Health Board Elections

Excitement in some papers yesterday because the pilots for direct elections to health boards cost £1.6m. 'Shocking', say the usual suspects, this could have paid for 64 nurses.

Sorry, but no it wouldn't. You would have hoped that the difference between recurring and non-recurring expenditure would have been understood, at least by serious health organisations. However, the BMA and RCN always opposed the extension of democracy to the NHS, so this was predictable enough. Their evidence to Parliament when the Bill went through reflected a very top down, professionals knows best, attitude to patient involvement.

I think it would be fair to say that I might not always agree with the Cabinet Secretary for Health, but on this one she got it right when she said:

 “I believe this represents good value for the kind of democracy that puts people at the heart of the NHS. It is a reasonable price to pay for making sure local communities are at the heart of local decision-making."

Yes of course the NHS is facing cuts but that is not an excuse to abolish democracy. In fact when difficult decisions have to be taken we need more democracy, not less. The Scottish Parliament elections cost £40m to administer. Parliament correctly decided to separate council elections from the parliamentary elections for sound democratic reasons, despite the additional cost.

It would of course be much cheaper to have a system of regional governors for local government or even a High Commissioner for Scotland. However, I haven't seen a Herald Editorial calling for that in these straightened times. Democracy is rarely cheap but it is the bedrock of our way of life. One third of Scottish expenditure goes to NHS Scotland. Sums of that magnitude deserve democratic oversight.