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Skip to 0 minutes and 5 seconds So, Alan, is health an important issue in these elections? Yes. We know that when we ask Scottish voters what are their main concerns coming up to these elections, health is normally one that reaches in the top three, if not number one. So health is a highly salient issue in these elections. We also see in a context where there have been major disputes with the doctors’ union in England as well. So, that brings the differences in health policy between Scotland and England into relief for these elections. And how has health policy been different in Scotland than in England? Well health is one of these areas, like education, where Scotland has traditionally had a separate system for running the National Health Service.

Skip to 0 minutes and 44 seconds So previously, this was under the control of the Scottish Office. And, like education, it’s one of these areas where there wasn’t really much of an overlap with England. So this is one of the areas that the Scottish Parliament has had exclusive control over since 1999. And we have seen big differences, like again in education, between how the National Health Service has been run in Scotland compared to how it’s been run in England. So while, in England, under the Conservative governments, certainly under Blair’s government, there was a move towards some kind of movement towards patient choice, where patients would get a choice over where they wanted to have their operation.

Skip to 1 minute and 23 seconds And, as such, you have different providers coming in to provide healthcare. So, some hip operations might, for example, be provided in an NHS hospital, but others might be provided by a private sector provider. And the push for health policy in England, has been to have that kind of market in health. And the idea is that this will raise standards and give patients more choice and make the system, overall, more efficient. And that’s mirrored in some ways in education policy where, in England, they’ve gone for much more of a diverse range of providers to provide education. In Scotland, it’s been different.

Skip to 1 minute and 59 seconds So, the internal market in healthcare – the split between purchasers of healthcare, providers of healthcare, that was put in place by the Conservative governments in the 1990s – that was dismantled under the first two administrations of the Scottish Parliament. And the Scottish Government’s policy has been a much more co-operative policy where you don’t really have much private sector involvement and where there’s not a diversity of providers. So instead of going for the market to try and raise standards and improve care, in Scotland they’ve gone for a much more co-operative approach in healthcare. And that’s a theme you can see running through the different parts of Scottish public policy, but particularly in health and education.

Skip to 2 minutes and 38 seconds What kind of commitments and pledges have the different parties been making during the campaign? Well, a lot of the pledges during the campaign this time have focused on more money for the NHS. There’s also been a lot of talk about integrating health and social care, so viewing healthcare much more holistically, and dealing with the problems that Scotland has in common with lots of other countries, like an ageing population. In terms of boldness on healthcare policy, well in the past we’ve seen the smoking ban in Scotland, which really set the standard for the rest of the UK in terms of that policy.

Skip to 3 minutes and 10 seconds And also the SNP has the policy on a minimum alcohol price, which is still working its way through a legal process. Elsewhere, we’ve seen the Labour Party promise also more money and a guarantee to see a GP within 48 hours. So, even this long after devolution, we can still see a lot of divergence between the type of policies that are being pursued in England and the types of promises in England and the types of policies that are being pursued in Scotland.


How has health policy diverged in Scotland, compared with other parts of the UK, since devolution? Alan Convery and Anthony Salamone discuss the NHS and the Scottish elections.

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Scotland and Wales Vote 2016: Understanding the Devolved Elections

The University of Edinburgh