A MESSAGE FROM THE FIRST MINISTER
Welcome to the National Conversation - a unique opportunity for you to consider and debate the most important issues affecting the future of Scotland
Gaelic language version
Over the last ten years the Scottish Parliament has shown how Scotland can successfully govern itself by providing distinctive, innovative solutions to issues that matter to Scotland.
I am proud to serve as Scotland's First Minister, and proud of what we have achieved in that time. I believe that by abolishing tuition fees, providing care for older people, freezing the Council Tax, cutting business rates, delivering record numbers of police officers and addressing health and education, the Scottish Parliament and Government have made a real difference to the lives of the people of Scotland.
But devolution is a process not an event and the time is now right to review and further strengthen the responsibilities of the Scottish Parliament.
The current economic crisis has clearly demonstrated many weaknesses in the existing constitutional settlement. Scotland has very limited scope to lower tax rates to provide a fiscal stimulus. We cannot borrow money to fund public works, or make changes to benefits, pensions or tax credits to meet Scottish needs. Instead, Scotland is dependent on decisions made by the UK Government at Westminster.
Our choices are also limited on issues such as climate change, alcohol misuse and investment in renewable energy.
We believe that Scotland should be like any other independent European country, working in partnership with our neighbours and with our own voice and the full ability to meet the needs of the people of our nation. This is why we plan to hold a referendum at the end of 2010, so you can decide.
But what does an independent Scotland mean to you?
The National Conversation is about giving you the facts, hearing your views and providing opportunities to debate some very serious issues about the future of Scotland. We believe that, only then, can you make informed choices when the referendum comes.
This leaflet is part of that ongoing process of keeping you informed about the opportunities and impact of an independent Scotland.
I look forward to debating these issues with you.
Rt Hon Alex Salmond MSP
Health and Wellbeing
A healthy population is essential to deliver strong economic growth. Scotland has already shown that we can successfully manage our own health system fairly and equitably to improve health for all.
We want to see a Scotland where healthcare services continue to be provided free at the point of delivery as far as possible and by a unified healthcare system based on working together, rather than a market-driven approach.
We also want to build a locally-led, patient-centred NHS, which promotes health and wellbeing and tackles health inequalities as well as treating illness and continuously improving the quality of care.
Under the previous administration we were first in the UK to introduce legislation banning smoking in public places. The Tobacco and Primary Medical Services (Scotland) Bill proposes further measures to protect Scotland's children from the harmful effects of tobacco and Scotland will become the first country in the UK to ban cigarette vending machines.
We are also leading the way in tackling alcohol-related health issues, through planned legislation on minimum pricing. These actions could be complemented by aligning alcohol duty and taxation to alcohol strength if there were devolved powers to do so.
There is no doubt that much has been achieved working within current devolved powers. However, there are many key areas which still need to be addressed, such as the regulation of healthcare professions, genetics, medicines, medical supplies and poisons, all of which are currently reserved to the UK Government.
How much more could be achieved if Scotland had full responsibility for deciding its own healthcare policy in totality, specifically to meet the needs of its people?
The Scottish Government is committed to improving health and healthcare services and has:
- increased health funding to a record £11.09 billion for 2009-10
- increased the number of NHS Scotland staff by 2.1% since 2007
- provided 2.2 whole-time equivalent medical and dental staff to every 1,000 people in Scotland (1.7 in England)
- supported all NHS Boards in meeting the current national maximum waiting times standards
- reduced the price of single prescriptions and prescription prepayment certificates, which will be completely free by 2011, one year ahead of the manifesto commitment
- removed hospital car parking charges for most patients
Our Health Boards (Membership and Elections) Act 2009 was passed unanimously by the Scottish Parliament, allowing direct elections to take place to Health Boards. This will ensure that our communities have a voice at the heart of the decision making process in their NHS.
Since May 2007, the Scottish Government has made steady progress to reverse the years of decline in NHS dentistry, which in time will see the unacceptable waiting lists that have built up in some parts of Scotland come down.
Latest figures published show that the number of General Dental Service ( GDS) dentists in NHS Scotland at September 30, 2008 was 2,703 - an increase of 157 (6.2%) from the previous year.
Since 1995 deaths from heart disease in under 75s are down 50.8%, whilst deaths from strokes in under 75s are down 49.8% over the same period.
Housing and Communities
Scotland is able to take a distinctive approach to its housing because large parts of policy-making are already devolved, including funding, planning, tenancy rights, housing quality and
property law.
However, the UK Government retains powers over key areas essential to revitalise Scotland's housing market. These include taxation (including inheritance tax and stamp duty), housing benefit, central borrowing and the regulation of mortgages.
Measures applied in a UK fiscal environment cannot be specifically responsive to house price pressures in Scotland, which has historically behaved very differently from the rest of the UK. For example, in the private rented sector, local housing allowance rules apply across the UK, irrespective of regional differences in policy or housing markets. All of these constrain our ability to meet Scotland's housing needs.
Our work is also constrained by the UK Government on the key issue of local authority housing debt. On average, the cost of servicing council housing debt accounted for 23% of income from rents in 2007-08, but in six councils it was more than a third. Restrictive Treasury rules constrain our capacity to manage the burden of this debt more effectively.
The Scottish Government has responded to the housing credit crunch in Scotland by:
- bringing forward £120 million from 2010-11 to support affordable house-building, in partnership with local authorities who provided £40 million of this funding
- launching a new Home Owners Support Fund which, together with the Mortgage to Rent Scheme and a new Mortgage to Shared Equity Scheme, helps provide £35 million to protect home-owners facing repossession
- expanding Open Market Shared Equity with a £60 million budget in 2009-10 to help more families to buy at the lower end of the housing market
- urgently reviewing ways in which reserved or devolved legislation should be strengthened to protect people under threat of repossession
Benefits, Tax Credits and Employment Support
Relative poverty affects almost one in five of our population.
Both Scotland and the UK have higher levels of child and pensioner poverty than the EU average.
We are working to increase sustainable economic growth, tackle poverty and help people who can work to achieve their potential through employment.
Policies relating to benefits and pensions, tax credits and employment support are hugely important in helping to alleviate poverty and low income. However, under the current constitutional structure these are largely reserved to the UK Government. This means that the Scottish Government:
- cannot make changes to the administration of benefits, tax credits and employment support
- cannot change benefits and pensions, tax credits and employment support in Scotland or opt out of changes made by the UK Government
- cannot supplement existing UK schemes without risking the recipient losing UK benefits or tax credits
- is constrained in developing devolved policies due to the interaction with the UK-led tax credit, benefits and employment support systems
These are all barriers to opportunity to many of the most disadvantaged people in Scotland.
Percentage of Children and Pensioners in Relative Poverty (below 60% median income), 2006
Source:DWP, Family Resources Survey and Eurostat, at Risk of Poverty Rates
Free Personal and Nursing Care and Attendance Allowance
Scotland led the way in providing free personal and nursing care for older people with assessed care needs. In response, the UK Government withdrew attendance allowance funding from older people in care homes receiving free personal care. The Scottish Government compensated those affected to ensure that they did not lose out.
Key Questions:
How might an independent Scotland better integrate health and other services to meet the needs of Scotland's people?
How should an independent Scotland regulate the housing market more effectively than at present?
How could an independent Scotland use the full suite of policy and funding powers to revitalise Scotland's housing?
How should a social security system operate differently in an independent Scotland?
Nicola Sturgeon MSP
Deputy First Minister and Cabinet Secretary for Health and Wellbeing
The health and wellbeing of a population is a key focus for any government. Good health, adequate housing and a benefits system that protects the most vulnerable are the basic building blocks of a civilised society.
Devolution has given Scotland many of the key levers to deliver high standards. I am proud that successive devolved administrations have sought to make the most effective use of their powers to meet the specific needs of Scotland's population.
The ban on smoking in public places, free personal and nursing care for older people, the reduction in prescription charges, the restarting of council house building and support for home owners in difficult market conditions all show what can be done for Scotland, by Scotland. However, I want this - and all future governments in Scotland - to be able to use all relevant powers to improve the lives of the people of Scotland.
Challenges such as the current housing crisis require innovative responses from across government. We have delivered those within our current responsibilities, but changes such as bringing in new large-scale investment in private rented housing are constrained by UK stamp duty rules, which disadvantage investors making bulk purchases by charging tax at the higher rate.
Scotland's relative levels of child and pensioner poverty are a scandal in an oil rich nation. Independence would offer us the opportunity to refocus our benefits systems to address this through closer integration with housing, education, employability and health policies.
The National Conversation is not simply about legislative powers and responsibilities. It is about how these new responsibilities would be used to address the issues we all face every day. I hope you will review the evidence, consider the facts and join the debate, so you can make informed - and crucially important - choices about Scotland's future.
