There is a phrase we should remember from the 1970s – stagflation

There is a phrase we should remember from the 1970s. Stagflation. For readers up here in Scotland, it’s nothing to do with Highland deer. Sorry, it’s a terrible pun, but it does have to do with things getting dearer.

Stagflation is the toxic mix of high inflation, soaring costs and poor employment figures.

Although financial experts are talking about prices “beginning” to go up in the supermarkets, here on the ground, we’ve been noticing it for a while. Also, we have the scourge of the zero-hours contract with no security, no job reliability, no holiday pay or sick pay etc – the initial impact on the job market is masked.

However, very like the 1970s, the root causes are the same:

Oil disruption – tick

Supply costs rising – tick

Policy errors – tick

For “policy errors”, we have to include a sub-category which would be corruption and utter lunacy on an industrial scale in the world’s – until recently – pre-eminent power, the US.

Add to that the AI con that many Western governments are into hook, line and sinker, with data centres mushrooming despite the public’s extreme gut reaction against them, and we may be looking at Elkflation as opposed to the much smaller 1970s Stagflation …
Amanda Baker
Edinburgh

THERE has been a splurge of selling government bonds round the world, including in the UK, driving up yields. The bond market players (already wealthy) want more money, ie bigger yields, just now, saying they are concerned about inflation and debt. But the UK Government can keep control. The US Treasury has already started buying back bonds to lower the yields/interest rate, which the Bank of England could also do.

The Government issues bonds as a savings facility, not for borrowing at all, so using “debt” to describe these is misleading. They are government money and it does not have to pay interest/yields on its own money. They offer a safe deposit for the private sector and foreign governments holding sterling. The government’s liabilities are not increased by the government issuing a bond.

In the UK, higher energy prices and food prices are driven by the US/Israel war on Iran, climate change and lack of regulation. These are not anything to do with excessive local demand. The UK Government needs to properly tackle these issues which are not new. As a currency issuer, the UK cannot run out of its own money and become bankrupt, so it can work for the whole economy, investing in resources where there is capacity, e.g. in its labour force, without inflation. The yields from government bonds are similarly government investment.

The bond markets need reform, e.g. on taxation. They lack accountability and act undemocratically. It is the government that runs the country, and it needs to manage the bond market. The Bank of England needs

to stop quantitative tightening and to be told by government to reduce interest rates. The government needs to stop issuing bonds to keep up their price. Ownership of bonds needs to widen, with democratic control on savings for the whole of society.
P Yates
Edinburgh

I READ Lesley Riddoch’s column in The National on Thursday.

At first glance, two health boards for the whole of Scotland looks like being one step away from full centralisation, so let’s wait and see what’s in the detail – it could herald the beginning of a new era of physician-led devolved administration.

On the whole, GPs are no longer jacks of all trades as in larger practices – they tend to deal with specific illnesses, such as bronchial or orthopaedic, communicating directly with specialist units, referring patients to consultants for tests, reports and, if necessary, treatment.

The new structure could lead to more devolution to consultants and GPs, with specialist groups based in major hospitals, their teams providing services over a number of hospitals and practices rather than by health board.

This would reduce postcode lotteries and improve the position in remote areas that at present cannot attract potential consultants who are not connected to hospital consultants in their area.

Norway has many advantages but, most of all, it does not suffer the burden of having a large number of the members of its parliament and councils from political parties headquartered in another jurisdiction, whose primary objective is ensuring that their country remains the subsidiary of another, while indulging in opposing in principle everything proposed by the governing party.
John Jamieson
South Queensferry

IN his letter, “The answer to achieving indy is staring us in the face” (Sunday National, August 30), Alan Crocket writes: “All we need for independence is a) a formal democratic head-count vote of the Scottish electorate, and b) implementation of a Yes result.”

When I went to secondary school, the first thing my English [the subject] teacher taught about was the difference between the spoken word and the written word. A verbal answer to a question may be limited, but regardless of that limitation, we convince ourselves that because we have had everything in our mind at the time, we have included it in our answer. In the written word, we cannot do that and therefore must be specific, meaning that words matter. The inference from what Alan Crocket writes being that outwith (a) and (b), nothing else matters.

The following extract is an example of being specific: “The tension becomes evident when a group within a state claims the right to separate and establish an independent state. If self-determination were interpreted as granting a general right to secession, it could undermine the territorial integrity of existing states and destabilise the international system. At the same time, denying all claims for political autonomy or independence could contradict the legal recognition of self-determination as a fundamental right of peoples ...

“Outside the colonial context, international law has been far more cautious in recognising claims to independence. The prevailing approach emphasises the protection of territorial integrity as a central element of international stability. The Friendly Relations Declaration reflects this position by affirming the importance of territorial integrity while recognising the right of peoples to self-determination within existing states (United Nations General Assembly, 1970).”
Michael Follon
Glenrothes

AFTER reading Gerry Hassan’s excellent article in last week’s Seven Days, I felt some aspects were missing. Sectarianism is the scourge of Scottish football. Celtic/Rangers has become one of the most famous derbies in the world because of the religious divide.

In the 1960s, when I was 14, 15, 16, I was potentially ear-marked to reach a decent level. For a while, it affected me that no matter how good I was, because of my religion, I couldn’t play for Rangers. Though it’s tempered a bit today, it’s still rife. I feel Rangers should publicly apologise for this policy, which went on for years. This would help to address a minority still chanting anti-Catholic songs.

I remember Jock Stein saying that if he had a choice of signing a Catholic or Protestant of equal ability, he would sign a Protestant, as their rivals would never sign the other ... humorous, but a sad picture of the times.

There should be an SFA policy that all clubs must play at least three Scottish-born players and two on the subs bench. I feel school football is massively important for the development of kids. It should be interdenominational when developing leagues. Clubs should visit schools to promote the positives of football and sport.

Finally, the two organisations running football in Scotland should be merged, with a strategy and a five-year programme for the development of grassroots football.
D Gill
via email

AS the political scene is sickening at the moment, I would like to engage all you Nationalites in a little lightheartedness. Many years ago, and I mean many, the ever-ebullient Clarissa Dickson Wright, who was an aficionado on bacon rolls, was telling all and sundry about this great bacon roll she had eaten at the Devil’s Bridge in Kirkby Lonsdale. Some years ago I was in a position to try this for myself. I thought it was good but not great. However, the main bugbear for me was that the roll was not buttered. Now, I am no snob or anything like that, but I just do not see the point of a bacon roll, or butty as they called it, without butter. I never gave it any thought until a couple of weeks ago when the good lady and I took a wee trip to Yorkshire for a couple of days.

As we were going to be passing through Kirkby Lonsdale, I thought I would try a bacon butty at the Devil’s Bridge. I informed the better half that I was going to ask the person who was making the butty if I could have butter on the roll. He looked at me as if I was an alien and said, we don’t butter em. That got me thinking.

My preference in such matters is quite simple. A bacon roll or butty must have butter. I wonder how all you out there feel about this? Do you think that this is an English trait, or is it the done thing all over? So, my friends. The question is, bacon rolls and bacon butties, butter or not!
Old John
Ayrshire

MARIE Curie welcomes the Scottish Government’s commitments to provide financial support for people with a terminal illness facing high energy costs, and to deliver pay parity for hospice staff as set out in last week’s Programme for Government.

However, these measures fall far short of the transformation in palliative care that people across Scotland were promised ahead of the election. Millions rely on high-quality end-of-life care, yet too often access depends on where someone lives.

Most palliative care is provided in local communities by GPs, community nurses and care home staff – and almost one in three people are currently missing out. Scotland urgently needs national minimum standards for palliative care, backed by clear accountability, so that everyone knows what care and support they can expect, regardless of their diagnosis, postcode or circumstances.

Reforms to the NHS and social care must be relentlessly focused on delivering equity, and ensuring everyone can access the care they need at the end of life. The commitments made earlier this year cannot be allowed to fade. Scotland’s new NHS must deliver equitable, high-quality palliative care for all.
Amy Dalrymple
Head of policy and public affairs, Marie Curie Scotland

SCOTLAND'S population of around 5.4 million is significantly less than the nine million living in Greater London. So, does Scotland need 14, three or even two health boards? I would argue not – a single national health board should be the magic number.

A single structure is better for recruitment, staff development, progression and retention of staff. It allows specialists not to be a single isolated specialist but part of a team of specialists sharing experiences and knowledge. For example, there is only one dexa scan specialist in Forth Valley able to interpret and report on a dexa scan – although the dexa scan is carried out within three months, there will be a further two-year wait for the results to be reported to you. Whereas, in Edinburgh, where there are at least seven of them, results are given to patients within three months. Having a nationwide pool of resources makes delivering healthcare metrics in many areas more achievable without reducing budgets.

The union response is typical, lacking vision that a consolidated workforce will help their members. More resource to tackle everyday demands, less stress as more resource to cover for absences, etc. Better staff development and promotion prospects which attract and retain staff. In a service where recruitment is already challenging and retention is difficult, you would think the naysayers would see the upsides for their members.

I don’t think those in admin or IT or other support areas need worry too much either as they will be just as important now as ever in ensuring scheduling of appointments, communication or supporting image (AI) analysis, cyber security, ongoing ERP integration (cost-saving), etc. Potential savings from not having to use and pay external healthcare contractors is more likely with a nationwide NHS resource pool, or procurement savings, or in recruitment and retention.

A national service helps reduce the potential of American healthcare creep into our service, as is happening elsewhere in the UK; American healthcare access to the NHS is a big part of Donald Trump’s trade policy agenda. The aim is to make the national service as functional and efficient as possible within the current budget constraints going forward as Westminster repurposes budgets for war preparation, dancing to Trump’s and Putin’s war-mongering tune.

We need the creation of ONE new national Scottish health board with representation from each area to ensure equal local accountability at a national level but based on the 32 council areas, offering more local accountability than at present. With a new health board chair taken from a different council area that would rotate every six months, similar to the EU presidency. The board should include a representative from the four main union groups (doctors and consultants, nurses, auxiliary staff, and care staff), the health minister, someone from social care and one or two patient groups – again the latter can be on a rotational basis. The culture of this board is key to its success. I don’t think two health boards across a west-east boundary is a sensible approach as it can still lead to a healthcare lottery.

A number of new hospital builds have suffered from poor hygiene design and control (ventilation, water, fire safety, flooding, etc) and project management. Each individual health board doesn’t have sufficient design capability, relying on external contractors but lacking the oversight knowledge and experience to be effective, as shown in too many recent build examples in Glasgow, Edinburgh and Forth Valley. However, a single design and validation team for all of Scotland would address this. It would also help with recruitment and retention of key staff in this area, especially with a number of new builds in progress/on hold.

The new health board support teams should be structured with a minimum number of distinct function groups responsible and accountable for:

a) Building and facility management, including specialist hygiene design and control and validation (ventilation, water, etc), and responsible for maintenance.

b) Recruitment, retention, skill development and resource management.

c) Digital technology management and cyber security.

d) Change, cleaning, sterilisation and quality-control management (e.g. SOPs/SOIs).

However, the biggest challenge for any health service is geography. Scotland is so big, and with many island communities relative to the rest of the UK, so delivery of services is key, I personally think this is best provided for on a national level.

However, distributing resources to the Highlands and Islands is still going to be challenging, irrespective of how many health boards there are. A national service has the responsibility to ensure all areas are best served. In many instances, a video call with a doctor or consultant will reduce unnecessary travel and speed up access for remote communities. Having a national service means doctors, consultants or specialists are not tethered to a specific health board or hospital but are a shared resource across the whole country.

For example, one option to mitigate geography, and in a climate-friendly way, is a greater use of short-range Loganair flights, especially once the new electric planes arrive. This should make it easier to get resources to these areas quicker. The Scottish Government could, for instance, buy a couple of the electric vertical take-off versions of these new electric planes on behalf of the NHS and lease back to Loganair to manage for the purpose of getting staff or patients to where they need to be.

I hope the union and political discourse don’t result in another failed attempt to bring forward a modern NHS accountable to its communities.
A Wilson
Stirlingshire