Scotland grows its own, by Iain Macwhirter

2 Mar 06
Not for Scotland the path well trodden. While Westminster endorses market-based public service reforms, the Scottish Executive is ploughing its own furrow on education, health and immigration. Iain Macwhirter reports

03 March 2006

Not for Scotland the path well trodden. While Westminster endorses market-based public service reforms, the Scottish Executive is ploughing its own furrow on education, health and immigration. Iain Macwhirter reports

There has been a mixed response in Scotland to the soaring numbers of English students applying to Scottish universities. Some nationalist politicians fear these 'fee refugees' are elbowing Scottish students out. But at least this has confounded critics who claimed that the abolition of university tuition fees would lead to a parochial and narrow-minded higher education sector.

Thousands more foreign students have also been making their way to Scotland – a 20% rise this year – to benefit from the two-year extension to their residency visas introduced by the Scottish Executive last year under the 'Fresh Talent' initiative. Now, English universities are starting to complain of unfair competition, and there is pressure for Scotland's visa regime to be implemented south of the border.

These are just two examples of the way in which devolution has introduced a new diversity into public provision in the UK. Scotland always was different, with its own legal and education systems. But the pace of differentiation has been stepped up since devolution in 1999.

Take home affairs. The Scottish Executive has challenged the UK Home Office over dawn raids on asylum seekers, and has been trying to pursue a more liberal immigration policy. Identity cards – if they ever happen – will not be compulsory in Scotland. The Freedom of Information regime here is also much more open than its English counterpart. In its first year, it has been remarkably successful in altering the climate of official secretiveness. Scotland is becoming a more open society.

The Executive has resolved to resist any new generation of nuclear power stations, unless or until there is a solution to the waste problem. If a new generation of Trident nuclear missiles is scheduled for the Clyde, there could be a furious response. Scotland intends to exploit the fact that it has – potentially – some 25% of Europe's entire wind and wave energy.

Proportional representation, introduced in Scotland in 1999, is to be extended to local government next year. This has changed the character of electoral politics by forcing parties to work together in coalitions. The council tax is also likely to be reformed first in Scotland. Free personal care, as recommended by the Sutherland Report, has been well received in Scotland, despite the expense.

But it is, above all, in resistance to New Labour's market-based public sector reforms, with their focus on competition and choice, that the Scottish Executive is embarking on a very different social journey. For Tony Blair, the need for reform is a self-evident truth. This is not the case in Scotland.

At the Scottish Labour Party conference last year, the prime minister delivered a calculated snub to the Scottish government and First Minister Jack McConnell by loudly proclaiming the success of English health reforms that have cut waiting lists, such as walk-in diagnostic and treatment centres. McConnell took it badly. He isn't impressed by the PM's habit of holding Scotland up as a warning of what happens when public services go unreformed. The FM subsequently made it known that communication had largely broken down between himself and the prime minister.

This year, when Blair came to the Scottish Conference in Aviemore on February 24 he went out of his way to praise the Scottish Executive. He cited its total smoking ban and its Hungry for Success programme for improving the diets of Scottish schoolchildren, which the prime minister said has been copied in England. Blair also highlighted the Executive's work on antisocial behaviour orders and the Fresh Talent initiative for attracting foreign students to Scotland.

Departing from the PM's public service message was a bold move for the Executive. On the face of it, Scotland isn't a great advert for the old 'one size fits all' state, in health at least. It gets around 20% more in funding per head than England, yet life expectancy for a male in Glasgow remains around 11 years lower than in the south of England. Waiting lists are finally coming down, but there is no equivalent to the promise in England of an 18-week maximum wait from GP to operating theatre. In the spring of 2005, when the PM delivered his conference speech, the number waiting for day case and inpatient treatment, 113,612, was higher than when Labour came to office.

In education, Scotland does better than England in many of the Organisation for Economic Co-operation and Development's Programme for International Student Assessment (Pisa) scores. However, many Scottish schools are failing. Earlier this month, the chief inspector of schools, Graham Donaldson, warned of the postcode lottery. 'In too many cases, there is an unacceptable variation in the quality of learning and teaching across classes,' he said.

All grist to the PM's mill. But, curiously, this hasn't translated into political demands for the English reforms to be imported. In the recent Dunfermline by-election, Chancellor Gordon Brown was given a severe electoral rebuff in his own home constituency. Hospitals were a big issue – specifically the transfer of orthopaedic services out of the local Queen Margaret Hospital. But there were no calls for foundation hospitals or private treatment centres – except from the Tories, who came a bad fourth. The Scots remain largely immune to the discourse on choice that has informed Blair's war on state monopoly. There is no question here of patients being offered a choice of hospitals in which to have their hip operations. You get what you're given; go where you're told; doctor knows best.

This resistance to choice has puzzled many people, not least Scottish Labour MPs, who find themselves voting in Parliament for restoring the internal market in the English NHS, with payment by results for trust hospitals, even though in Scotland old-style 'predict and provide' prevails. Scottish MPs in Westminster have also voted for variable tuition fees in English universities, when tuition fees have been abolished in Scotland.

They will shortly be required to vote for another Education Bill, possibly including selection and self-financing for English schools, when these have been rejected in Scotland. It is a constitutional anomaly that much irks the English Conservatives. But the West Lothian Question doesn't seem to impinge much on the consciences of Scottish voters.

Scotland remains the last bastion of what the prime minister's former spokesman, Alastair Campbell, dubbed 'the bog standard comprehensive'. No Beacon schools, foundation schools or city academies here. Selection is outlawed (except for Catholics, who have their own schools under the 1918 Education Act). Scots seem content to send their children to the one-size-fits-all schools that Blair insists are failing. Why?

Well, it could be that the canny Scots are just biding their time; waiting to see whether there really is a great leap forward in England following the prime minister's initiatives. They're sceptical but not stupid, and they do care about education – passionately. Jack McConnell isn't anti-reform or even ideologically hostile to the market. But the Scottish Executive has been staying its hand, aware that there are strong cultural and demographic factors at work.

There is much less private education in Scotland than in England (almost twice as many English pupils go to fee-paying schools as Scots) and private medicine is almost unheard of. This is for the rather obvious reason that most Scots can't afford it – only about 60,000 earn more than £50,000 a year.

The biggest private hospital in Scotland, HCI Clydebank, had to be bought by the Scottish Executive two years ago because it was going bust. Expansion of private health is difficult here because there is so little of it.

Another reason is geography. Scotland has a third of the landmass of the British mainland but less than a tenth of the population. The idea of hospitals competing for patients might make sense in densely populated areas such as the English Southeast, but in Scotland it simply doesn't work, unless patients are prepared to travel long distances.

The BMA in Scotland has long argued for the 'collaborative' approach to health care to be continued in Scotland, whereby GPs establish their own contacts with hospitals and simply allocate patients according to availability. There is surprisingly little demand from the medical profession for market-centred reforms, even though GPs are small business people who are contracted by the state, rather than employed by it.

In England, the Blairite reforms have been prompted by the fear of middle-class flight from the state. The increase in the number of people jumping NHS queues to get private operations in the late 1990s forced the waiting list issue to the top of Labour's agenda. The subtext to the latest education white paper – before it was watered down – was to give middle-class parents greater scope to select schools, to stop them going private to avoid the local comprehensive. But in Scotland, most of the middle classes are staying put. It's quite enough buying a house and saving for a holiday without having to start paying for private schools too.

There is also, perhaps, a lingering egalitarianism and collectivism in Scottish culture. Scots are very jealous of the lad o' pairts tradition of anti-elitism in education, and so of course is Gordon Brown, who has campaigned against 'elitism' in Oxbridge entrance procedures. He regards collective provision as a moral virtue – public service is 'a calling, not a career', as he put it in his own speech to the Scottish Labour Conference last year.

Brown believes there is more to public provision than markets and choice, and this seems to be a pretty accurate reflection of the views of many Scottish voters. How much of this translates into his stewardship of the country when he becomes prime minister remains to be seen. But it still goes down well back home.

So, Scotland is pursuing a very different public sector agenda from England. And while the present prime minister is convinced that there is no choice but to promote choice, in Scotland, people seem to have chosen another model. And it is not at all certain yet which is going to win out.

Doctors in Scotland remark on the huge deficits being registered by English hospital trusts. Many believe that the English reforms are becoming unsustainable, and that the invasion of the private sector is going to alter the NHS fundamentally. The disappearance of health service dentistry is held up as a warning of what can happen when privatisation is given its head.

There has been a degree of Schadenfreude in Scotland at the indifferent performance of some English city academies. The teaching profession in Scotland believes that parental choice is largely presentational. They are confident that the comprehensive principle, north and south of the Border, is being rehabilitated now that even Tory leader David Cameron has come out against academic selection at 11.

Of course, seen another way, regional diversity could be regarded as itself an extension of choice. Why not allow Scotland to experiment with a more 'European' social model, while England pursues the 'Anglo-Saxon' road? If Scotland has the political will and legislative power to create a more Scandinavian-style society, then who is to argue?

The only real question is whether England is prepared to pay for all this through the Barnett Formula, or whether Scotland will have to raise its own tax revenue to pay for its own mistakes – and successes.

Iain Macwhirter is political commentator on the Sunday Herald


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