Talking-up Scotland

This positive forward-looking and imaginative report by Robert P Ingram, Ronald R Morrison, Gordon G Benton of the Centre for Scottish Constitutional Studies deserves wider attention than it is getting.

Link:

ProspectusSHARE

From one of the authors:

I was asked to take a look at an initial draft of ‘The Prospectus for an Independent Scotland’ and over the last three months got more involved in it that I ever imagined I would be. The sheer scope of the paper was limitless, and together, finally with some help from my daughter Shona, we finally put to bed what we hope will be an interesting and valuable draft discussion document, arguably for the first time setting out what would have to happen and what, with the Scottish people’s approval, what could happen after Scotland achieved its Independence. For many in Scotland at this extraordinary time in UK politics, this is not too far away.

 

It was increasingly clear from the media, especially the ‘readers letters’, that the Scottish voters were not at all sure what the prospects for a free Scotland would be, and in what form it would take. This Prospectus addresses 20 of the main issues, setting out the Authors’ ideas on what the future immediately after Independence would be and additionally, going to be.

 

I have attached a copy for your interest. Some of you may not, but many of you will have some interest in seeing in your lifetime an Independent Scotland, but whatever your political views, and whatever your particular interest (not to say real experience that can be brought to bear on different subjects), any constructive comments (positive or negative) would be most important. Critique  will have a significant impact on the final document proposals.

 

With Very Best Wishes, and hoping to hear from you shortly if find any of this of interest.

 

Gordon.

They were called out at 02:38 but there’s no mention of the response time in the MSM reports so I feel sure there were no complaints about it and thus no opportunity to revisit their earlier scare stories about staff shortages. A local resident told TuS that they were there ‘quicker than you could tell Ruth Davidson was lying, like, ken!’

Using Reporting Scotland editorial guidelines, TuS is no able to re-use our earlier report to harp on about the Scottish Fire Service’s good figures:

Here are the official statistics revealing staff numbers, especially the ‘crucial’ part-time, retained, firefighters, to be fairly constant. English figures for context, later.

‘Staff Headcount On 31st March 2018 Scottish Fire and Rescue Service (SFRS) had a total headcount of 7,776 staff, which is down 0.7% on the total last year. The 3,546 wholetime operational staff (full-time firefighters) make up the largest staff group at 46% of the workforce. This was a reduction of 2.7% on last year’s headcount for wholetime operational staff. Retained Duty System staff make up the next largest group accounting for 37% of staff with a headcount of 2,863. This is relatively unchanged on last year. The largest proportional change is in the control staff group which increased by 24 (14.5%) in the last year, bringing the total up to 189.’

https://www.firescotland.gov.uk/media/1316680/sfrs_fso_stats_2017_18.pdf

In England, from 2011 to 2017, the total FTE of firefighters (full-time and retained) decreased from 43,360 to 35,620, 17.8%!

https://www.ethnicity-facts-figures.service.gov.uk/workforce-and-business/workforce-diversity/fire-and-rescue-services-workforce/latest

Comparing Scotland with England:

Scotland has 6 409 firefighters while England has 35 620. So, England has 10 times the population but only 5.5 times the number of firefighters. Before the Tory cuts, the ratio would have been 7 times as opposed to 10 times. Bearing in mind Scotland’s larger area per head of population, that might not seem unreasonable.

And, deaths in fires are falling:

From BBC UK News in December 2018:

‘Fire safety checks across England have fallen by 42% over the last seven years, according to the new watchdog for fire and rescue services. HM Inspectorate of Constabulary, Fire and Rescue Services says brigades do a good job in emergencies, but amid cuts have reduced “vital” prevention work. The watchdog said the number of audits carried out by firefighters dropped from 84,575 in 2010-11 to 49,423 in 2017-18.’

https://www.bbc.co.uk/news/uk-46627987?ns_mchannel=social&ocid=socialflow_twitter&ns_source=twitter&ns_campaign=bbcnews

In Scotland, published in August 2018:

‘The number of fire safety audits carried out in 2015/16 was 9,829. Most of the premises audited by the SFRS have relatively adequate fire safety measures and are categorised as ‘broadly compliant’ (9,180 audits: 93%). While 79% (7,779 audits) of the premises audited have average or low levels of relative risk.’

https://www2.gov.scot/Resce/0053/00530445.pdf

In Scotland 2015/16, 9 827 safety audits were carried out. England has 10 times the population and so, all things being equal, might have been expected to have seen 98 270 fire safety audits. However, in 2017/18, England saw only 49 423 fire safety audits, just over half the number. Fire safety audits in Scotland are thus almost twice as common, per head of population, in Scotland as in England.

Why? Cost-cutting Tory local authorities? Cost-cutting Tory central government?

This shocking news, post-Grenfell, follows earlier reports here:

‘Stricter [fire] safety rules leave Scotland out of danger’ The English media spot the difference. Did BBC Scotland?

‘High rise fires in Scotland at lowest level in eight years’

 

From YouGov for 28-29 May 2019, with a Scottish sample of 152:

• Con 19%
• Lab 12%
• Lib 11%
• SNP 44%
• UKIP 1%
• Green 6%
• Brexit 7%
• Chuka 1%

So, Willie Rennie, you’ll have to just pretend you’re in England, next time you open it. As for HM Opposition Leader in Scotland, Ruthie, hah!

Also, interesting, from the survey, was the evidence that Scots are far less concerned about crime with only 14% compared to 23-41% across other parts of the UK. Why might that be, Reporting Scotland?

 

At Holyrood yesterday:

Alexander Burnett (Aberdeenshire West) (Scottish Conservative and Unionist Party): To ask the Scottish Government what support it will offer people in Scotland who lost money due to the collapse of London Capital & Finance to seek compensation.

Kate Forbes: This is a stressful time for all who are affected by the collapse of London Capital and Finance (LC&F). The regulation of financial services, including the services your constituent has highlighted, is a reserved matter to the UK Government. Consequently, Scottish Ministers are unable to intervene in the practices employed by financial services companies or in individual complaints.

https://www.parliament.scot/S5ChamberOffice/WA20190528.pdf

I know, not all of the investors will necessarily be Tories, but I feel sure the majority are, that ‘his constituent’ is and that few will be anywhere near the poverty line even after this. It’s not a priority for the SG in these times of austerity and punishment of the poor, the disabled and migrants.

Who is Burnett?

Anyhow, why is Holyrood being bothered with this? See this from 3 weeks ago:

See this parliamentary question and answer:

Annie Wells (Glasgow) (Scottish Conservative and Unionist Party): To ask the Scottish Government whether it will bring payments under the Scottish Infected Blood Support Scheme in line with those in England, and what the reasons are for its position on this matter. (S5W-23071)

Joe FitzPatrick: Overall funding for infected blood support in Scotland remains proportionately higher than in England on a population basis and our support is based on recommendations agreed with Scottish stakeholders through both the Financial Review Group in 2015 and the Clinical Review on the impacts of chronic hepatitis c in 2018.

Funding for the Scottish Infected Blood Support Scheme (SIBSS) was also significantly increased in December 2018 in response to the recommendations made by the Clinical Review.

While payments for some groups may appear to be higher for those on the English Infected Blood Support Scheme (EIBSS), in some areas SIBSS payments remain higher and so we would not wish to consider parity with the English scheme if that means that some SIBSS beneficiaries lose out financially.

For example, those SIBSS beneficiaries with chronic hepatitis c have all received an additional £30,000 lump sum payment, with those with chronic hepatitis c and also HIV having received an additional £50,000 lump sum. Neither EIBSS beneficiaries nor those on the Welsh or Northern Irish schemes have received these payments. In addition, widows, widowers or partners of those who have died who are registered with EIBSS are only entitled to means tested payments if they are on a low income, whereas widows, widowers and partners registered with SIBSS receive higher levels of payments which are not means tested. They receive the full amount of annual payment their spouse or partner would have been receiving if they were alive for the first twelve months after their death and, from then on, 75% of what they would have been receiving. The Scottish Government will keep payments in Scotland under review at this stage and plans to meet Ministers from the Department of Health and Social Care and the Welsh Government and officials from the Northern Irish administration to discuss what may be possible to achieve greater parity across the UK in the longer term.

https://www.parliament.scot/S5ChamberOffice/WA20190529.pdf

To be fair, it is quite difficult (for a Tory MSP) to understand.

We hear much of how the ‘vile cybernats’ are putting some folk off switching their allegiance from No to Yes. We’ve even seen the bizarre though revealing site of senior SNP politicians turning on their own online campaigners because they have become too confrontational, too direct, too aggressive. There is no reliable research on this but after a lifetime evaluating unpublished and published research, I’d put money on the so-called cybernats such as Wings over Scotland and it’s products such as the two ‘wee books’, having had much more impact in attracting votes and little on losing them compared to that achieved by some soft, navel-gazing, conditional elements. The Yes movement is diverse and contains, within it, many who are let’s say, more down-to-earth than some of our more genteel ‘leaders’ in the parties, than their professional staff and among some self-appointed expert commentators. Much more likely to be responsible for the recent flatlining of support and only modest recent increases despite Brexit chaos, are these factors.

1. ‘Passengers and Careerists’

All democratic radical movements, unless they have an early victory, tend toward comfort. Political leaders, without meaning to, lose their edge and desire to attack, as their personal circumstances improve, as they get used to rule-bound ‘civilised debate’, as their mortgages get bigger, and as they grow to like and to respect their opponents as human beings, especially when they seem more civilised than some of their more impatient supporters who don’t seem to realise how difficult things are. Though prepared to deny it vehemently, they have come to identify primarily with other politicians, prepared to praise them, and to prefer the journey to the arrival because that is now their career and they have too much to lose by arriving. They become ‘passengers.’ Then, they get special advisers who are oh so educated but who, in many cases, are just careerists and have come to them on a path which could just as easily have led to advising any of the parties. Over time, this turns a perhaps more amateurish anti-establishment movement which might have succeeded, into one which thinks itself so sophisticated, but which is no longer so ambitious. People are not stupid. This loss of commitment to the cause is visible and can only be driving support away, to the more radical Greens, or to apathetic despair.

2. ‘Celebratory Republicans’

Though I left school uneducated in this respect, I now know of the full horrors of the British Empire in Ireland. Ireland is my other team in every competition. I wish them well in everything. If they want re-unification, they should have it. However, SNP politicians raving about their love for Celtic FC, getting into petty squabbles with Rangers fans or vacillating over condemnation of the Catholic Church and boys’ clubs connected to Celtic FC and the disproportionate abuse of children in both, can only offend potential supporters. Share every defeat for Rangers FC, identified as someone committed to the Yes cause, and you may well be weakening it. Some Rangers fans support independence and some are open to persuasion but waving the tricolour in their faces, as a self-identified Yes-supporter, and you drive them away. By all means cheer on Ireland and Celtic and by all means embrace your faith but remember these are not relevant to our purpose and flaunting them may damage our chances.

3. ‘Sisters’

There have been a few notable recent examples of prominent leaders of the independence-supporting parties who have made clear their strong feelings of support for a former presidential candidate, for a retiring PM and for a retiring former leader of an opposition party. All were women and sadly that might be why they have attracted such uncritical expressions of support, but one is clearly a psychopathic war criminal, one is a full-blown hypocrite and two of them are openly vehement opponents of Scottish independence. To feel able to praise these people is to place a sense of shared sisterhood above all else including your primary political purpose.

4. ‘Gender identifiers’

As an older man, I might be confused here but I mean to say those identifying as Yes supporters who then devote disproportionate amounts of their media time to matters of sexuality and gender identification and may be driving away potential supporters who disagree or who, like me, do not understand the issues fully. Once more, debate and campaign for what you believe in but do not confuse or dilute the Yes campaign’s main narrative with matters which are not really part of it.

Fed by the press frenzy over the Pulse magazine’s freedom of information story, BBC 1 will be headlining dramatic surgery closures and GP shortages, ‘across the UK’, all day today. Blind to the Scottish context, keen to undermine the Tory Government, they inadvertently shoot wee BBC Scotland in the foot. As I write (06:50) Reporting Scotland are holding back on any attempt to generalise the scare into Scotland. Things may change.

The reasons are clear.

There is no breakdown of the data yet published telling us if surgeries are closing or in short supply in Scotland, but we know this from 2017:

The ratio of practices to overall population is:

• England 1 practice for every 6962 people
• Scotland 1 practice for every 5532 people
• Wales 1 practice for every 6746 people

Above figures are from the BMA’s General practice in the UK – background briefing 2017

With regard to getting appointments, we know:

‘87 per cent of people found it easy to contact their GP practice, while more than nine out ten (93 per cent) were able to get an appointment within two days.’

https://www.scotsman.com/news/politics/fewer-patients-reporting-positive-gp-experiences-says-survey-1-4729842

With regard to GP numbers, BBC 1 had already made things difficult for Reporting Scotland only 3 weeks ago with this:

‘Scotland has the highest number of GPs per head of population in the UK, research commissioned by the BBC shows. Analysis by the Nuffield Trust think tank shows there are 76 GPs per 100,000 people, compared to a national UK average of 60.’

https://www.bbc.co.uk/news/uk-scotland-48191210

As recently as January 2019, they had claimed such figures were not available:

‘Similar data is not available for Scotland, Wales and Northern Ireland but GP recruitment is known to be problematic across the UK.’

We did know, of course, and we also knew that GP vacancies in Scotland were only just over one-third of the level in England

Based on a survey by the GP magazine on 6^th July 2018, Pulse, the Independent reported:

‘GP vacancies (in England) rise to record levels despite recruitment pledge, survey suggests. Long patient waits and unsafe, rushed appointments are unlikely to end any time soon as vacancies have risen from 9.1 per cent to 15.3 per cent since the (UK) government pledged 5 000 more doctors.’

https://www.independent.co.uk/news/health/gp-vacancy-nhs-70-doctors-waiting-times-appointments-patient-safety-a8433596.html

In sharp contrast, the GP vacancy rate in Scotland was only 5.6%, just over one-third, at the end of 2017.

http://www.isdscotland.org/Health-Topics/General-Practice/Publications/2018-03-06/2018-03-06-PCWS2017-Report.pdf

 

 

NHS England has largely given up and across the globe health targets are regarded quite differently but in Scotland they remain highly politicised and simplistic, even moronic. Despite well-known problems with target-setting including both failure to improve services and even a tendency to worsen them (below), the opposition parties and their lackeys in the MSM (above) leap gleefully, as they have done today, on ‘missed targets’, demanding improvements in the name of the people and either directly or by implication, condemning the ‘SNP Government.’

Where targets are hit or even surpassed, as with IVF, drug and alcohol treatment, they are ignored. Where they are approached despite pressure from soaring demand, as in A&E and in cancer treatment, it is never enough for commentators.

[What follows has mostly been presented here before]

Nearly all of the NHS Scotland targets are for treatment within a period of time for between 90% and 95% of patients. Anything below that is described as a failure to meet the targets and is the trigger for ministerial apologies, opposition attacks and miserable patient interviews but this is not helpful in improving services nor is it the case in other places.

The European Observatory on Health Systems and Policies, in 2008, concluded:

Despite the scale of this activity, there is scant evidence of the effectiveness of health targets. The process of establishing targets may have little linkage with mechanisms for governing, financing and delivering health services (Wismar and Busse 2002)…..Health targets may even be counterproductive – the current debate on their use is dominated by examples from the English National Health Service (NHS) in which the use of numerous extremely detailed targets, backed by incentives and sanctions, has led to widespread opportunistic behaviour. Distortion and even misreporting of data, accompanied by adoption of dysfunctional actions, achieve the targets but worsen patients’ situations (Wismar et al. 2006). (p3-4)

http://www.euro.who.int/__data/assets/pdf_file/0008/98396/E91867.pdf

 

From an international study in 2014:

‘Most countries are following the UK 4-hour target [A&E] as it is recognised that there is a benefit to adding in a time constraint. Victoria and Ontario [Canada] both have set the achievement target lower, at 75% and 90% respectively, compared to 95% in England [and Scotland]. Moreover, neither system actually meets their target, and especially in Victoria there are few consequences to this. In Stockholm [Sweden] the county monitors performance on the 4-hour target but this is not nationally mandated.’

 

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/382847/Annex_5_AandE.pdf

 

In a 2015 report for the Health Foundation (p5) the following reservations about an obsessive focus on targets were made:

 

1. There have been instances where reported performance has improved without services improving for patients: ‘hitting the target but missing the point’.

 

Example: Cancelling procedures along parts of the pathway not covered by the target (for instance aftercare) in an attempt to direct resource towards the targeted area of referral to treatment, even though overall patient outcomes could be negatively affected. 

 

2. [Targets] may lead to a disproportionate focus on areas which are measured at the expense of those which aren’t.

 

Example: Reports that the Quality and Outcomes Framework (QOF) had a negative impact on holistic care in general practice, with the targets skewing focus towards single-conditions or issues.

 

3. There have been reports of gaming and manipulation of data.

 

Example: Some ambulance trusts reported reaching patients in less than one minute (a near impossible time), suggesting manipulation of the data to meet the target.

https://www.health.org.uk/sites/default/files/OnTargets.pdf

 

Research from business schools, reported in Forbes magazine in 2013, suggests a wider and deeper problem with the whole idea of target-setting, arguing that they tend to do more harm than good and that they often cause real damage to organisations and to the people who work in, or who use, them:

‘We argue that the beneficial effects of goal setting have been overstated and that systematic harm caused by goal setting has been largely ignored,” the researchers conclude. Bad “side effects” produced by goal-setting programs include a rise in unethical behaviour, over-focus on one area while neglecting other parts of the business, distorted risk preferences, corrosion of organizational culture, and reduced intrinsic motivation.’

 

https://www.forbes.com/sites/hbsworkingknowledge/2013/01/02/why-setting-goals-can-do-more-harm-than-good/#492a9d16115a

 

Where intensive national broadcast media attention to failures to meet targets is added to the above consequences, the effects must surely be even greater. During a recent one-month stay in hospital while at the same time writing this blog, I was able to ask 24 health practitioners about their reactions to the negativity commonly broadcast about NHS Scotland’s performance by BBC Scotland and STV. I had been especially interested in how their morale might have been affected but not one of the 24 reported watching or listening to Scottish news broadcasts other than by accident.

Scottish MSM weaponizing of the NHS, while potentially quite effective in scaring older and more vulnerable Scots into conservative mindsets conducive to voting against change, surely risks conflict with those professional groups working in it and often otherwise aligned with their Loyalist mission.

https://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Publications/2019-05-28/2019-05-28-End-of-Life-Summary.pdf

Many patients want to spend their last days at home with their families and friends. Scottish Government strategies are increasingly making that possible. From ISD today:

• In 2018/19, there were 53,168 deaths in Scotland excluding those where an external cause such as unintentional injury was recorded. For these individuals, 89.2% of their last six months of life was spent either at home or in a community setting, with the remaining 10.8% spent in hospital. This is equivalent to an average of 20 days in hospital in the six months prior to death.
• Over the past nine years, the percentage of time spent at home or in a community setting has gradually increased from 85.3% in 2010/11 to 89.2% in 2018/19.

https://www.isdscotland.org/Health-Topics/Health-and-Social-Community-Care/Publications/2019-05-28/2019-05-28-End-of-Life-Summary.pdf