Building Bridges?

Ok , I'm back. And what brought me back was this article today in the Herald. Nicola Sturgeon and her Irish and Welsh counterparts have written a letter to Alan Johnston, asking why he has gone ahead with negotiations about pay deals with NHS workers, without referring to them, and asking him to hold back from any major decisions until they have been consulted. Now, some might see this as political posturing. But I don't see it that way. This is the nub of a far more complex and troubling problem that is the NHS.

The NHS in Scotland, Wales and Northern Ireland has always had a life of its own. But the idea of the NHS was that it was just that; a national health service that delivered an agreed standard of health care across the UK. Over the past few years, England and the rest of the UK have moved further and further apart. England is much further down the road to privatisation than its UK counterparts, whereas the devolved parliaments have largely steered away from this. Wales in particular took a scunner to PFI deals; its parliament shut its Private Finance Unit in 2004. So the question is; is there any point trying to influence what is happening in England, or should we just burn the bridges and keep privatisation out at the border? Judging by this letter from the three health ministers, they have opted to go for influencing the English, rather than leave them to their own devices.

There may be a couple of reasons for this decision. Westminster controls the budget for Scotland (and NI and Wales) through the lump sum that it gets every year. Therefore it still controls Scotland's health budget, although indirectly. If the Scottish Government takes the decision to use central funding for things like the Southern General, it will have to take a bite out of the cake slice that Westminster gives it. Therefore, it cannot ignore what is going on down south.

Secondly, companies such as United Healthcare and Atos are no respectors of borders. If Scotland decides simply to put up the shutters, it might not be enough. Perhaps the fight does have to be taken to them.

The main difference between England and the rest of the UK at the moment, is that England is the only part of the UK that still has first-past-the-post. Consequently, things move much slower politically in England than they do here; there is no room for independents to jouk in and shake things up as the St Johns Livingston crowd did in Lothian. There is not a party in England that you could call the friend of the NHS at the moment, and it is extremely worrying that there is an agreed deafening silence on privatisation of health in England.

So should we burn the bridges or should we cross them to invade? I would go for a third option. England badly needs proportional representation, so that the voice of the ordinary English can be heard on this issue.I don't think the English want privatisation any more than we do. But the people who have not spoken yet, need to find their voice.