Molly Pollock looks at the dangers the Scottish NHS is facing from Barnett formula calculations as England moves increasingly, with stealth towards privatisation. She uncovers the raw truth that Tories are interested in private profit and not on delivering a sustainable publically funded health service for all.
The Barnett formula was first introduced prior to the 1979 general election by the Labour chief secretary to the Treasury Joel Barnett, after whom the formula is named. Initially it was viewed as a temporary solution for determining funding allocations between the UK’s nations, but it has remained in use for over forty years. Up until 1999 and the formation of the devolved administrations it was used to determine the level of UK government spending on public services in Scotland, Wales, and Northern Ireland. Since 1999 the Barnett formula has been used to set the budgets of the devolved administrations.
The Barnett formula only applies to public services that are devolved. If, for instance, the UK government increased the police budget, this would result in additional funding for the devolved administrations in Scotland and Northern Ireland, where policing is devolved, but not in Wales, where policing is not devolved. However Wales would possibly benefit from Westminster’s increased police spending on behalf of England and Wales.
The formula calculates devolved budgets by using the previous year’s budget as a starting point, and then adjusting it based on increases or decreases in comparable spending per person in England.
“For example, if spending on healthcare in England increases by £100m, the Scottish government’s budget would increase by £9.7m since Scotland’s population is 9.7% of England’s. Similarly, the Welsh government’s budget would increase by £5.6m and the Northern Ireland Executive’s budget would increase by £3.4m. Since the devolved block grants are not ringfenced, the devolved administrations would be free to spend the additional money on services other than healthcare.” Institute for Government
What happens in England affects Scotland
Whilst there would always be outlets for increased funding, in reality with budgets tight and borrowing strictly limited, it would be extremely difficult, probably impossible, for a devolved administration to make up any large shortfall in their budget by other means. Which is why the Health and Social Care Bill going through Westminster is so crucial. Apart from paving the way for the introduction of wholesale privatisation of the NHS in England it will have very significant effects on the budgets of devolved administrations.
So more money from private healthcare companies taking over functions in the English NHS means less public money spent on it. And the UK government would surely be keen to cut NHS funding to use the monies in other areas, such as perhaps giving lucrative health contracts to associates (as has been done with PPE contracts) or in further reducing the tax ‘burden’ on high earners.
So less state money spent in England therefore a reduction in the Barnett formula finance for the devolved governments – possibly to the point where because of the cuts in funding NHS privatisation became the only option for these administrations to keep services operating.
The UK Tory government, which is no supporter of devolution and which is working to undermine it wherever possible, would be more than happy to see this happen. If this fails then they have the Internal Market legislation to fall back on. Besides, Westminster, even with a system of devolution, retains overall control and won’t hesitate to overrule Holyrood to get what it wants, especially if opening up our heath services to American healthcare companies helps get desperately neeed trade deals with countries such as the USA.
Privatisation of the NHS in England has been creeping in and has long been the goal of many Tory MPs who have close links with private healthcare companies. According to an article in Ransom Note: “Union group UNITE have released a list of 70 MPs with proven links to private healthcare providers – and here’s the rum bit – all of these MPs voted in favour of the recent Health & Social Care Act, a bill that went a long way towards privatising swathes of the NHS.”
The list is now six years old but the names remain familiar. It can be viewed here.
And what might a privatised health service in the hands of American healthcare corporations offer? Frightening charges outwith the reach of most people judging by this infographic from International Insurance.com But even if you can afford insurance that doesn’t guarantee your medical bills will be covered.
In this Double Down News video Dr Bob Gill, NHS doctor and filmmaker, gives his views. Prepare to be shocked.
The American healthcare system is ‘totally disfunctional, endemically fraudulent and hugely expensive” and the UK government is determined to copy it.
Five of the six Scottish Tory MPs voted in favour of the Health and Social Care Bill – Alister Jack, Andrew Bowie, David Duguid, David Mundell, Douglas Ross, and John Lamont.
Scotland’s only road out of this is to vote for independence.