Health and a Scottish Parliament

Pennie Taylor: Health Correspondent

Some facts:

• The health budget in Scotland amounts to £4.26 billion.
• 52,000 nurses and 10,500 doctors are employed in the sector.

In hospitals accross Scotland, there is a similar problem - full waiting rooms with staff battling to cope. Despite past efforts, there is no sign of demand for treatment falling. It is proposed a Scottish parliament would achieve that by targeting the root causes of ill health - by improving housing and diet and addressing poverty. Do voters in Scotland think that this is achievable?

The majority of people I spoke to in a hospital in central Glasgow believe that Scotland's health would be better looked after under a Scottish parliament. One nurse said "Seeing things first-hand, seeing how things are lacking, obviously that's making me feel we can do a better job on our own." A man in the waiting room complained: "You cannae have a healthy society where you've got subserviance to a foreign country."

June Andrews: MPs can be on the scene quicker

Those representing the interests of NHS staff and patients take no sides over devolution, but do see potential advantages. June Andrews of the Royal College of Nursing: "We would have the opportunity to deal with people close-up; be able to say to any member of the Scottish parliament, "You get here in three hours and look at this problem". That is a big difference from trying to catch someone at the weekend when they come back from Westminster."

It is proposed a Scottish parliament would take a fresh look at difficulties and come up with better ways of using the health budget. Doctors say there are clear priorities, for instance, community care. Dr John Garner, British Medical Association: "There is a lot of debate between health and social workers as to where one's responsibility begins and another's ends. If there was a unified budget, there would perhaps be opportunities for ensuring that seamless care, that we all talk about, continuing and actually benefiting the populous."

What changes do Scotland's patients want to see? Patricia Dawson, Scottish association of Health Councils: "We would certainly be looking for issues of accountability, greater openness, greater involvement of the public in the decision-making around health, and greater involvement of patients in determining and planning for their own health care."

Scotland: more money per patient than England

Under Westminster, Scotland receives an estimated 23% more per patient to pay for health care than England. This is a long-standing recognition of Scotland's greater health problems. But could the vision of a healthier nation be delivered without extra spending? John Deffenbaugh, a Management Consultant believes that this is possible: "I think you can probably get by with what is there if you re-jig resources and the way they're being used. If you really want to make a quantum leap, a step-change in what is being provided, then yes, you can always use more resources."

For all the potential opportunities devolution offers the health service, there are potential problems. Health professionals wouldn't want to see different pay scales north of the Border. What about the fact that Scotland trains many more doctors than it uses? Whatever the outcome on September 11, those who work in the health service in Scotland say they'd welcome the chance to debate its future.