There’s something perverse about the SNP claiming to be the defenders of the NHS. The reason for this can be found in the letter N in NHS. When the NHS was set up in the forties it stood for something that would be available to everyone across the nation. But the nation that was being talked about was, of course, the UK. The people who created the NHS didn’t want a service that would only be available in England or Scotland. They wanted a service that would be available to everyone, no matter where they were from. It was for this reason that they called it the National Health Service.
Over time the NHS has evolved. Health is one of those areas that has long been devolved. We have a Scottish NHS, a Welsh NHS, a London NHS. These are devolved further into various trusts. But none of this really matters for the NHS is still national in the sense that it is something available to every citizen of the UK. It is available to me just the same if I’m on holiday in England or in Wales or in Northern Ireland. It still remains national in the same way in which it was created. It remains something British, something for all of us who live in Britain.
What the SNP are proposing to do is the very opposite of what the founders of the NHS wanted. They want to make the National in NHS apply only to Scotland in the same way that the National in SNP only applies to Scotland. Whereas the founders of the NHS had a vision of something that was available to every Briton, the SNP would like to break up the NHS, in the sense in which it was founded, and make it something that is no longer British but only Scottish. They want to create an NHS for the Scots, while the founders of the NHS didn’t think in those terms at all. After all, one of the reasons for setting up the NHS was that the British people had just suffered together through years of war and privation and no one cared much if you were Scottish or English, such distinctions mattered little when you had been fighting and dying together.
Had they been given the chance, would the SNP have set up a National Health Service in the forties? No, of course not, they would only have been bothered about healthcare in Scotland. But imagine if Nye Bevan had been a Welsh Nationalist and had only been bothered about healthcare in Wales. We would never have had an NHS at all. It was because he had a national vision, which extended beyond Wales that he was able to see that Britain needed a health service that would be free to everyone, no matter which part of the UK the person was from. It was because he was not a nationalist that Bevan was able to create the NHS.
It should be clear then that the SNP are not in the business of defending the ideals of the NHS, they are in the business of wrecking them. The NHS is a British institution and like every other British institution it would be destroyed by the SNP vision of independence. The Scottish NHS would of course continue, but it would no longer be part of the same whole, just as Scotland would no longer be part of the same whole. There would also be an NHS in the rest of the UK. But these organizations would share no more than the same initials. They would be separate organizations, with no more in common than the French NHS or the Australian NHS. That’s what it means when you change the meaning of the word “National” from British to Scottish.
I’ve no doubt that in an independent Scotland the Scottish NHS would provide us with excellent health care. But we would lose something and something quite special, which can be illustrated in the following way. I heard a rather tragic story the other day about someone from Aberdeen who is really struggling with her health. She needs a transplant. Recently an ambulance took her all the way from Aberdeen to Newcastle, because there is a centre of excellence there in the type of care she needs. When a transplant organ becomes available anywhere in the UK, she will be flown to Newcastle by helicopter as will the organ. Our NHS is interconnected in ways that most of are hardly aware of until that time when we depend on an expert or a hospital somewhere quite far away in another part of the UK. What nationalists fail to realise is that it is because Newcastle and Aberdeen are part of the same country that we can expect cooperation like this to happen automatically. The SNP may try to promise that everything would stay the same if we voted to put Newcastle in a foreign land, but independence would change all our lives in ways that are hard to predict.
At present I can expect to obtain good and largely free healthcare throughout Europe if I fall ill on holiday. Moreover there is healthcare cooperation between separate countries like Britain and France. We can hope that these sorts of arrangement would continue in the event of Scottish independence and that we would get the same sort of treatment as a Frenchman gets currently in England. But the interconnectedness of healthcare which at present obtains across the UK does not obtain between Britain and France and over time is liable to be disrupted by Scottish independence. The reason for this is that such interconnectedness depends on our being part of one country, the UK. In all sorts of ways that we barely notice, our everyday lives are influenced by the interconnectedness that exists because we live in a single nation state, Britain. Whatever the SNP promises, they cannot promise that this degree of interconnectedness would continue for independence essentially is about creating a separate nation state. No two independent nation states are as closely interconnected as the parts of one nation state. Once this is understood, it becomes clear that Scottish independence involves the loss of something fundamental and something that we all take for granted. We might not even notice its loss until such time as we need it.