A big coronavirus did it and ran away
The SNP can’t blame the pandemic for failings 14 years in the making.
Nicola Sturgeon skipped First Minister’s Questions last week and was replaced by John Swinney. If only he’d had the good sense to skip it, too.
The Deputy First Minister has many qualities but he struggles with the human thing. Specifically, trying to sound like one. He has a voice that is low, flat, and languid. The syllables shuffle out in funereal procession, as though showing signs of life would be disrespectful. It doesn’t matter what he says, whenever you watch him speak you think he’s trying to sell you life insurance.
Having the demeanour of an undertaker and a voice like an elephant tranquilliser can come in handy sometimes, but not when you’re up against an energetic performer like Anas Sarwar. In what was perhaps his strongest FMQs so far, the Labour leader left Swinney looking cold and out-of-touch on the crisis in the NHS. It was an almighty duffing in which Sarwar exposed once again how faulty the SNP has been in its management of the health service.
Sarwar pressed Swinney on the death of Richard Brown, a 55-year-old Glasgow man who, despite repeated 999 calls, died after lying for five hours in a stairwell waiting for an ambulance. The Glasgow MSP linked this death to earlier fatalities and reports of widespread discontent among ambulance workers. This prompted a highly telling response from Swinney, who argued ‘the issue is all tied up with the fact that a whole-system solution is required’.
Not only was it a robotic, technical argument but Swinney sounded like an outsider commenting on the situation rather than a senior minister in the government responsible. This seemed to trigger a detonator inside Sarwar, who exploded in reply: ‘The Deputy First Minister said that the system is broken but who has been in charge of the system? The SNP has been in government for 14 years, so let us not pretend that the problem has just appeared.’
There it was. The problem crystallised perfectly: the SNP is in power but unburdened by responsibility. It can preside over a problem for longer than a decade then, with a straight face, vow to solve it. The Nationalists are like arsonists who set blazes at night and sell fire extinguishers during the day.
The flames are getting particularly intense around the NHS. The tragic spate of avoidable deaths brought about in part by the under-resourcing of the Scottish Ambulance Service is just one facet of a much broader crisis. Ministers do not like the word ‘crisis’ and yet it is the only fitting description for the multiple fronts on which the health service is struggling to cope.
A&E waiting times are recording some of their worst performances since the data began being compiled. Health boards are telling patients to stay away from emergency wards unless their condition is ‘life threatening’ and the health secretary has cautioned the public to ‘think twice’ before calling 999.
The GP-patient link, severed during the lockdowns, has still not been restored, with many having to rely on telephone or video appointments. The NHS is 3,438 nurses short of the number required to run the service and the British Army has been called in to provide urgent cover.
The nurses who are there have voted to strike over pay. Delayed discharges are up and planned operations down, alongside a rise in the number of surgeries cancelled on the appointment date or the previous 24 hours. Dental treatments dropped by 75 per cent last year and four in ten oral surgeons are said to be mulling over an exit from NHS work altogether.
This is not to mention the cervical screening scandal or the waiting times for cancer treatment, the avoidable deaths of child patients of the Queen Elizabeth University Hospital or the lengthy delays encountered when trying to access mental health support. A recovery plan drawn up by the Scottish Government is generally seen as flimsy and not up to the scale of the challenges facing the health service.
Whenever ministers are confronted on these failings, they lay the blame with the Covid-19 pandemic even though the fissures in the NHS facade were visible long before most Scots had even heard of Wuhan. It is a convenient excuse and a risible one: a big coronavirus did it and ran away.
Coronavirus did not bring Scotland’s NHS to this parlous state; it merely cast a brutal light on just how dire the straits are. Politics is a ruthless business but there is something especially low about taking political cover behind a public health crisis that has killed thousands of Scots.
It's true enough that the SNP isn't owed all of the blame. The NHS is permanently in crisis in all parts of the UK. The Nationalists regard this as a get-out-of-jail-free card when it simply reflects the suffocating cowardice of the health policy debate in Britain. We have made a national religion out of a costly, inefficient bureaucracy that delivers mediocre outcomes compared to similar countries and no minister or would-be minister dare say so without killing their political career.
But that pan-UK roadblock to reform is more impassible in Scotland, where ministers aren't even trying to address the consequences of status quo-ism. That is because they are a status quo themselves, a political establishment which overthrew the old order and embedded itself in the years that followed. Health was high on the agenda when Alex Salmond and Nicola Sturgeon were trying to entice voters over to the SNP in 2007. Populist pledges to reverse hospital closures helped secure their path to government, where a populist health secretary — Sturgeon — mostly avoided the sort of difficult decisions that might have put the service on a firmer footing.
Fourteen years is a long time to have squandered and particularly so when you have been running arguably the most powerful devolved legislature in the world. It is not merely a political error. It is a dereliction of moral duty.
Anas Sarwar is beginning to sketch out a critique along these lines which could prise open a debate on the SNP’s performance in health and the gaping distance between its rhetoric and its record. It won’t be easy. The Nationalists rely on Scotland’s weaker democratic infrastructure, which allows them to escape the kind of scrutiny to which the UK Government is subject. But, as Max Weber observed, politics is the slow boring of hard boards and Sarwar (and the rest of the opposition) will have to keep at it until they break through.
What might help is framing the issue in a way accessible to the electorate. Most voters don’t keep up with the latest in nursing recruitment figures or diagnostics waiting times. A blizzard of statistics from opposition politicians means nothing to them. There is a heart to this matter and it must be cut straight to: if the SNP can’t fix these problems in 14 years, exactly how long is it going to take? It’s all well and good saying Scotland should be independent but shouldn’t it have a decent health service in the meantime?
The SNP used to be kept in check by its members' desire to elect more MPs to advance the cause of independence. But when the party gained devolved government, and especially when it proved it could extract a referendum from the British, it gained a new holding position. Even if it wasn't making progress towards a second vote, as long as it remained in power the coming of such a plebiscite was still excitingly proximate. So far this has shielded the SNP from any dissatisfaction its core vote might feel over its performance on the NHS and other services.
It cuts both ways, though. The longer the Nationalists remain in power, the longer their grassroots is made to wait for a second referendum, then the weaker the case to ‘wheesht for indy’ grows. With no realistic prospect of either indyref2 or the SNP being ousted from government, there is waning incentive for the rank and file to put up and shut up. The opposition has made a strong start on Nicola Sturgeon’s record but the more damaging challenge might end up coming from her own side.
Originally published in the Scottish Daily Mail on November 15, 2021.
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