For the sake of sanity

nhs_threatI sincerely hope people read this article in full. Morag and Ulrich Fischer provide an insightful and informed overview of Scotland’s mental health services. It’s by no means an entirely favourable review. It is clear that much remains to be done. Overall, the article conveys a distinct sense of hope and confidence. But there are also evident concerns.

These concerns relate, in some measure, to the fact that Scotland’s mental health services are under serious pressure. But such pressure is an inherent characteristic of a genuine public health system in which the overarching principle of universal care free at the point of need must be fully honoured while striving to resolve the intractable problem of potentially infinite demand chasing severely limited resources. That is what our health workers do. All of them. Doctors and managers and nurses and cleaners and all the rest. They cope with the demands. They manage the resources. They deal with the pressure. That is their job. And, whatever the British politicians squatting in the Scottish Parliament say, they do that job remarkably well.

When elective and/or non-critical procedures are postponed in order to free-up capacity to deal with some extraordinary demand, this is not a failure on the part of health service workers as those British politicians would have you believe. This is just them doing their job.

In order to do this job; in order to cope with the pressure, there is one thing that the people who run Scotland’s NHS absolutely require above anything else – even money. They need control. Without an appropriate level of control, normal workaday pressure becomes intolerable stress. It is not pressure that breaks systems or people. It is the stress of responsibility without authority; expectation without capacity; aspiration without hope; pressure without control.

There are striking parallels between factors affecting the mental well-being of individuals and those which impact on the functional ‘health’ of groups, organisations, communities and even nations. Lack of control is one example. Insecurity is another. When an individual is under pressure to perform (or conform) but is deprived of the relevant choices, that individual will experience stress and suffer a deterioration in their mental health. This will always be the case. Only the degree of deterioration will vary from person to person.

Similarly, when an organisation, community or nation is under pressure to achieve defined goals while being denied the decision-making power that is required, that entity too will tend to become dysfunctional.

Insecurity arises when such ability to choose as the individual may possess – or believe they possess – comes under threat. Or when whatever limited decision-making power exists within the organisation, community or nation is perceived to be in jeopardy.

Morag and Ulrich Fischer recognise the threat. They feel the insecurity. Having described the successes and ongoing efforts and continuing progress in Scotland’s mental health services, they issue a stark warning.

All this might be under threat should we allow Westminster to ride roughshod over devolved powers.

That warning must be heeded. We must not allow Westminster to strip powers from the Scottish Parliament. We must cease to tolerate the withholding of powers that rightfully belong with the Scottish Parliament.

We must categorically reject the British state’s asserted veto over Scotland’s right of self-determination.

We must loudly and vehemently denounce the anti-democratic British Nationalists who would deny us the opportunity to choose a different way.

We must dissolve the Union!


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Mind your language!

saltire_breakoutIt is disappointing to find The National referring to “the NHS”, as if there were a single UK-wide health service. The British media and the British political parties habitually conflate NHS Scotland with NHS England in order to taint the Scottish health service with the defects and failings of its English counterpart. If it is to effectively offer an alternative perspective on Scotland, it is essential that The National avoids such misleading terms.

As we gear up for a new referendum campaign, we must all play a part in reframing Scotland’s political discourse. When the British propaganda machine refers to “the NHS” this is not mere carelessness. It is intentional. It is part of a purposeful effort to confine the narrative to a particular frame – the frame of a ‘One Nation’ British state. We must emphatically reject this frame. We must reclaim our language. We must create our own narrative. We must reframe our entire political discourse.

Scotland is a nation. It is not part of another nation. We are not seeking independence from another nation. Scotland is not ‘un-independent’. Scotland is an independent nation within a political union. We are not seeking independence from ‘Britain’. Britain does not exist as a country. It exists only as a convenient myth created by and on behalf of a British ruling elite. Britain is not a nation. It is the structures of power, privilege and patronage which support and sustain that ruling elite. It is a system by which the few ensure that their interests are served at the expense of the many.

The political union which has been imposed on Scotland is democratically unsustainable because it denies Scotland’s status as a nation and prohibits the effective exercise by Scotland’s people of the sovereignty that is inalienably theirs. Historically, the British state has maintained its grip on Scotland by persuading enough of us that we are subordinate. Language plays a huge part in this process. The wilful discounting of Scotland’s separate health service being just one example.

With the evolution of a distinctive and increasingly divergent political culture in Scotland, more and more people are questioning the myth of the British nation and challenging the asserted authority of the British political elite. People are no longer inclined to meekly accept that Westminster can have a veto on their right of self-determination. People are more inclined to openly and loudly protest the efforts to subordinate Scotland to the British Crown in the British Parliament.

Realising that the Union can no longer be held together with pomp, pageantry and propaganda, the British establishment has resolved to formally strip Scotland of its status as a nation using the opportunity presented by Brexit.

If we are to successfully resist this malignant ‘One Nation’ British Nationalist project, we must escape the mindset inculcated in us over generations of immersion in a narrative shaped by, and for the purposes of, the ruling elites of the British state . We must do this in ways large and small. By insisting on the distinction between NHS Scotland and the rapidly disintegrating remnants of England’s health service. By exacting respect for our democratic institutions and elected representatives. By requiring an end to the withholding of powers from the Scottish Parliament.

By demanding that the Union be dissolved.


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Beware of BritNats!

nhs_threatShona Robison is, of course, quite correct to highlight the threat to Scotland’s health service posed by Brexit. Talk of “an immigration system that works for the whole of the UK” from the British government makes no more sense than anything else about the entire Brexit fiasco. Devising such a system in the face of the diverse and diverging needs, priorities and aspirations of the four nations would be a massively complex and problematic task. A task which, on the basis of all available evidence, we must therefore assume to be well beyond the capacities of the current London regime.

It is inevitable that a BritNat Brexit imposed on Scotland by this regime will do real and serious harm to NHS Scotland. Pandering to a xenophobic obsession with immigration is bound to have an adverse impact on workforce recruitment and retention. We can only guess at the deleterious effects of Scotland being dragged out of the EU agencies which facilitate cooperation in medical research, recognition of qualifications, drug approvals and much more. Our enforced isolation from the single market can hardly be less than catastrophic for Scotland’s burgeoning life science industries. The British political elite have no answers to questions about the rights of Scottish patients to access treatment in the EU – only vacuous, patronising platitudes.

All of this is bad enough. But there is an additional threat which Shona Robison does not mention. The threat of Scotland’s cherished public health service being laid bare to the ravages of predatory US corporations – sacrificed by a British state desperate to secure anything that can be presented as a shiny new transatlantic trade deal.

Does anybody seriously believe that the ‘UK-wide common frameworks’ which the British government proposes to inflict on us have anything at all to do with making Scotland’s healthcare system work better for patients? Given what we know of the British political elite’s obsession with austerity and rigid adherence to neo-liberal orthodoxies, is it not infinitely more likely that the purpose is to prepare NHS Scotland for large-scale privatisation? As a non-negotiable condition of any deal, those ravenous corporations will demand the removal of such inconveniences as a Scottish Parliament and Government committed to the principles of universal healthcare free at the point of need.

The obvious ‘solution’ is to take control of NHS Scotland out of the hands of Scotland’s democratically elected representatives and hand it to a shadow administration which is not accountable to Scottish voters. An unelected quasi-government, based at the Scotland Office, which can be relied upon to give precedence at all times and in all matters to the interests of the British state and its corporate clients over the needs, priorities and aspirations of Scotland’s people.

And why wouldn’t they? Why would the British state not adopt this ‘solution’? After all, when Scotland voted No in 2014 we gave the British political elite licence to do whatever they want with our nation. Why would they not take full advantage of that licence?

Those who voted No may protest that this is not what they voted for at all. But it’s a bit late now to start thinking about consequences. They should have read the small print. They should have heeded the warnings.

The mistake Scotland made in 2014 must be rectified. If Scotland’s precious NHS is to be rescued from the menace of rabid British Nationalism then the licence that was so recklessly given to the British state by that No vote must be revoked. All of Scotland’s vital public services, along with the distinctive political culture and democratic institutions which sustain them, are put in jeopardy by being party to a political union which renders us powerless to protect them. That political union must be dissolved.


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