we’ve chosen to keep our NHS in public hands. We do not charge patients for prescription medicines, and we’re investing in new and upgraded hospital facilities.

We’ve also honoured the pay agreement made with nurses, and ensure that everyone working for our NHS is paid a living wage. Our NHS is not always perfect, and faces some real pressures as the baby-boomer generation starts requiring more age-related healthcare. Nonetheless, most of us depend on access to NHS care and value the service we receive.

The story in NHS England is very different. As the NHS there has been gradually broken up and the lucrative bits privatised, a number of Health Boards have gone bankrupt, waiting times have soared, and there’s a total post-code lottery of care. The Westminster Health and Social Care Act 2012 has big implications for the funding of NHS services in Scotland because the expected cuts to spending down south will have a knock on impact on the money allocated to the Scottish Government.

In Scotland we contribute more revenue to the UK Treasury per head of population than the rest of the UK – and have done so in every one of the last 33 years. However, Westminster remains in full control of the amount of money we get back.

This ‘block grant’ calculated through the Barnett Formula is dependent on the UK’s spending priorities, so cuts to health and social care services in England reduce Scotland’s allocation. For every £100 cut to England’s NHS expenditure, £10 will be cut from Scotland’s budget. It’s a convoluted system, rather akin to handing your next door neighbour the entirety of your salary, and receiving pocket money back.

With a Yes vote, the power to set our budget in line with our priorities will enable us to continue to provide healthcare free at the point of need.

With a No vote, the situation is far more uncertain. Many respected authorities believe England won’t have an NHS in 5 years time, and if we follow Westminster’s path, it will become increasingly difficult to maintain services here. We also know that we face big cuts in the block grant in the event of a No vote, with all the UK parties promising cuts to the Barnett Formula, and more austerity.

We have a once in a lifetime opportunity to take Scotland’s future into our own hands in September. With powers over our own budgets we can provide security for our NHS, and set ourselves priorities suited to our own needs and circumstances.

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