Dentistry in an independent Scotland

07 July, 2014
 

Introduction

On Saturday 10 May, the Scottish Dental Show hosted an independence and dentistry debate in front of an audience of nearly 100 dental professionals at Braehead Arena in Glasgow.

The debate, chaired by former GDC president and Edinburgh GDP Hew Mathewson (referred to throughout the transcript as HM), centred on the motion ‘Scottish general dental practice will be better for patients and dentists in an independent Scotland’ and featured four panellists:

Clive Schmulian (CS) the principal dentist at Clyde Dental Group, a group of practices in the central belt
who spoke against the motion.

Anas Sarwar (AS) MP for Glasgow Central, a former General Dental Practitioner and Deputy Leader of the Scottish Labour Party, a member of the Better Together campaign who spoke against the motion.

Gerard Boyle (GB) a partner in Shawlands Dental Practice in Glasgow who spoke for the motion.

Dr Willie Wilson (WW) owner of Thistle Pharmaceuticals and a recently retired academic who previously lectured to Glasgow dental students on pharmacology for thirty years who spoke for the motion.


Transcript:

HM: Good afternoon everyone. I’m Hew Mathewson, I’m a general dental practitioner from Edinburgh and I’m here to chair this debate.

Of our four speakers, who are all Glasgow graduates, three are dentists and one is a former lecturer to dentists. I think it is fair to say that they will be known to most of you one way or another.

The motion we are going to debate is: Scottish general dental practice will be better for patients and dentists in an independent Scotland.

One speaker from each side will speak for five minutes, then we will have 15 minutes for you to ask questions and make points. The second pair of speakers will then speak followed by another 15 minutes Q&A, before one speaker from each side will give their closing arguments for a maximum of three minutes.

The first speaker in favour of the motion will be Gerard Boyle, a partner in Shawlands Dental Practice in Glasgow.

GB: I have been a dentist for 25 years and I work in an NHS practice in Glasgow. Like most of you I believe strongly in social equality, a welfare state and, most of all, in the National Health Service. I have never been a member of any political party but I am a Labour voter and I will be voting Yes in the Scottish Independence Referendum on the 18th of September.

From an NHS perspective, as we look at the continued viability of NHS dentistry, funding is the key. The Scottish budget for NHS dentistry is about £400 million a year. We have been told by the Scottish Government that, for the foreseeable future, this budget will be cash limited. With further UK Treasury cuts planned, it will not only be cash limited, it will probably be cut as well.

The cost of providing that service is going up every year and the number of dentists in the system is continuing to rise. A cash limited system can only mean a per capita reduction to individual dentists and a corresponding reduction in the quality of the service.

Within the current constitutional arrangement of a devolved parliament, while Holyrood is directly responsible for the management of the NHS in Scotland, the coffers of the NHS are controlled from down south by George Osborne and Danny Alexander. It is clear that these two ministers have a thinly disguised contempt for the public sector and do not value the importance of a comprehensive, state funded NHS. With this coalition in power, we should all be worried. The alternative to the current coalition is either perhaps one involving UKIP or maybe a Westminster Labour Government. From a party that has become so watered down over the last 20 years, we cannot tell Labour from Tory. It is not the Labour party that voters in Scotland recognise and it is not my Labour party.

This so-called New Labour party was in government eight years ago and gave dentists in England and Wales their current disastrous NHS contract, with local commissioning, UDAs and tight annual budgets to work within. The impact of this idiotic contract is that there are now one million fewer people who have access to NHS dentistry in England.

It is this brand of New Labour that has now embraced the Conservatives in the Better Together campaign. Wisely, none of the devolved governments in Scotland have taken our NHS down the same path as the NHS in England.

Only 84 per cent of healthcare south of the border is provided by the NHS. In Scotland, that figure is over 99 per cent.

This gives the public in England the impression that NHS care is cheaper to deliver per capita in England. It isn’t. It is just that people are having to pay more privately in addition to their NHS care, and the combined cost is actually higher in England than it is in Scotland.

The Better Together campaign claim that public services in Scotland are more expensive to deliver in Scotland than the rest of the UK. And somehow it is in our interest to preserve the Union to ensure that these so-called handouts continue. What you should all know is that all the Unionist parties are planning to reduce the block grant to Scotland in future – the so-called Barnett squeeze. This will mean a lot less money for the NHS in future and less money for dentistry in Scotland.

The current UK government has already started its war on the NHS, raiding our pension funds to pay for the failure of their financial system. A financial crisis that happened under the watch of Anas Sarwar’s UK Labour party.

Can I remind you that our pension fund is in surplus.

I have looked at the basics of the economic argument and, while I am a dentist, not an economist, I do have an O grade in arithmetic and I also run a business. It is all about money in and money out. In an NHS dental context, the big issues are: ’Where is it coming from?’ And: ‘How much is available?’

Let me assure you, there is a lot more of it in an independent Scotland. Ladies and gentlemen if you want to preserve the NHS, vote Yes.

HM: The next speaker is Clive Schmulian. He is the principal dentist of the Clyde Dental Group, a group of practices in the Central Belt, and he is going to speak against the motion.

CS: It’s a long time since I have been involved with a political debate and I am actually quite surprised that I ever made it here as a dentist because the reality is that for my five years as an undergraduate I spent a huge amount of my time being involved with student politics and party politics.

I did manage to graduate in 1993 and went into practice, settled down, got married and had kids. I decided to put politics on the back burner, or more to the point, my wife decided to put politics on the back burner for me.

But, in the past 20 years there have been huge changes in dentistry and in politics in Scotland. And, unlike that really negative case presented by Gerry – the usual hatchet job attacking the Tories, attacking Labour, attacking everybody – I want to put forward a positive case about the benefits of being in the Union.

One of the key things for me is that I think that Scotland has the best of both worlds. We have a Scottish Parliament, created in 1999, which has responsibility for health, education, transport etc. In dentistry, we have seen the benefits of having a separate system, but still being part of the United Kingdom – the key argument for me is that we have the best of both worlds.

Let’s look at the benefits of devolution for dentistry over the past 10 years, delivered by a liberal Labour administration and the SNP government. Let’s look at the benefits, let’s look at education and Aberdeen Dental School. Many of the young dentists here will have benefitted from student bursaries. These are all benefits of devolution.

The fact that more money is spent in Scotland per head of population than in England – £1,200 more is spent the way the funding is created. That is what they don’t want to tell you and that is what we are trying to protect.

Let’s look at how the Scottish Parliament has invested in dentistry in the past 10 years. The Scottish Dental Access Initiative, Childsmile – putting prevention at the centre of our practices – that’s all funding from the Scottish Parliament and that could all be at risk under the plans of the SNP.

The reality is that there is one mention of dentistry in the White Paper from the SNP and it is just a side mention when they are talking about doctors and dentists’ pay. There is no interest in dentistry whatsoever. It’s an afterthought.

The Yes campaign promise everything, everything is going to be hunky dory and rosy after independence. We are going to get rid of Trident, we’re going to have windfarms, everything is going to be brilliant. The reality is that healthcare is under pressure because of an elderly population and these challenges are the same challenges that are facing England and Scotland. And yes, things are different in Scotland, we have benefitted from a different system.

Clinical governance affects us all, we don’t have the Care Quality Commission, we have the nice, friendly people like Gerry coming to our practices and at least they know about dentistry.

And what other challenges will face dentistry after independence? What will happen to the General Dental Council? At the moment, while the funding and delivery of dentistry is organised by the Scottish Parliament, we are still regulated by the GDC. Many of us may have concerns about the GDC, we might be concerned that the GDC is more interested in prosecuting dentists for selling the wrong diameter of floss than hairdressers doing tooth whitening. But who is going to be governing us come independence? The reality is that we don’t know. Like so many other things about independence there is uncertainty, no answers.

I was speaking to a couple of the lab guys here at the show and they are doing a lot of work in England. England is the biggest domestic market for Scottish labs and they are really concerned that they are going to lose out after independence. That’s going to be a threat to jobs in dental labs. That’s just one example of how independence is going to put jobs at risk.

I think these are unnecessary risks. At the moment we have the security of being part of a strong United Kingdom, one of the biggest economies in the world and the benefits of having the control over our domestic affairs through a Scottish Parliament.

I don’t want to gamble with our currency, I don’t want to put jobs at risk and I don’t want our pensions to be threatened. I believe that dentistry, our patients and our nation as a whole is Better Together as part of the United Kingdom and I would ask you to vote No today and in September.

HM: Questions and answers. I’m only allowing one speaker from each team to respond to each question or point.

Question: I have been on a course by John Cameron (senior dental advisor, Practitioner Services Division) and he was mentioning the same thing – that the Scottish dental budget is £385 million, that’s for a population of 5.5 million, which roughly constitutes 8 per cent of the total population of the UK. He told us that from down south in England, they were putting serious pressure because that is about £62 per person, per year to provide dentistry. Whereas, in England they are comparing it to only £35 per person, per year. Do you think England would be more fairer to Scottish dentists?

Because there is such a thing as economics of scale in Scotland that works against us.

AS: It is great to be here today. I see people who have trained me, who I have studied with, worked with and some of my dear friends in the audience. I hope that works in my favour in terms of this debate.

In terms of the important point that you raise sir, the reality is that, in the last 15 years in Scotland, spending on public services has doubled. Not been decimated as has been suggested by other speakers, but actually doubled as a result. As Clive mentioned, we have the best of both worlds. We have the ability to decide what is best for us here at home in terms of our health service, our education system right here in Scotland and yet still be part of something much bigger.

Those decisions would be made exactly the same way whether we decide to go independent or remain part of the United Kingdom. You don’t vote Yes to protect the NHS. You vote No to protect the NHS, because right now we pool and share resources right across the UK to make sure we have more to spend right here on the services that we rely on.

HM: I think you’re beginning to make a point rather than answer the question so I’ll stop you there.

GB: I touched on this in my five minute slot. There is significantly more private work done in England and it gives the illusion that NHS care is more expensive to provide in Scotland and that we are somehow being subsidised by other nations in the UK. Clive quoted a figure of £1,200 per capita additional to Scotland in the block grant. That is correct, but you have to look behind the figures and that’s exactly the argument that has been used to reduce the funding for the Scottish budget and healthcare in particular.

Q: I’m a GDP and currently a No voter for independence, although I could be persuaded – so only marginally No. One of the things that concerns me in relation to independence and dentistry, is a point that Clive raised about the regulation of dentists and DCPs after independence. Now, I understand the position of the SNP just now is that we would continue to be regulated by the GDC in London, which I find an odd position. What will certainly not happen is a Scottish Dental Council, there will be a healthcare regulator, somebody like Healthcare Improvement Scotland, which does concern me slightly.

GB: I share those concerns, however, things have changed with the GDC in recent years – in the past we were regulated, certainly as dentists, by dentists. We have now got used to the concept of the whole team being regulated by, not only dentists, but dental care professionals. The logical solution to that, should it be in a Scottish context, would be that there would be some kind of all-encompassing healthcare regulator, given the size of the population and the system in Scotland.

CS: We’ve all got concerns about the General Dental Council, as I said in my five minutes. But the reality is that nobody knows, it is not a priority of the Yes campaign to decide what happens to the GDC. The GDC could still continue to be our regulatory body after independence, that’s entirely possible. It is also entirely conceivable that, in the event of a No vote, Scotland could have a separate Scottish Dental Council.

So, things could change either way to be perfectly honest and I don’t think that independence per se is going to drive it. I think, either way, we could have the GDC or a Scottish Dental Council.

HM: I don’t want to take sides, but nothing in my past life – involvement with the Scottish Government and regulatory reform – suggested there would ever be a Scottish Dental Council. The intention, if there is a separate regulator, would be a healthcare regulator for Scotland, which like most regulators now would be mostly lay. So, I don’t think there is any likelihood of a Scottish Dental Council, it’s certainly never been discussed at a government level.

CS: If I could come back on that. What I’m saying is that none of these things have been formally discussed but there is no reason, just like lawyers – there is a separate legal system in Scotland and lawyers are governed by the Law Society of Scotland. If there was a will do to it, there could be a separate Scottish body. I’m not suggesting or advocating that, but there is nothing stopping that, at the moment.

Q: I’ve got two points if I may. My first point is, just going back to what was commented earlier on what Scotland receives in the block grant. From my perspective, Scotland does receive, per head of population a greater degree of funding than the rest of the UK. Equally, Scotland contributes far more in terms of revenue. When you actually look at the balance, it is actually greater in favour of the rest of the UK, in terms of what the net spend is. So just to clarify that point.

Secondly, there was comment made with regards to Trident. Is there actually a positive case to retain Trident? Personally, I don’t think there is…

AS: First of all, on the point about revenues and spend. The reality is that if you look at the percentage bases which the Scottish Government have been talking about, you could make a point that, based on percentages, we put in more than we receive back, although that wasn’t the case in this year’s revenues and receipts. If you look at it in cash terms, Scotland receives £10 billion more in spend than it puts in, in terms of revenues. If you take the last year alone, you’ve heard a lot about oil revenues. In the last year alone in Scotland, revenues from oil have fallen by £4.4bn. £4.4bn in one year. That’s the entire education budget for Scotland.

As part of the UK, oil makes up two per cent of our GDP. As an independent country it would make up 25 per cent of our GDP. That exposes us to a lot of risk.

Q: I’ve looked at the GERS (Government Expenditure and Revenue Scotland) report, which obviously the figures have been based on. And, if you go back beyond the last year, or the last five years – if you go back to the 31st March 1980, actually Scotland has contributed something like £72.5bn to the rest of the UK based on those same numbers. Particularly with regards to the oil perspective as well. Obviously there was the windfall tax that was applied by, I think, the coalition government. But equally, the impact of the investment in the North Sea did have an impact on the revenue that was generated, because you can’t invest in the same fuels at the same time that you are taking oil out. So, as much as the revenue dropped, that was an investment for Scotland’s future.

AS: The point is that that was UK investment in the North Sea, not Scottish. That was money pooled from right across the UK to invest in the North Sea.

A £4.4bn reduction is not one to be scoffed at, like I said, the entire education budget of Scotland, lost in one year.

The point you make about Trident; I don’t support nuclear weapons, I think nuclear weapons are a bad thing. But I don’t think it is right to say ‘actually we’ll just move them 300 miles down the road’ that’s not credible enough.

And if you look at what he proposal sets out, from the money that was saved from Trident, which comes to about £250m a year, if Scotland was to remove Trident. That’s not £250m that has been promised to be spent on dentists or ’s money that they have said will go to spend to beef up Scotland’s defence force to make up for the reduction in the defence force as part of the UK.

WW: It’s a very relevant point that you bring up, because the bottom line is the money in the whole system. The point about public expenditure, you have quoted £1,200 per head more per person in Scotland, but Scotland pays £1,700 more per head in taxation, therefore we are still not getting back as much as we would if we were independent.

The best way to look at that is, if you go back five years, if we were independent, Scotland would be £8bn in the black. Not in the red as we have been under Westminster administration. So, the money does add up and, as you said, if you went back 33 years, we would be well over £50bn with a surplus, rather than with a huge deficit and debt that we have at the moment.

The other point about Trident is, not only would we save a quarter of a billion each year if we got rid of Trident now, but there is the prospect, supported by all the Westminster parties of £100bn spent over the next couple of generations rebuilding and renewing Trident, which is just the most appalling prospect of all.

Q: Do you consider the recent clawback a vote winner or a vote loser?

GB: I’m not an apologist for the SNP government, I’ve already stated that I’m a Labour voter. I disagree with the way that the clawback was handled as many of you know. The problems inherent in the situation that caused the clawback were as a result of continuous registration and I wouldn’t disagree that was, like most people in here, a mistake. So you won’t find any argument from me.

HM: Is it not the case that our professional association, our negotiators, negotiated on our behalf to pay the clawback to fund the retrospective payment for six months? So, I don’t know that we can really complain about it.

GB: I would view that as a damage limitation exercise Hew.

AS: There is a wider point on the clawback which is that bad things can happen in the NHS as part of Scottish Government that has all the powers over the NHS. The second point being, you heard earlier on that we need to become independent to avoid the privatisation of the NHS, that might be forced by Westminster.

Scotland has full control of its NHS right now and actually we have already had part-privatisation of orthodontics in Scotland under the SNP Government. So let’s not pretend that bad things don’t happen right now on the SNP’s watch.

HM: I think we’ll move on to the next stage of debate. First of all, I will ask Willie Wilson, who is the owner of Thistle Pharmaceuticals and a recently retired academic. He previously lectured to Glasgow dental students on pharmacology for 30 years. He’ll speak for the motion and he tells me that he has both Anas and Clive’s marks in his back pocket and if they get out of hand, he’ll reveal them.

WW: I lectured for 30 years on dental pharmacology, which is one of the reasons I am here. But really, the most relevant thing is that I can share with you are to do with my career as a pharmacist. Community pharmacy has close connections with dentistry and optometry in the sense that we are all contractors to the NHS. We are operating as businesses on the periphery of the NHS.

The two key points are that we are held in very tight contracts so that the contracts do not allow competition, in the sense that is now experienced in England. And the other clear point is that financially we are absolutely dependent on the NHS for funding.

So, consider for a moment that the NHS has done reasonably well and NHS Scotland has done reasonably well by dentists as my colleague has just explained. It has done very well by pharmacists over the last 14 years. One of the few improvements in pharmacy that relates, to a certain extent, to dentistry is the distribution of pharmacies. Right at the beginning of the Scottish Parliament they passed an act which prevented the huddling of several pharmacies around a health centre at the expense of no pharmacies in housing estates and the periphery of cities.

So, these are the kinds of things that the Scottish Government has done well and I would argue that the NHS has prospered in Scotland over the last 14 years, whereas we are seeing quite the opposite in England.

In terms of remuneration, if you stand back and look over the whole NHS, it is reasonable that prosperous people like dentists and pharmacists and so on should bear a bit more pain than the nurses and the lower paid staff. And that is one of the things that the Scottish Government has done. It may leave a bad taste, but that is what they have done.

Considering the NHS in general over 40 years, Scotland and England have diverged tremendously. In England, you have privatisation and commercialisation is going ahead quite rapidly and competition is the watch word. They no longer have patients in England, they have customers. There is rationing of treatment, both at GP level and in hospitals, and there is self-funding – that is the mechanism by which the patient, or customer, can put up the cost of an operation and essentially jump the queue.

Very soon, within a few years, the NHS in England will consist of a two-tier service. We have to ask ourselves, do we want that in Scotland?

There are two very good reasons why it is liable to come about in Scotland and it will come about if we vote No.

The first is economic. The Barnett formula has been attacked by politicians of all parties and is very likely to be ditched. Whether or not the Barnett formula is ditched, Mr Osborne has promised us, over the whole of the UK, £25bn per year of additional cuts to what we have already. From 2015 onwards, £25bn of cuts over the UK. Scotland’s share of that will be pretty disastrous.

Politically, we have Miliband and Balls saying that they will uphold Osborne’s proposals for tax and we have, perhaps significantly Mr Burnham, Labour’s shadow health secretary in England, saying that he wants to see more consistency in Scotland, England and Wales.

So, you have to vote Yes if you want to avoid privatisation.

HM:
I now call on Anas Sarwar, MP for Glasgow Central, former general dental practitioner and deputy leader of the Scottish Labour Party, referendum coordinator for the Labour Party and he will speak against the motion.

AS: Thank you, it is an absolute pleasure to be here. This is a really strange experience for me; I went into politics to get away from dentists, rather than to come and talk to dentists. That didn’t really work because I married a dentist while I was practising as well. Although she keeps reminding me that the reason why dentists have the highest suicide rates is most of them are actually married to other dentists.

This has been a rather strange debate I have to be honest, in terms of the case being made for Yes. Because, the reality is, all I have heard is a case against the English NHS. If you are voting Yes because you don’t believe in the English NHS, you are voting Yes for the wrong reasons.

We have a separate and different NHS for a reason.

You’ve heard it already, we’ve had 14 years of a different NHS in Scotland and we keep that same NHS even if we stay part of the United Kingdom. That’s what we mean by devolution. That’s why, if you like the NHS, if you are proud of the NHS, if you want the NHS to stay in public hands, that can still happen and will happen. It is a commitment from my own party that that will happen under a Labour government as part of the UK.

Now I want to come and talk to you about an idea that I believe is bigger than independence. An idea, in fact, that has its roots right in the NHS. And that is the pooling and sharing of resources right across the UK for the benefit of everyone in the UK.

And I’ll tell you what I mean by that. I think it is a positive and not a negative that the tax paid by a worker in Glasgow helps support someone on low incomes in Newcastle. Or a tax paid by someone in Cardiff, helps someone who is unemployed or who has a disability in Aberdeen. That is a strength and noone can ever tell you that is a weakness.

You’ve had two mentions today of the Barnett formula. The Barnett formula is not under attack from the Labour Party. The Barnett formula, we have said quite clearly in our own devolution committee report, will remain as part of our agreement as part of the UK. The only vote that kills the Barnett formula is if you vote Yes to independence.

If you vote Yes, there is no Barnett formula because there will not be that formal agreement with the UK Treasury. The positive case that I make to you as dentists, for your patients, your families and the communities that you serve every single day, is that we have an agreement that is, as you have heard from Clive, the best of both worlds, in terms of having a strong Scottish Parliament that works in partnership but still has the security of being part of the UK. A Scottish Parliament that will be strengthened with further tax powers and welfare powers by the next government.

We are also the best for jobs. The fact that one in five workers in Scotland work for a company that is headquartered in another part of the UK.

Best for jobs, best for income. And that means people spending money, hopefully, in your own practices as well.

It’s best for public services. The fact that we have £1,200 more spent per head in Scotland’s public services than we do in other parts of the UK.

The fact that tax paid right across the UK helps support us and our public services here in Scotland.

The fact that despite losing £4.4bn in tax receipts in one year from the North Sea, that didn’t result in a reduction in Scotland’s budget or a reduction in the amount of money we spent on healthcare and education this year in Scotland. That is another example of safety and security as part of the UK.

It’s best for pensions. Each and every one of you pay into an occupational pension scheme. It’s not a Scottish scheme, it is a UK-wide occupational pension scheme. At the moment, the rules from the EU are that you cannot have any debt-based pension scheme that crosses any borders. Every pension scheme is based on debt. If you look at your own pension scheme it will be based on a debt that won’t be paid until at least 18 years time. And the rules of the EU are that, if Scotland votes Yes to independence – this isn’t scaremongering, this is fact, it is EU legislation – within three years we have to fill that gap of that debt in terms of that cross border pension scheme. And that has an impact on my pension because I paid my superannuations as well for the short period I was a dentist. But it has an impact of every single one of your pensions as well.

It is best for business. As well as practitioners you are also business people. The fact that we trade twice as much with the rest of the UK than we do with the rest of the world combined, is a strength. Why would we want to make the rest of the UK, currently our biggest business partner, our biggest business competitor? It doesn’t make sense for us.

And the final point, is going back to that best of both worlds option. I’m proud of the NHS, I’m proud we have created an NHS, not just for Scotland, but an NHS for everyone right across the UK.
Let’s protect our NHS, let’s protect our public services, let’s protect our pensions, let’s protect our jobs, let’s protect our businesses and let’s vote for what is in the best interests of Scotland and let’s vote No.

HM: Any points or questions?

Q: There’s been a lot of talk about remuneration on the NHS but not a lot of talk about quality of care, efficiency, what would be a better system. I’m not an academic, but NHS-wise there is a lot of push for time and money. You see the private system steaming ahead in terms of technology, quality of treatment – could somebody have something to say on that?

AS: That’s real politics for me. I wish we were talking about social policy rather than constitutional policy.

We set out, at our own party conference a month ago, a document that I wrote, which is our alternative to independence. The so-called ‘Red Paper’, the Together we can document. In that, we made clear that now is the time to have a fundamental review of the NHS in Scotland. Stay true to the principle, of it being not in private hands and free at the point of use. No privatisation of our NHS.

But a recognition that actually our demographics have changed, our challenges have changed in the NHS. But our NHS hasn’t changed at the same time.

Not a race to how we have 15-minute care visits, down to 10-minute care visits and down to seven-minute care visits. Not dentists having to think ’my goodness I have got to get a patient in, do the treatment as quickly as possible because time is money’. Actually going back to quality of care and standard of care, that’s the real debate we need to have on social policy and constitutional politics doesn’t change that. Constitutional politics doesn’t change anybody’s life, apart from the politicians who want that new power. What you do with the power you have got to make a difference, that is what makes a difference to people’s lives. And I can’t wait for the day that we start talking about what we do with our public services rather than what powers we have.

GB: You can’t talk about quality and detach it from funding. You need money to deliver quality care. Anas mentioned that we have talked a lot about the difference between the systems of dentistry in Scotland and England and we would like to think that that wouldn’t change. We do have a successful system within Scotland, but it does require the same level of funding or more than we have at present.

He also mentioned that there were no plans to scrap the Barnett formula on which all of this depends. Well, can I quote Margaret Curran the shadow Scottish secretary, who has said, like David Cameron and Alastair Carmichael, she supported scrapping the Barnett formula, she said that in February of this year.

AS: It’s not true. There was a report published just last month – I am happy to send it to Gerry – that makes it quite clear Labour supports the Barnett formula and will keep it in place as part of Scotland remaining part of the UK. If you want to get rid of the Barnett formula, leave the United Kingdom. You only have a Barnett formula as part of the United Kingdom.

Q: I just want to ask whether we will lose the Barnett formula if we have another coalition government, say the Tories and UKIP?

AS: I go back to my point – the only way you definitely lose the Barnett formula is by leaving the UK.

The Barnett formula is a funding agreement that the UK treasury has about how it spends money, not just in Scotland, but actually how it distributes money right across the UK. That’s the agreement the UK treasury has in terms of how it allocates its budgets to each of the local authorities in England and to the Scottish Parliament, and then the Scottish Parliament feeds that down to local authorities in Scotland. That’s a funding arrangement that the UK treasury has. If Scotland votes to go independent, it will not be for the UK treasury to decide how it allocates funds right across the UK, including Scotland. It will be for Scotland to decide what it does with its own tax receipts and how it allocates money in Scotland.

So, the Barnett formula does not exist if Scotland chooses to go independent. As part of the UK, we have a Barnett formula, which is still in place despite the fact that we have a coalition government. They have not scrapped the Barnett formula and we have made it absolutely clear that we will not scrap the Barnett formula.

WW:
In a way, the Barnett formula is irrelevant. It hasn’t protected us from the billions of pounds of cuts that we have suffered in the last five years. The Scottish budget has been cut back in proportion to the British budget

AS:
How much has it been cut back by?

WW: In a sense, it doesn’t matter if the Barnett formula survives or not. What matters is George Osborne’s cuts of £25bn a year from 2015 onwards. The fact that the Labour government supports and will uphold these cuts, means that is the bottom line financially. We will continue to get cuts, slightly greater than we have had in the last five years.

AS:
How much has the Scottish budget been cut by?

WW: I wouldn’t have an exact figure.

AS: Because the reality is that it hasn’t been.

WW: It certainly has been.

AS: The reality is that it hasn’t been. If you look at percentages, in terms of growth of how the Scottish budget is growing post-devolution, it has certainly not grown in the same exponential rate it should have. So, in 1999 when we had the creation of the Scottish Parliament, it only had a budget of £15bn. Now it has a budget of £30bn.

WW: That’s inflation.

AS: No, I don’t think inflation has been so extreme that it was £15bn in 1999 and £30bn in 2014.

Scotland’s budget has not been cut, the only budget that has been cut, in cash terms, has been the local government budget.

HM: I’m gonna stop you there. Another question from the back please.

Q: Just to add to that point, I made a comment earlier that, from 31 March 1980 until now, there has been £72.5bn worth of excess that Scotland has contributed to the rest of the UK exchequer. But the point that I was going to make was that Scotland does not necessarily get the governments that it votes for. In the last 65 out of 67 years, the Scottish block of MPs have not been able to influence which party has actually got into power. So, with all due respect, as much as Labour, perhaps from your perspective, have said that the Barnett formula will remain. We, by voting Labour in Scotland, will not necessarily get the government that we voted for. We get the government that the rest of the UK votes for.

AS: On the point about getting the government you voted for. I didn’t get the government I voted for. 54 per cent of the people that voted in the last Scottish Parliament election didn’t get the government they voted for.

Glasgow didn’t get the government it voted for in the last Scottish Parliament election. We’re not calling for a Glasgow independence.

Democracy is that way, we all vote, we are all part of one collective. We all vote and not all of us get the government that we voted for. But the reality is, if you look at the government that we have got, if you look at the collection of votes in terms of what the Tories and Lib Dems got combined, they got more than the SNP did at the last election in Scotland. So, perhaps they could argue that they got more of the government they voted for.

And, in terms of my own political lifetime, I first voted in an election in 2001, I did get the government I voted for. Sixteen year olds that will be going out to vote, for 14 out of the last 16 years of their lives, they will have got the government they voted for.

We can go back to 1979 all we like. The money we are talking about is the money today. The governments we are talking about, are the governments today, not 1979. This decision is bigger than David Cameron, it’s bigger than the Tories, it’s bigger than Alex Salmond, it’s bigger then me and it’s bigger than the Labour party. The decision we make will last well beyond the last memory of any of them and that is what we have to think about.

Q: Can I just add to that? Anas has just quite eloquently just confirmed the point I just made. Thank you.

WW: I think democracy is at the very basis of this referendum. The way I like to see it is that when you are voting in an election in the future, when we are independent, your vote will be worth 11 times more than it is at the moment.

When we talk about debt and spending and so on, we really should remember that the UK has run up an enormous debt of £1.4 trillion that we are all saddled with.

CS: Where would the Royal Bank of Scotland be without the UK treasury bailing it out?

Look what happened to Iceland and Ireland, small countries who have had to be bailed out.

WW: RBS was bailed out more by the Federal Reserve than it was by the British Government.

AS: Not true.

HM:
I’m going to take one last question and then it’ll have to be a very short answer before we move on to the closing remarks.

Q: Thank you everyone for this very interesting debate. I’m a foreigner, but I have lived in this country for nearly 30 years and benefitted from it greatly. Can someone in the Yes camp explain how much it is going to cost for separation?

Every aspect of our lives are going to be changed and how much is this going to cost and is the money not better used elsewhere?

WW: I think the short answer is that all the services that we enjoy, we pay for already. In shedding some of the things that we really don’t want, such as an enormous defence structure that costs probably about double what we would need for independence. We contribute about £3.5bn towards defence of the UK, only £1.8bn of that is spent in Scotland. There are huge savings that we are going to make that will pay for what you call the cost of separation.

AS: The Yes campaign would like to tell you that everything that you like will stay the exact same and nothing you don’t like will ever happen anymore. We are going to break up the MOD, we are going to break up the Foreign Office, we are going to break up our welfare system, we are going to break up our pension system, we are going to break up the UK treasury, we will break up our Department for International Development. But, apparently, none of it will cost a thing.

It is just not rooted in reality. The reality is, I am not saying the UK is perfect, far from it, but we can work together with the rest of the UK, to deliver fairness right across the UK.

HM: Right, I am going to call on a speaker from both sides, one speaker, to give a short closing sum up of their remarks.
WW: It is difficult to pull together all of this debate in such a short time, but several very important points have been brought up.

Pensions are certainly important, everyone is eventually concerned about their pension. Anas was describing the difficulties with certain private pensions in relation to EU law. Personally, I am quite sure that the European Union will sort out those difficulties no bother. But pensions for NHS workers, which is a huge organisation are organised in Scotland already, they are paid from Scotland already and they are in surplus, unlike pensions in many private enterprises and unlike state pensions which are definitely not in surplus, thanks to Gordon Brown and other politicians in the past who have pretty much wrecked and raided our pension system.

I would like to make a little point about Anas; here is a man who is not just defending a principle that is somewhat indefensible – the principle that Scottish people should be allowed to make decisions about things that concern Scotland’s future, but he is defending his salary and his expenses. Enough said.

AS: I made more as a dentist by the way…

WW: Talking about businesses competing. All businesses do compete, but the differences about businesses involved within the NHS is that we are held within very tight contracts that prevent us from competing. All that is broken down in England and competition is going mad.

And that is the reason why the English NHS will cost more and more to the actual customer because the customer is having to pay for administrators, marketing managers, insurance experts and all the people who are the bean counters, the accountants who deal with the exchange of money. All that non-productive activity detracts from the NHS and its true role in life, to serve the health of the nation. I would much rather Scotland kept a national asset, which is probably the most popular thing that Scotland has among the entire population. The national health as a national asset.

CS: I believe that both Anas and myself have made a really positive case for keeping Scotland as part of the United Kingdom. Both Willie and Gerry have been utterly negative throughout both their presentations.

They have raised the bogeyman of privatisation when we are all committed to the NHS in Scotland. They have talked about rationing, they’ve threatened us, they’ve said how bad Gordon Brown is, how bad Ed Balls, Milliband, David Cameron, the lot. How negative can they be? They don’t want to put a positive case. It is all about the negative.

We have been so positive about the benefits for Scotland, for the NHS in Scotland and for dentistry in Scotland.

We had a question attacking defence spending. I’m not going to apologise for the fact that Scotland is part of UK defence. There are people from the military here today and I think we should be proud of Scotland’s role in the military.

I’m not going to apologise for supporting Scotland as being part of a strong United Kingdom. Unlike some small countries we didn’t need to be bailed out. I think it is good that we are part of the United Kingdom, one of the leading economies in the world.

Some of us touched on the politics, we didn’t have time to get on to the currency issue. But I think it’s a key issue that affects us all and I think it has political implications. Are we going to have a separate currency, a Scottish pound? Which, I think we all know is a non-starter. And the reality is, if we are going to have a currency union, I don’t think it was helpful for George Osborne to come up and slightly patronise us. If there is going to be a currency union, the reality is that, if there is a Yes vote and England becomes separate, it is far more likely to be a Conservative government without all the Labour voters up here. With a Conservative government and Conservative policies probably lower taxation south of the border and that will influence Scottish politics. Because, if you have a currency union – and we have seen what happens if you have different spending in different parts of a currency union, you only need to look at what happened in Greece – you can’t have that. So, the English Tories, that you pretend to be so bad and evil – and maybe they are, I’m not here to support them – will still have an influence over what happens in Scotland. Because Scottish spending, the spending that you are so keen to promote and protect with independence, will still be influenced by what goes on south of the border.

Where will all the jobs go if England has this so bad Tory government with low taxes and flexible economy. The jobs will go south. We will lose jobs in Scotland.

The best way to protect health spending, the best way to protect Scotland’s future is for Scotland to remain part of the United Kingdom. We are Better Together, vote No.

HM: Our speakers have done exceptionally well, it is obvious from their ability to stick to time and their preparation that they put a lot of work into it, and I would like you all to thank them for that.
Applause

Secondly, I think we have to thank Scottish Dental magazine for organising this debate, it’s clearly been a popular idea and it has been fascinating.

Every effort has been made to transcribe this debate as accurately as possible. However, if you spot an error, please contact

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