August 20, 2014 6:34 pm

The fruits of independence

The Yes campaign’s take on health combines misdiagnosis and political hypochondria
©Bloomberg

I awake in a yurt in a campsite in Montrose. Numbed by the glamour that comes with reporting on the Scottish independence referendum, I rub my eyes and assess the situation. I have hardly slept in this hobbit hut. The sun shines over the links that form the littoral of the stony east coast town. I think back to Anchor Bar, where last night I drank with Yes campaigners after their event. Resembling a nice pub only in that it serves alcohol, Anchor Bar has a sign on its wall that reads: “What if the hokey-cokey really is what it’s all about?” Pondering that, I feel ennui. I need coffee – and an infusion of health, fruit perhaps.

I expect no trouble locating an orange or a banana. But in Montrose they are scarce commodities. I try the high street, where one shop clerk kindly informs me that there are several excellent bakeries. This is true. Montrose enjoys a bridie; one newsagent’s “fresh food” section seems to melt under the boiling ooze seeping out of the meat pies. Alas, vitamin C is nowhere to be found. Not even in the leisure centre. At the café, I scan the desultory sandwiches – is it possible for bread to be ashamed of its fillings? Caramel shortbread is a breakfast option. This is the place where nutrition goes to die.

Health has become a major issue ahead of the September 18 vote. The Yes campaign claims that only an independent Scotland could ensure that the National Health Service was well-funded and in public hands north of the border with England. It says that perfidious “Westminster” – the synecdoche whose pejorative use by Yes campaigners reminds me of the deployment of “Washington” by Tea Partiers – cannot be trusted with the wellbeing of Scotland.

The threat is almost baseless. Real spending on health in Scotland rose 68 per cent from 2000 to 2011. Health has been exempted from the worst of the UK government’s austerity drive. Scotland also has a lot of control over its health budget. Any reduction in the NHS budget in England (should one occur) would not automatically translate into a reduction in spending in Scotland. Most importantly, Scotland has full autonomy over its health policies. This is why it has not seen the same structural reforms as in England. “Privatisation”, an idea as overblown as bagpipes at the Edinburgh fringe, is Scotland’s gift to reject. It also has its own public health strategy.

Therefore, should scurvy ever scourge Montrose, it would have little to do with the UK government. Scotland has enough health problems without having to make up other ones. It has the worst health of any region in the UK, according to the OECD. Only the US and Mexico have higher obesity rates, reports the Scottish Health Survey. Eighty per cent of Scots eat fewer than the recommended five portions of fruit and vegetables a day.

Alex Salmond, first minister and new devotee of the 5:2 diet (which involves two days of near-starvation for every five and does not require any fruit), knows about Scotland’s public health problems. His government has published several studies into the issue. Mr Salmond knows poor health has deep causes: geography that historically limited agriculture, Scotland’s vertiginous deindustrialisation and what a 2010 report for NHS Health Scotland called the country’s “food culture”. What England does with its health service is not one of them.

The campaign is in its final month. The false threat to the Scottish NHS is calibrated to attract undecided left-leaning voters. But it is also part of the fundamental argument made by the Yes campaign: Scotland is different – and diverging. The logic goes: we value a public NHS; England did a bit, now it does not. So different, says the Yes side, that anything other than independence is an offence to democracy. No matter that support for the NHS to be free at the point of use is a near-universal belief held across the UK.

Raising the spectre of privatisation also hints at two paradoxes of the Yes campaign. The first is that for a campaign for Scottish independence it is awfully fond of keeping British institutions. The second is that for a leftwing campaign it is rather conservative. There is little curiosity about whether any of the reforms in England might have helped people. In education and in health, reform means defending the status quo. (I am reminded of the coolness faced by Teach First, the successful and innovative education charity, when it explored setting up in Scotland.) A status quo Scotland already controls.

Whatever happens on September 18, then, I worry that it will still be hard to find fruit in Montrose.

john.mcdermott@ft.com

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Letters in response to this column:

The English are getting first pick of Scotland’s fruit / From Ms Jane Kitto

Finding Tesco and analysing the Scottish referendum / From Mr Colin Quinn

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