2012: Will we die after independence?
One of our very favourite No-campaign scare stories of the year was the Huffington Post’s “Vote Yes And You’ll Die Of Cancer”. But if Scotland chooses independence in 2014, will it actually affect our healthcare? After all, we’ve already noted how NHS Scotland has been independent since inception (and why we need a Yes vote in order to provide it with a stable funding base that won’t be cut out from under it via the effect of Barnett consequentials under Westminster austerity).
But it’s also worth examining how it would work in practice. What about if we travel to the rUK or in Europe? What about the cross-border co-operation that currently characterises the relationship between the UK’s two health services? Would we still be able to be treated in an English hospital if we vote for independence? Let’s find out.
To answer the question we need to look at what happens now. It’s not only the citizens of the UK who can get free medical care on the NHS – anyone who falls ill here will be provided with emergency medical care. Citizens of European Economic Area (EEA) nations, however, also receive additional healthcare, as do those of other countries with which the UK has reciprocal arrangements. This arrangement is facilitated through the European Health Insurance Card (EHIC).
EHIC is issued free of charge and allows anyone who is insured by or covered by a statutory social-security scheme of the EEA countries (and Switzerland through a different agreement) to receive medical treatment in another member state for free or at a reduced cost, if that treatment becomes necessary during their visit (for example, due to illness or an accident), or if they have a chronic pre-existing condition which requires regular care, such as kidney dialysis.
The intention of the scheme is to allow people to continue their stay in a country without having to return home for medical care; as such, it doesn’t cover people who have visited a country for the specific purpose of obtaining medical care, nor does it cover care – such as many types of dental treatment – which can be delayed until the visitor returns home. It only covers healthcare which is normally covered by a statutory healthcare system in the visited country, or it would render travel insurance obsolete.
The net result is that if Scotland becomes independent there’ll very little effect on the provision of services as they are today. This only remains the case if the rUK is also within the EU, of course, though even if some sort of unholy Tory/UKIP alliance saw the rUK leave, it’s highly unlikely that it would give up access to the EEA – the world’s largest free-trade zone – and would endeavour to remain within the agreement through another means (possibly via membership of EFTA).
But not for the first time, the only real potential danger to the future of the Scottish people’s health lies in remaining within the United Kingdom, not in leaving it.
Nice analysis. As ever, once you dig a bit deeper, the scare stories evaporate. So many supposed benefits of the EU are, on closer inspection, external arrangements like the EHIC scheme and the Schengen free movement area, which are available to non-EU countries.
A word on NHS reciprocal healthcare. I retired in September 2010 on an occupational pension. For 30 years in France I have worked on secondment from the UK for an intragovernmental organisation. During this time I paid UK taxes and national insurance on the UK element of my salary. Since I have made my life in France and my family live here I have remained, believing my healthcare would be taken care of through the reciprocal arrangement with the NHS. This held true for a period related to what I was due dating from my last payment into the National Insurance scheme.
If I were living in the UK this limitation would not apply. In tying my healthcare provision to residency the UK are, I believe, in breach of Article 45 of the EU Treaty on the freedom of movement of workers: had I known my healthcare would be cut off I might well not have remained working in France and returned to UK.
As I will not be 65 until November 2013 I have been obliged to make private arrangements for the intervening time.
Being a pedant, I would remind you of ‘memento mori’.
However, as a GP up North (Moray) I can assure you the Scottish NHS is in far better shape than the English one and that the fact that the ‘Lansley’ reforms are not touching us a source of relief.
That public spending would be preserved in an independent Scotland would only be a good thing and help us to maintain the service to a high standard.
There are already protocols in place regarding cross border patients within the UK and I see no reason for these to end upon independence. Largely, they’re just an effective way of making sure that the right authority pays for the patient’s healthcare.
Health is one of those areas which the Neoliberals must attack in order to prove to England that there is no alternative. Ironically enough, even though most of the English population is nearer to mainland Europe you won’t find articles in the English press reflecting on service provision in France or Belgium etc. A special place is saved for Scotland and it’s wacky, unaffordable, subsidised, communistic, failing, unfair NHS.
At a conference earlier this year NHS [England] Chief Executive Sir David Nicholson, in answer to the question, which country outwith England he would prefer to be treated in general practice, said: ‘Scotland. Because of the amount of money per head of population it gets.’ I’m not sure, though, if this was an acknowledgement of Scottish Government funding or a Daily Mail type rant regarding Barnett.
As regards the title of the post, my immediate reaction was, “Jeez, I hope so! I certainly don’t want to die before independence!”
Re the caption on your map, EFTA countries are also in the EEA.
I’m with Morag; I definitely don’t want to die before independence!
I was in Yugoslavia (before the schisms) with a choir tour. One of the choir members had a fall and needed hospital treatment. CT scan, everything, all on the house. And very very fast so she didn’t miss her plane home. As someone said, let’s hear it for communism.
Yeah thanks Holebender. The Rev meant to put Blue is EU members of EEA and Green is EFTA members of EEA.