Thursday, 29 September 2016

Scottish Government suffers NHS defeat

Something quite remarkable happened in Holyrood yesterday.

The SNP minority government experienced a rare defeat after all opposition MSPs united behind a Labour motion calling to protect local NHS services.

After the government's amendment, committing to "maintaining and improving safe and effective local services across Scotland" was defeated, the 62 SNP MSPs abstained from the final vote, meaning that the Labour motion was passed by a margin of 64 to 0.

Labour, the Liberal Democrats, the Conservatives and the Scottish Greens want the government to call in proposals affecting services across Central Scotland. What is particularly concerning is that proposals to reshape services could be made without ministerial approval, and the opposition parties believe this is an unacceptable situation. As Labour's Anas Sarwar said: "It would be a democratic outrage if we allowed health boards to proceed with these decisions without individual members of this parliament or indeed this minister having a say."

The health board proposals for service change affect maternity services at Inverclyde Royal Hospital and the Vale of Leven Hospital, children's services at the RAH in Paisley and orthopaedics at Monklands Hospital in Airdrie (all, oddly enough, places I've previously worked). Glasgow's Centre for Integrated Care and Lightburn Hospital could also be affected, with the latter potentially facing closure. There can be little doubt that much of the decision making is being driven by financial pressures, resulting in plans for increased centralisation of services.

It's very easy to jump on the emotive "save the NHS" or "keep our local hospital" bandwagons. I've done it myself when there's been good reason. But I'm also sufficiently aware that clinical needs are constantly evolving and therefore how we provide NHS services should, too. There are often perfectly valid clinical reasons for revisiting service provision. However, how we do this is vitally important and the process must be transparent and accountable. There has to be adequate consultation, and there must be opportunities for ministers to have a full discussion with, if necessary, the option to oppose such changes.

Cabinet secretary Shona Robison said it would be “inappropriate” for her to discuss the proposals in detail, or indeed whether or not she supports them. She did state there is the possibility that the final decisions could come before her for approval, but didn't make any guarantees. She stated: "Local people can be ensured that in all such cases, ministers take all the available information and representations into account before coming to a final decision. I think that is the proper and responsible way to run our health services." This was not entirely convincing,

Lib Dem health spokesperson Alex Cole-Hamilton said afterwards: "This vote sends a clear message to the health secretary that these damaging NHS closure proposals need to be called in by ministers and scrutinised by the Scottish Parliament." During the debate he had claimed it was "astonishing" that the issue was only discussed in parliament due to the opposition tabling a debate, and while recognising that "challenging decisions" needed to be made, called for Ms Robison to "enlist [MSPs] as champions" in redesigning health services.

It's extraordinary for anything to unite all the opposition parties in Holyrood, and this unprecedented (but not entirely unexpected) reversal for the government demonstrates the need to ensure it has the confidence of parliament. Some level of opposition support will always be necessary and the Greens cannot simply be assumed to offer it unconditionally. The outcome of the vote is not binding on the government, and inevitably uncertainty about the future of the NHS can unite across party lines in a way that other issues cannot. Perhaps it would be wrong to make too much of it - but the Scottish government was fortunate to narrowly avoid defeat (in rather bizarre circumstances) last week on its council tax proposals and this will be another shot across its bows. The Herald described it as "a bloody nose for the SNP", which seems to be overstating the situation, but the government will have had better weeks.

It's a good result in that it's sent a clear signal to the government that decisions affecting the NHS must be accountable and open. Whether the government acts on the vote is another thing, but I fully expect given the nature and sensitivity of the issue that it simply has to. Certainly, as a former Lib Dem member Gerry McGregor suggested, the result puts to bed the notion that the SNP government is effectively a dictatorship supported by the ever-compliant Greens. It's also positive to see the opposition parties working constructively to ensure democracy holds government to account - and for Labour to be showing a little of the kind of leadership we used to expect from them.

Tuesday, 20 September 2016

It's not Tim Farron's beliefs I don't respect, but the lack of openness

I've not been at Conference this year.

I love Conference, so it's quite difficult to have to follow it from a distance and miss out on the opportunity to meet old friends and make new ones. It's also not quite the same watching TV coverage to being on the conference floor, with the opportunity to vote and speak. You don't get quite the same feel for what's going on - which is why it's perhaps best that I leave commentary on this year's Conference to people who were there and actively involved in the political discussion.

But I will comment on something, and it's something I've commented on before.

On Sunday, iNews reported that Lib Dem leader Tim Farron has asked that we "respect his views as a Christian on gay sex". Now, I've had my differences with Tim before, and three years ago - after Tim had made a statement that the Bible is "either wrong or utterly [and] compellingly true" - I wrote this piece arguing that perhaps a party president should avoid making such statements, especially when it is implied that Christianity is an inflexibly prescriptive set of rigid beliefs and that those who think differently must by definition be something other than Christian.

That didn't mean I don't respect Tim's right to personal views. I might disagree with them, but I'd fight for his right to hold them. As a liberal, I naturally respect anyone's right to their own beliefs, but they are not worthy of respect simply by virtue of them being Christian and whether expressing those views is necessarily wise for someone in a senior political (and secular) position is another matter altogether.

So, what did Tim actually say this week to lead to that sensational headline? According to various news outlets, he was responding to not altogether unreasonable questions as to whether he understood why some people remained concerned about his inability to say whether he thinks same-sex relations are inherently sinful (he famously, shortly after being elected leader, refused to give a straight answer - no pun intended - to Channel 4's Cathy Newman.)  Tim is reported to have said: "No, is the honest answer, because I think people look at my liberalism, my desire to support people’s rights to make whatever choices they want, and I kind of also expect in the same way people – maybe it’s a naive expectation – to respect my beliefs as a Christian.

“And obviously that means a whole range of things about how I then choose to live my life. It also means that I don’t go around pointing the finger at anybody else. I don’t go making pronouncements on theological matters. And I think as someone who is a liberal, everybody has the right to marry who they want to marry, love who they want to love, and that’s the position we take."

There are a few things to say in response to this. But I'll give the first opportunity to these two members of the twitterati:

The first thing Tim has said is that he doesn't understand such people and that concerns me. "No, is the honest answer..." Really? Naturally there is scope in politics for disagreement, but I hope I make attempts to understand opposing perspectives especially if I have offended someone. When such a failure to connect results in people leaving our party and rejoining Labour - even if it's just one person - then unnecessary damage has been done. Indeed, in stating that he doesn't understand people's concerns, couldn't he be accused of not showing respect to their views and beliefs?

Let's now move on to what appears to be the real issue - that of respecting Tim's "beliefs as a Christian".

I should first make my own position clear for those who don't know me. I'm a member of the Liberal Democrats, a Christian in the United Reformed Church and someone who by fortunate accident of birth happens to be bisexual. I'm hoping in the near future to train for church ministry, so to suggest that I don't respect Christian beliefs would be utterly absurd.

However, there is one obvious flaw in Tim's plea for respect. It's this - I can only respect someone's beliefs if I know what those beliefs are. And so far he hasn't told us what he believes, simply that his beliefs are Christian.

And that brings us to another little difficulty - myself and many others hold Christian beliefs that tell us same-sex relationships are not sinful. My own church recently voted to allow local congregations to take their own decisions on whether they wish to marry same-sex couples. Others denominations are having their own conversations, most notably the Scottish Episcopal Church and the Church of Scotland. It's quite obvious to anyone with any interest in contemporary theology that there is no singular "Christian" position on same-sex relationships.

Unfortunately, Tim implicitly suggests that there is a single Christian belief on the issue, that should be respected without the need to be explained. The obvious inference is that, whatever his views are, they are the definitive Christian viewpoint.

It may surprise you, but I don't actually care too much if Tim thinks same-sex relationships are sinful. I don't care if he thinks my orientation is sinful.  What concerns me more is that someone who leads a party whose slogan is "Open, Tolerant and United" is less than open about his beliefs. It concerns me that tolerance appears not to extend to an acceptance of those Christians who take a different view. It also is of enormous concern that this issue won't go away, and that there seems to be a lack of appreciation as to how this could damage the party. It's not just the issue of members leaving; the influential LGBT+ media has had a field day and unfortunately this kind of thing creates more headlines that bold policy motions. We won't be able to draw a line under this until we get some...erm, well, some openness.

That doesn't seem too much to ask for. So Tim, if you're reading this, you'll know that I will never share the views you appear to have on same-sex relationships. You'll also know that I also will never take too kindly to the suggestion that your Christian belief is somehow more valid than mine. And you'll be aware that I disagree Christianity has a single position on very much - and that appeals to respect an assumed Christian position won't be effective on me. But be assured that I will respect your honesty on this, just as I respect your honesty on a raft of other issues.

Of course, disagreement doesn't imply a lack of respect. I vehemently disagree with, for example, Rev David Robertson of the Free Church of Scotland but I respect his views as sincerely held - I'm less respectful of some of his actions in openly criticising Christians whose perspectives differ from his own. In Tim's case, I respect his actions when he stands up (and he has, let's not forget) for a society in which "everybody has the right to marry who they want to marry, love who they want to love"; however, it's impossible to respect beliefs that are kept secret. Neither is it possible to respect the lack of openness from someone committed to that very thing, nor the insistence that we should respect unspecified beliefs simply because they are "Christian". That's an affront to logic.

I hope we can move on from this. I don't want our party leader to continually experience hostile questioning on what he thinks is sinful. So next time it comes up, I'll happily respect Tim's response if he says either "No, of course it's not sinful" or "Yes, actually I do. But that's a personal view and it in no way affects my political perspectives." I can agree to disagree, but I cannot respect the lack of openness.

If you want us to respect your beliefs, Tim, then please tell us what they are. You never know, it might be less damaging that the constant evasiveness.