You are here: Home / Yes Lochaber / Blog / Threats to the NHS

Threats to the NHS

To accompany our forthcoming meeting on Independence and the NHS Dr. Neil Arnott outlines the nature of the threats to our treasured institution.

Private health care results in those without money not getting the care they need and those with money getting the care they dont need. Nowhere is this more obvious than in the USA where there is a fully privatised system with copayments. Health care in the USA is a multibillion dollar industry but it is estimated that the USA wastes $247 billion per year on unnecessary health care while swathes of the population go under insured or without any cover at all. The Commonwealth fund 2014 report shows the USA spending $8,508 dollar per capita on health care as compared to $3,405 in the UK and, in performance terms, the USA is ranked at the bottom of 11 OECD countries with UK at number 1. The problem of providing healthcare to the underinsured is exacerbated in the remote and rural areas of the USA.

Private health care is like an anxiety tax. Endless amounts of money can be spent on reassuring and seeking out treatments of marginal efficacy. The scenario of anxious people becoming leveraged on debt to invest in unnecessary health care interventions is an obscenity. At end of life rich Americans are afforded little dignity as all the stops are pulled out to keep them alive past the point where any reasonable person would feel this is dignified.

On the other hand those without money or who are not prepared to pay, miss out on preventative medicine and chronic disease goes undiagnosed and untreated until such time as complications make it more expensive to treat. In rural areas patients are particularly disadvantaged by the double whammy of relatively low income, and the fact that services are restricted due to increased cost of meeting geographical barriers.

The 2012 health and social care act or the 'secretary of state abdication of responsibility to provide comprehensive health care' act has set the scene for the end of the NHS through privatisation.

In the UK four things are certain in health care under the right political climate over the next 20 years:

  1. The NHS in England will be privatised. Its well underway already.
  2. A system, of copayments, either out of pocket and insurance payments will emerge.
  3. This will detrimentally effect the Barnet formula funding allocation to Scotland.
  4. The transatlantic trade and investment partnership will not exclude health care in the UK.


The result of this will be as follows:

  1. Without having control over its entire budget, the Scottish government will need to ration health care, increase taxes or privatise and bring in copayments.
  2. Scotland will not be able to withstand the incursion, under free trade regulations, the incursion of multinational or US based private health care companies.
  3. Remaining NHS resources will wither and be either replaced by private health care or closed down if not profitable.


The only way to protect the NHS is to take it out of politics and enshrine a publically funded NHS in the Scottish constitution. The constitution would include the core principles of the NHS from 1948

  1. that it meets the needs of everyone
  2. that it is free at the point of delivery
  3. that it is based on clinical need, not ability to pay


To protect rural and remote areas, a constitution will also include facets of the 1912 Dewar report recommendations for the Highlands and Islands medical service which are:

  1. The right of the individual, regardless of ability to pay to local and accessible health care.
  2. The responsibility of the Secretary of State for Health to provide health care to every individual.
  3. The importance of delivering good quality, well organised and satisfactory medical services.


The only way protect the NHS enshrined in a Scottish constitution is to have an independent Scotland. So a YES vote on 18th September is the safest option for protecting the NHS in Scotland.


This is an archived copy of the Yes Highland website created prior to the referendum in September 2014.

If you are looking for the current website please go to

Yes Lochaber