One of the great ironies in the referendum campaign has been the emergence of the NHS as a referendum issue. The SNP, wont to accuse the No camp of scare stories, has itself been running a scare story of its own. The NHS, it argues, is under threat because of privatisation in England.  

You may be surprised by that line of attack given that the NHS is entirely the responsibility of the Scottish Parliament. And you would be right. 

In fact the NHS in Scotland has been a considerable success for the Scottish Parliament — certainly in comparison to the problems it has faced in England — and it therefore demonstrates the effectiveness of devolution in delivering Scottish solutions for the Scottish context. 

As Dave Watson of Unison noted in June in the Open Democracy site: “Since devolution, the NHS in Scotland has taken a very different path to that of NHS England. It has embraced co-operation rather than competition. And new figures show that Scots reckon that it delivers for them.”

Not that it has saved the Scottish NHS from PFI/PPP and the left certainly needs to discuss how, for example, additional borrowing powers for the Scottish Parliament could help address that issue. 

Neil Findlay, the left-wing Labour MSP and spokesman on health, further contends that if there is a threat to the NHS in Scotland it is the SNP government which poses it to patients and staff alike. 

He cites falling bed numbers and nursing staff and a 37 per cent increase in spending on private healthcare and points to a Department of Work and Pensions study that reveals that just under 8,000 NHS workers are on zero-hours contracts.  

This should be — but is not — the discussion we are having at the moment. Instead in language every bit as “scary” as the scaremongering the No campaign is accused of, leading Yes politicians predict the end of the health service in Scotland as we know it. 

Here is the BBC website: “Earlier this year First Minister Alex Salmond warned of a ‘growing threat’ to the Scottish NHS from an agenda of ‘privatisation and fragmentation’ at Westminster. ‘Under the Westminster system, cuts to spending in England automatically trigger cuts in Scotland,’ he said. ‘So if private money replaces public funding in England, our budget will also be slashed no matter what we want or need.’”

The argument being pursued here is that because the Barnett formula works on increased funding going to Scotland based on an increase in England, then a spending cut in England as a consequence of privatisation will mean less money will go to Scotland.

What this disguises is the full horrors of privatisation. The private sector is not coming into the market to take money and offer care to patients who might otherwise have used public services — that form of privatisation is peripheral. 

The point is that services are subcontracted out to the private sector, hip replacements for example, funded by public money.

Consequently the amount of public money going into the health service in England is not falling. 

According to a report produced by the King’s Fund charity, which looked at a number of projections, it is increasing and, according to the Treasury’s official Red Book for the 2014 Budget, spending on England’s NHS is scheduled to increase from £105.6 billion in 2013/14 to £110.4 billion in 2015/16. 

Consequently there will be no cuts to the Scottish NHS budgets as a consequence of the Barnett formula. They will increase. Worse still, lost in  scare story and counter-scare story, is the lack of exposure on the impact of the Transatlantic Trade and Investment Partnership (TTIP). 

As Katy Clark MP pointed out in the Morning Star on August 20, TTIP will make it very difficult to bring services that have gone into the private sector back into public ownership because companies will have the right to sue for lost profits.

If the SNP is concerned to protect Scottish public services including the health service, then it might want to rein in its leader Alex Salmond’s enthusiasm for TTIP. Here he is addressing the Brookings Institution in Washington DC in April 2013: “Despite all of the current difficulties in the eurozone, we saw a reminder of that just two months ago — with the announcement of the planned Transatlantic Trade and Investment Partnership between the EU and the USA. 

“Estimates show that once this is established, the European economy will get a stimulus of half a per cent of its GDP. For Scotland, given that the USA is our largest individual trading partner outside the UK — our trade with the EU as a bloc is greater — the agreement will be especially good news.”

It will not be good news for Britain’s or Scotland’s public services.

Of course, and rarely mentioned by independence supporters, the doomsday scenario of Cameron and the right winning the next election depends on the Tories winning the argument that the reduction in public services and the decline in living standards British workers are experiencing is a necessary element of restoring the economy to good health. But are they?

 The UK polling site puts Labour ahead in the polls by a margin which translates, using their methods, into a 44-seat majority for Labour. 

I hope that if, as the polls suggest, there is a No vote, the left can devote its energies to exposing the damage and the danger that Cameron, Johnson and their ilk pose and discuss radical alternatives including what additional powers a Scottish Parliament will need to underpin a successful NHS and how we stop TTIP in its tracks.

Vince Mills is a member of the Red Paper Collective and a contributor to Class, Nation and Socialism: Red Paper on Scotland 2014.