So many wounds, so many bruises, so many scalps, and yet still the SNP can’t help themselves. In the same week that Humza Yousaf announced his resignation, the party was up to its old tricks again. But we’ve been here before haven’t we? We can see the magic now. We know how it’s done.
It works like this: you’re trying to get an appointment with your doctor, you’re worried about the state of your kids’ education, you’ve just bust your tyre on a pothole, or you’re wading through the litter and rubble in Glasgow. Things are terrible, basically. But the SNP has news for you: at least they’re not as terrible as they are in England!
This week’s version of the trick concerned the health service, specifically the news that, as from Wednesday, the cost of a prescriptions in England were going up by 2.6% to just short of a tenner; so not a small amount of money. The SNP leapt on the news and pointed out that if a similar charge applied in Scotland, where prescriptions are free and people receive on average 19 of them a year, it would cost the average person £188 annually. So again: not a small amount of money.
But as usual with SNP press releases, you need to be wary, very wary. For a start, there was no mention of the fact that in England, there’s a long list of people who do not pay the prescription charge. The over-60s. The under-16s. Full-time students. Pregnant women. People with a physical disability. People with serious medical conditions. And, of course, people on income support or other benefits.
The SNP approach to the money that’s actually raised from prescription charges in England is also revealing. The party commissioned research from the House of Commons library on the subject and it found that households in England have paid more than £6billion in prescription charges since the fees were scrapped in Scotland in 2011.
The SNP’s take on this is that the £6bn is an unfair financial burden on people, taking money out of people’s pockets during a cost-of-living crisis. And certainly for some people who do not qualify for the wide-ranging categories I listed above, the prescription charge will be an extra, unwanted cost.
But let’s look at it the other way round. What the English system is doing is making a calculation (via a means test) that some people can afford to pay the prescription charge, which means that £6bn is raised which would otherwise have to be paid by the government or the taxpayer. In other words, the cost of the medicine and dispensing it is real and this is a way of covering some of that cost.
In Scotland, the costs are just as real of course and just as big; in fact, we’re generally much sicker than England so the financial burden is likely to be higher. What the research shows is the net cost of dispensing items and providing services in Scotland in 2022/23 was £1.5bn. But instead of asking those who can afford to do so to cover some of this, all of it is covered by the government or the taxpayer.
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The result is the upside-down effect we see with all of the SNP’s universalist policies: people who could afford to pay for their prescriptions get them for free and the cost is covered by other people who earn much less than them. This is similar to the point the Law Society has made about university tuition fees: there’s a finite amount of money and much of it is being spent on funding students whose families can afford to pay, meaning the policy disproportionately benefits those from better-off backgrounds.
The same applies to the buses, which are free in Scotland for all young people and pensioners, including, again, those who can afford to pay. What this means is that there’s a big bill for the public purse: in the first year alone, it was £5,211,682.19 to run the scheme and £97,166,918.69 to reimburse the bus companies, all of it paid for by the taxpayer, including people on low incomes. But how about the bus companies being reimbursed instead by people who can afford to buy a ticket?
What all of this does, the prescriptions, the tuition fees, the buses, is it creates and perpetuates the myth of free while concealing the costs which are, in the end, paid for by ordinary people anyway, through taxes. This is why the SNP press release on prescriptions talked about healthcare in Scotland being “free at the point of use”, the critical misleading phrase being “at the point of use”. Eventually, it is not free; we’re just charged in other ways.
The point surely (and Scottish Labour seems to get this) is that we should seek to impose the charges in the fairest way possible while also seeking to keep the costs down, and universalism does the opposite of that. First, it increases the overall bill by providing the service to everyone, or almost everyone, and secondly, it imposes the charge in a way which means that the well-off are funded by the less well-off. As I say, it’s upside down, but worse: it’s unfair.
But perhaps there’s hope of sorts. In announcing she wouldn’t be standing for the SNP leadership this time round, it’s clear Kate Forbes has come to some kind of arrangement with John Swinney and one thing we know about Ms Forbes is she’s economically conservative. She also said that under Mr Swinney, the SNP would return to “governing from the mainstream". So I’ll tell you what’s mainstream. Trying to keep public spending down. Imposing charges fairly. And being honest about the cost of things.
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