The Scottish National Health Service is separate from the National Health Service which covers England, however, it is intrinsically linked because of the way our public health service is funded. This means that if there is a cut or limit to spending on NHS England by the UK Government then it has a similar decrease in the funding that Scotland receives to fund its NHS.

As a Devolved nation within the UK, Scotland’s taxes are paid into the UK Treasury, a portion of the money is then distributed back to Scotland via a mechanism called The Block Grant and this is calculated by The Barnet Formula.

If Scotland wants to spend more money on its public services – like our NHS – then it has to make up that funding by taking it from some other area of the Budget.

For instance in Scotland in 2023 there were no strikes of NHS Staff as happened in England. The Scottish Government negotiated with the unions and  BMA Junior Doctors accepted a record pay deal in Scotland, the single biggest investment in Junior Doctor pay since the Scottish Parliament was established in 1999.

160,000 NHS staff – including nurses, midwives, paramedics, allied health professionals, porters and others – received an average 6.5% increase in pay in 2023-24. £49.3 Billion – Scottish Government Spend on Public Services Supporting People & Communities

The Scottish NHS has developed differently to the NHS in England through the choices made in Scotland by our Scottish Parliament.

In Scotland NHS prescriptions are free for everyone;  free dental care up to 26 and everyone gets a free check up; regular eye tests are free; free flu vaccine if you’re more at risk from the effects of flu; free period products in many public buildings including schools, colleges and local councils; and you could claim for the costs of food and travel if you’re the parent, carer or sibling of a young inpatient getting hospital care.

In England people pay for their medical prescriptions: here are the current rates –

Prescription charge type	Previous charge (up to 30th April 2024)	New charge (1st May 2024 onwards)
Single charge (per prescription item)	£9.65	£9.90
HRT PPC (valid for 12 months)	£19.30	£19.80
3-month PPC	£31.25	£32.05
12-month PPC	£111.60	£114.50

Whoever is returned to make up the UK Government it will affect the funding of the NHS in Scotland – even though the Scottish NHS is separate.

All of the Manifesto pledges from the Conservatives, Labour and LibDems, are for the NHS in England. The SNP manifesto states that it will pursue the ‘Keep the NHS in Public Hands Bill’ because it sees this as the best way to protect the public health services in every part of the UK.

So let’s look at those election pledges.

The Conservatives: ‘Clear Plan, Bold Action, Secure Future’

On the NHS in England the Tories pledge to:

“Increase NHS spending above inflation every year, recruiting 92,000 more nurses and 28,000 more doctors, driving up productivity in the NHS and moving care closer to people’s homes through Pharmacy First, new and modernised GP surgeries and more Community Diagnostic Centres.”

The Tories will ‘transform NHS Technology and Productivity –

invest £3.4 billion in new technology to transform the NHS for staff and for patients. The NHS Productivity Plan will see NHS productivity grow by 1.9% a year from 2025-26 – unlocking £35 billion of cumulative savings by the end of the decade. We will:

They also pledge to:

• grow opportunities for all types of providers – NHS, charity or independent sector – to offer services free of charge to NHS patients, where these meet NHS costs and standards.
• cut waste and bureaucracy in the NHS, reducing the number of managers by 5,500
• remove bureaucratic obstacles to the use of new medicines, such as the NHS Budget Impact Test

Labour., ‘Change’

At number 2 on Labour’s first step to deliver their government agenda is ‘Cut NHS waiting times’ in England.

In their 5 mission statements they will ‘Build an NHS fit for the future’ at number 5.:

• Cut NHS waiting times with 40,000 more appointments every week
• Double the number of cancer scanners
• A new Dentistry Rescue Plan
• 8,500 additional mental health staff
• Return of the family doctor

To achieve this:

• patients should expect to wait no longer than 18 weeks from referral for consultant-led treatment of non-urgent health conditions.
• in England deliver an extra two million NHS operations, scans, and appointments every year
• introduce a new ‘Fit For the Future’ fund to double the number of CT and MRI scanners
• a New Hospitals Programme
• transform the NHS App
• move the NHS to a Neighbourhood Health Service
• deep reform of social care

Scottish National Party (SNP) ‘A Future Made In Scotland’

The SNP pledge to “Protect our NHS from the twin threats of Westminster privatisation and austerity. The UK Government should back our Bill to keep the NHS in public hands and boost NHS England funding by at least £16bn each year, providing an extra £1.6bn to NHS Scotland.”

The manifesto states: “Independence is the means of addressing concerns over the cost of living and funding of the NHS. We believe the powers that come with independence are essential to building the stronger economy required to boost living standards and public services.”

• Under the SNP, funding for Scotland’s NHS has more than doubled and NHS staffing is at a record high – with far more doctors and nurses per head in Scotland than south of the border
• investing £300m to drive down waiting times
• ‘Keep the NHS in Public Hands’ Bill – . The Bill will stop any UK government undermining the principles and protections of the NHS as part of any future trade deals.
• Boost NHS spending by a minimum of £10bn extra each year to address rampant inflationary pressures and improve performance. This investment into NHS England would generate an additional £1bn annually for NHS Scotland to help meet increasing demand.
• Match Scotland’s NHS pay deals by increasing investment in NHS England staff pay and conditions of at least £6bn. This would deliver around £600m for Scotland that we could invest in pay deals for our hardworking NHS staff
• Stand up for our workforce. SNP MPs will call for the reversal of recent moves by the Tories to stop care workers from overseas bringing their families with them to work in the UK.

Liberal Democrats ‘For A Fair Deal’

The LibDems pledge for the NHS in England is to:

• Give everyone the right to see a GP within seven days, or within 24 hours if they urgently need to, with 8,000 more GPs to deliver on it.
• Guarantee access to an NHS dentist for everyone needing urgent and emergency care, ending DIY dentistry and ‘dental deserts’.
• Improve early access to mental health services by establishing mental health hubs for young people in every community and introducing regular mental health check-ups at key points in people’s lives when they are most vulnerable to mental ill-health.
• Boost cancer survival rates and introduce a guarantee for 100% of patients to start treatment for cancer within 62 days from urgent referral.
• Help people to spend five more years of their life in good health by investing in public health.

Scottish Green Party  ‘Vote Like Our Future Depends On It’

The Greens state that “Scotland manages only 40% of its taxes, while it gets to decide on around 60% of spending. And even in these areas, when Scotland makes decisions which differ from the UK Government, it can have significant consequences under the Barnett Formula, meaning Scotland loses out overall.”

With independence, Scotland would have full control over taxation and financial policy, and could use these powers to choose a different economic path. Prior to independence, the Scottish Greens are calling for full devolution of the remaining taxation powers to Scotland, including powers over Corporation tax, Inheritance tax, environmental taxes and alcohol and tobacco levies, and for enhanced borrowing powers.

• calling for legislation to make it illegal for the UK Government to conclude trade deals which negatively impact UK residents’ access to healthcare services; open up the NHS to privatisation; or compromise public health initiatives such as those to tackle smoking.
• Scottish control over medicine regulation
• modernise the law to decriminalise abortion and repeal the Abortion Act 1967, to ensure everyone can access essential reproductive health care.
• The next UK Government should fundamentally reform the law on the possession of illegal drugs, so that possession of any drug should no longer be an offence.
• The next UK Government must proactively support the rollout of safe consumption rooms in Scotland’s cities.

So although the Scottish NHS is separate, whatever the UK Government chooses to do with the NHS in England will affect Scotland, Wales and Northern Ireland.

The candidates standing in the Orkney and Shetland Constituency at the General Election on 4th July are:

Fiona Grahame