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The Herald Scotland
09-07-2025
- Health
- The Herald Scotland
We need a different approach to the delivery of public services
Chief among them was Scotland's Public Services Reform Strategy – Delivering for Scotland. In his foreword to it, Ivan McKee, Minister for Public Finance, acknowledges that Campbell Christie's vision has not been delivered to its full potential. Some might argue that those words underplay the scale of the deficit. Whatever the truth, it is unarguable that nowhere is the gap between ambition and progress more acutely felt than in relation to health inequalities. In its 2023 report, Leave No One Behind, the Health Foundation asserted that the persistence of health inequalities in Scotland over the previous decade was related to three underlying factors – the accumulation of severe multiple disadvantage, a stagnation in living standards and, tellingly, the fragility of public services in the wake of austerity. It is welcome therefore that the Health and Social Care Service Renewal Framework and the Population Health Framework were also published as the recess approached. While the former is concerned with health and social care delivery, the latter recognises that progress on improving health and reducing inequalities requires action beyond those services. In doing so it echoes Leave No One Behind's focus on the socio-economic determinants of health – income, housing, education, employment. While early health interventions matter, it is prevention which will determine whether Scotland can reverse the tide of worsening health inequalities – among the worst in western Europe – over the next decade. But in their response to the Population Health Framework, analysts at the Scottish Health Equity Research Unit, funded by the Health Foundation, have questioned how far its specific actions reach beyond health and social care. While welcoming the framework's focus on prevention, they point out that actions in crucial areas such as housing are more limited. They call for a broader range of cross-government actions, clearer implementation plans and robust monitoring and evaluation. However, they also recognise that the Public Services Reform Strategy shines a light on the very things which need to happen to ensure intention is met with action – clearer leadership, greater accountability and, critically, budget processes that enable the long overdue shift to preventative spend. Despite fiscal challenges, funding can and must be reshaped to support a different approach to the delivery of hard-pressed public services. Campbell Christie died just four months after his landmark report was published. For those living in Scotland's most deprived communities, where the gap in healthy life expectancy compared to those in the least deprived reaches 25 years, the changes he called for cannot come a moment too soon. Chris Creegan is Director of the Health Foundation's Improving Health and Reducing Inequalities in Scotland Programme Agenda is a column for outside contributors. Contact: agenda@
The National
28-04-2025
- Politics
- The National
Scottish independence and trade unionism must work hand in hand
Trade union engagement in shaping the future of our county is vital. Indeed, I doubt change can happen or be sustained without their support. There is no mention of constitutional reform among the 116 resolutions which have been tabled for debate. A sign perhaps of other pressing priorities, or that the question more generally has slipped down the agenda. But Scotland's labour movement has a long history of supporting home rule. A generation ago, the STUC was instrumental in bringing into life the Scottish Constitutional Convention, the civil society body that led the drive for a devolved Scottish Parliament. READ MORE: Top trade unionist blasts Labour's GB Energy 'betrayal' In part this was due to the passionate commitment of union leaders such as Campbell Christie, Bill Speirs and others. But it also represented an understanding among union members that there was a direct connection between the structure of government and the outcomes for working people. Trade union backing for Yes during the 1997 devolution campaign was key to the landslide victory in that year's referendum. And as Tony Blair's government moved to the right, starting wars abroad and breaking promises at home, a rift began to set in between the Labour Party and its Scottish electorate. A seismic shift in political support took place in the noughties as Scotland's workers turned to the SNP which was attacking Labour from the social-democratic left. This culminated with the election of a majority SNP government in 2011, and the stage was set for a referendum on Scotland's independence. Former prime minister Tony BlairBy now, social and economic reform was presented as a central rationale for becoming an independent country and many trade unionists realised that not only was there more than one way to skin a cat, but that having the power of an independent country might just have a better chance of success. Studies show that most working-class voters backed independence in 2014, and poverty and inequality were motivators of the Yes vote. But even as trade union members embraced the objective of independence, few of their organisations explicitly endorsed the campaign. RMT was the only union to explicitly back independence following a ballot of its Scottish members. For other unions there was an uneasy balance between London HQ trying to deliver a No vote for Labour leader Ed Miliband and Scottish officials who understood that message would split their membership. The result was a policy of considered abstention for most. Today, polls vary but most people would acknowledge Scotland is split down the middle on independence. Given the Union is supported more by wealthy and retired voters, it's not much of stretch to suggest there is majority support for independence among those who go out to work in the morning. READ MORE: John Swinney to call on UK to back Scottish industry in STUC Congress address True, it might not be the most important issue on their minds but as we approach next year's Holyrood election and beyond this is likely to increase. The demands for the political power that independence offers will become stronger and more plentiful as the Labour Government continues to fail to change anything much. Certainly, Labour have a better attitude to trade unions than the Tories and there have been some positive policies. But as the Government squeezes public spending, protects the wealthy and runs through the gears on rearmament, the balance sheet is increasingly negative. This means that the possibility and prospects of Scotland becoming an independent country will increasingly come into focus. As this happens, our trade unions must be part of the debate. Trade unions exist principally to defend their members in the workplace, individually and together. They are a vital civilising instrument on the excesses of capitalist enterprise, trying to ensure the rights of workers are upheld. (Image: Paul Campbell) But unions have always been aware that the pressures on their members stem from policies that are determined or influenced by governments. From the days of the Labour Representation League in 1869 to the present day, political intervention has been seen as necessary and essential. That is as true today as it ever was. The case for independence is not about flags or anthems but about taking control of Scotland's natural resources and ensuring they are a common treasury for all. It's about building a more equal, inclusive and positive society, where people and respected and valued. It's about all of the things that trade unions were created for. But before these options can even be considered, the people of Scotland will have to win the right to debate and choose them, a right currently denied by the Supreme Court ruling. In that, the STUC's position is clear: the Claim of Right must be upheld, and the people must be able to choose their own method of government. The SNP Trade Union Group is working to make sure not only that the independence message is heard at the heart of the movement, but that our unions are central to designing and building a new Scotland. Tommy Sheppard will be among the speakers at an SNP Trade Union Group fringe meeting at the STUC Congress on Monday, taking place at 5:30pm in the Quaker Meeting House, 7 Whitehall Crescent, Dundee, DD1 4AR . It is entitled Where Next For Scotland? Trade Unions and Political Change
