On my train journey from Edinburgh this morning, I listened to a BBC Radio Scotland phone-in about the implications of Scottish independence.  The intricacies of a possible de-coupling from the UK are fascinating – from the economy to people’s pensions, to the NHS.

I’ve yet to read an article written specifically about the pros and cons from a medical research or science point of view.  But this is a good overview of the economic issues as recently appeared in the Financial Times.  In terms of the day-to-day, though, I wonder just how much more of a difference formal ‘independence’ will make in some areas.

For the irony is that, for a good few years, the forums I am involved in have become well-versed in encompassing the devolved administrations and their points of view as if they are wholly independent.  The discussion and negotiations are not always easy.  Sometimes – well, quite often actually – colleagues look jealously upon the enlighted approach they are taking.  But the upshot is that broad agreement is reached sooner or later and the various partners left to their own devices to how it is implemented.  So the real issue is not about de-coupling.  Rather it is how to ensure these different approaches remain linked to everyone’s benefit.

While away, I have intermittently followed the latest blows being traded over NHS reform. Mike Birtwhistle from MHP has blogged insightfully about the various politics behind the stance, or should I say different stances, of the medical professions.

How ironic it is that the Royal College of Physicians – who brought the BMA to heel to create the NHS in 1944 – is now being pressued by the BMA to ‘save the NHS.’  Or so the BMA would have us believe.  The relationship between the two has never been an easy one.  My sense is that the survival instincts of the Colleges – which are even greater than that of our own political parties – will come out on top.  They will want to stay at the negotiating table come what may.

Meanwhile, the irony is that life with the NHS reforms goes on.  Chris Ham, Chief Executive at the King’s Fund, wrote a blog last week which was much quoted for only one aspect, his comments about what the aforementioned medical professions and their latest salvos.

His other main observation was that, while the politics rev up again, the reforms continue apace in other ways, regardless of and without little need of legislation. And many, including Royal Colleges, position themselves rightly and astutely to ensure the reforms benefit their respective constituency – note this from the Royal College of Paediatrics and Child Health (RCPCH) about the new Children’s Forum. 

In other sectors – medical research for instance – the debate during the parliamentary stages has been highly relevant, important and constructive.  Much has been gained and much is still on the table.  Its cross-party support can only be helpful as we reach the final stages of the legislative process.  The potential impact on how the NHS supports research in the future is significant.  So, for some, I am sure, it would be ironic if this gain were to fall along with the Bill.  At the very least it would supposedly leave things in a bit of a pickle.  But I doubt very much that will be the outcome, one way or the other.

If you wish to get up to speed with the latter debate ahead of the Report Stage of the Bill in the House of Lords have a look at the ever-comprehensive analysis on Becky’s Policy Pages.