More on the Scotland in Union letter


In the letter to The Herald from (seemingly) Ian Murray MP’s election agent, this stood out: “… the SNP Government has tried to integrate health and social care, but it has systematically cut local authority funding, and INTEGRATION HAS NOT HAPPENED.” (my emphasis)

It’s really not hard to refute this claim. However, it’s the kind of public assertion from a notable political activist that brings NO credit to the Labour Party in Scotland. Or perhaps it’s just the kind of knock-about political banter – the not to be take too seriously, over the top political rhetoric – that some Labour activists are happy to engage in even on the most important of topics?

(As an aside, anyone asserting the status of local authority funding over time without substantial qualifying information is seriously over-simplifying a complex matter – and could be motivated to deceive. Beware!)

So for perspective on integration, let’s see how others see Scotland. I offer a few quotes (from July 2018) from the health think tank, the Kings Fund. This is an authoritative organisation largely focused on health and social care in England. It has no obvious ‘skin in the game’ in terms of Scotland’s politics.

“Imagine a place where you could debate and refine policy on integrating health and social care for three years, leading up to legislation. And then, organisations and staff could take a full year to learn new ways of working together in shadow form, with unwavering political support, before becoming accountable for bringing services together to improve health, care quality and value. There’s no need to imagine; that’s what is currently happening in Scotland.”


In the main 2018 report on integration as it is developing, we are informed:

“In Scotland, more than half of the total NHS and adult social care budget is now delegated to an integration joint board (IJB) for each area (apart from Highland, which has a unique arrangement). IJBs have a statutory basis and are not ‘owned’ by either the NHS board or the local council. This gives them unprecedented scope to work collaboratively to shift resources to community-based services and to develop new models of care as a shared, cross-system endeavour. They are now in their second year of operation and we’ve been able to reference various examples of their work in our report.”

And on early progress: “Integration of health and social care is a key priority for the Scottish Government and significant infrastructure – including a national delivery plan and outcome and integration indicators for monitoring progress – has been established to support it. Reviewing our conclusions when we reported on lessons for England from the other UK countries’ approaches to integration (Ham et al 2013), it was noticeable that Scotland had made progress in all the policy and systems issues identified as important …”

That was back in 2018. That integration, a fiendishly complex but important objective, remains a work in progress is certainly true. However, for someone who presumably wishes to be taken seriously to dismiss the evidence of ongoing work by many, many people across Scotland over years – from government ministers to frontline health and social care workers – with an all so casual ‘integration has not happened’ remark in a letter to a newspaper is, candidly … let’s just say a ‘disappointment’!

I hope this is not representative of the political culture in Labour’s Edinburgh South constituency party!

One thought on “More on the Scotland in Union letter”

  1. Audit Scotland says that integrating health and social care has been a key government policy for many years. It traces the legislation beginning in 2002. The final piece of legislation was 2014, Public Bodies (Joint Working) (Scotland) Act which introduced a statutory duty for NHS boards and councils to integrate the planning and delivery of health and social care. All integration under the Act had to be in place by 2016.

    I wonder where Mr Tate has been and is the Letters editor of the Herald an alien?

    Click to access briefing_180412_integration.pdf

    Liked by 2 people

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