Professor John Robertson OBA
I've used the Grok AI to assist in researching and presenting this paper. I'm able to check the references it helpfully offers.
Last year the Scottish and English media widely reported a one-year surge in TB cases reported in Scotland from 2022 to 2023.
Yesterday, Public Health Scotland published the latest data:
To my knowledge, the media have not since reported the fall in the number of cases between 2023 and 2024.
For context, all things being equal, we might expect England to have had around 2 700 cases in 2024. It had almost exactly twice as many:
In 2024, England recorded 5,480 tuberculosis (TB) cases, a 13% increase from 4,850 cases in 2023. For the first half of 2025, provisional data shows 2,770 TB notifications, a 3.9% rise compared to 2,665 in the first half of 2024.
https://www.gov.uk/government/news/tuberculosis-cases-in-england-continued-to-increase-in-2024
Why might this be? Differences in housing, poverty and healthcare, perhaps?
What environmental factors have been shown to contribute to the spread of TB?
The World Health Organization (WHO) identifies poverty as a powerful determinant of tuberculosis (TB) due to its influence on living conditions and health outcomes. Poverty exacerbates TB transmission and progression through several key mechanisms:
Crowded and Poorly Ventilated Environments: Poverty often leads to overcrowded living and working conditions, which facilitate the spread of TB bacteria through airborne transmission. Poor ventilation in these settings traps infectious droplets, increasing exposure risk.
Undernutrition: Malnutrition, common in impoverished communities, weakens immune systems, making individuals more susceptible to developing active TB from latent infection. https://www.who.int/teams/global-tuberculosis-programme/populations-comorbidities/social-determinants
Limited Access to Healthcare: Poverty restricts access to timely diagnosis and treatment, allowing untreated TB to spread. One person with untreated infectious TB can transmit the disease to 10-15 people annually. https://www.who.int/teams/global-tuberculosis-programme/populations-comorbidities/social-determinants
How do Scotland and England compare in terms of affordable housing?
Scotland generally provides more affordable housing per capita than England, particularly in terms of social housing and overall supply relative to population. Here’s a concise comparison based on available data:
Supply of Affordable Housing: Scotland has consistently outperformed England in delivering affordable homes per head of population. Between 2007-08 and 2022-23, Scotland delivered an average of 14.2 affordable homes per 10,000 people annually, compared to 9.8 in England. In 2022-23, Scotland completed 10,458 affordable homes (19.1 per 10,000 people), while England’s rate was 11.3 per 10,000. https://www.gov.scot/publications/quarterly-housing-statistics-march-2024/pages/housing-supply-including-affordable-across-the-uk/
Social Rent Focus: Scotland prioritizes social housing, with over 70% of its affordable homes since 2007 built for social rent (e.g., 7,000 of 10,000 annual affordable homes in the last UK Parliament were for social rent, compared to only 8,000 annually in England). https://scothealthequity.org/housing-in-england-and-scotland-a-comparative-analysis/
How do Scotland and England compare in terms of poverty rates?
Scotland generally has lower poverty rates than England, based on available data up to 2025. According to the Joseph Rowntree Foundation’s 2023 report, Scotland’s overall poverty rate was 18%, compared to 22% in England. Child poverty rates also reflect this trend, with Scotland at 24% in 2023/24, compared to 31% in England, largely attributed to policies like the Scottish Child Payment and lower housing costs in Scotland’s social housing sector. https://www.believeinscotland.org/scotlands-poverty-rate-20-lower-than-englands-says-authoritative-report/
https://www.actionforchildren.org.uk/blog/where-is-child-poverty-increasing-in-the-uk/
Finally, healthcare is a big topic to do fully so just this:
Scotland has more doctors and nurses per head of population than England, based on available data up to 2025.
Doctors:
Scotland has a higher number of general practitioners (GPs) per capita. Recent figures indicate Scotland has around 83–95 GPs per 100,000 people, compared to 63–78 GPs per 100,000 in England.
For all physicians, Scotland had 30.5 doctors per 10,000 people in 2013, compared to 26.6 in England. More recent data from 2021 suggests the UK average is 3.18 doctors per 1,000 (318 per 100,000), with England specifically at 3.2 per 1,000, while Scotland’s higher GP ratio suggests a stronger per capita presence. https://www.bmj.com/content/346/bmj.f3752
https://www.theglobaleconomy.com/United-Kingdom/doctors_per_1000_people/
Nurses:
Scotland has more nurses and midwives per capita. In 2021, Scotland had 8.4 nurses per 1,000 people, while England had 5.8 per 1,000. Another source from 2017 reports 8.1 nurses and midwives per 1,000 in Scotland compared to 7.9 for the UK average, with England lower due to its larger population and lower staffing ratios. https://www.businessforscotland.com/scotlands-nhs-outperforms-the-rest-of-the-uk-heres-why/
NHS Scotland’s workforce data from 2021 shows 28.5 whole-time equivalent (WTE) staff per 1,000 people, compared to 21.4 WTE in England, reflecting higher overall clinical staffing, including nurses. https://www.gov.scot/news/nhs-workforce-at-new-record-high/
So, back to me – Scotland has only half the TB rate of England due to less poverty, more affordable housing and better healthcare access.
Finally, might independence for Scotland with immigration controls help in any way?
In 2023, where place of birth was known, 67.5% of tuberculosis cases in Scotland were born outside of the UK. Tuberculosis incidence in individuals born outside of the UK was 19.2 times higher than in individuals born in the UK. The most reported risk factor for tuberculosis was being a refugee or asylum seeker.
Talking-up Scotland 'Albatraz' 
ST
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Who has heard this and all the time I thought Labour and yoons said it would only last a few years.
Rachel Reeves has said North Sea oil and gas has ‘an important role to play for many decades to come’.…
Who would have thought it. McCrone report
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on the subject of ‘better health care access’ this from Saturday’s Guardian
https://www.theguardian.com/society/2025/aug/01/three-million-on-nhs-england-waiting-lists-have-had-no-care-since-gp-referral
Wonder what Baillie et al will dream up to try to distract from this truly shocking story?
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Legerwood, the chances of it being either reported in the “Scottish” media, or Baillie being challenged, is probably about 3million to one.
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Indeed but such is their stupidity they don’t seem to realise we can read the ‘English’ papers.
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TB is nowhere near so prevalent as it once was, even the England figure of 10 per million shouldn’t ring alarm bells, but when the figures are so low for Scotland, there is always some political muppet prepared to milk it on %ages – Likely farmed by a Labour Spad to the Wrecker, but only the budgie read it whilst having a crap.
However, there is a rather more obvious reason for the low 2022 figure, Covid….. 😉
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