These commentaries by John Macgill represent his opinions only and not those of any Ettrickburn client.

Cost of medicines falling

Three Nations Three Practices

Community Pharmacy Eliminating Hepatitis C

Homeless People make Glasgow

Heart Failure – we can get treatment right for everyone

Bundles of Safety

Community Pharmacy’s Leader in Scotland

CPO: On the Road to Achieving Excellence

Pharmacy technicians may become prescribers

Profile: Dr Norman Lannigan OBE

Profile: Jonathan Burton MBE

Profile: Clare Morrison MBE

Deep Dive Pharmacy

Mind the Gap - Diagnostic Skills for Pharamacists

Bundles of Safety

Supporting Excellence - Alison Strath Interview

2018 Pharmacy Forum Agenda Launched

Which Referendum to Choose

Three Perspectives on Pharmacy and Mental Health

Pharmacy and the New GP Contract

Bordering on Problematic

Recognised by the Queen and her community

VACANCY Reporter/Researcher: Health and Care Policy in Scotland

Prescribing in Mental Illness – A Practice Pharmacist’s Perspective

What Matters to You? Communication in Pharmacy

Prescribing in Mental Illness – A Patient’s Perspective

Focusing the Vision: Dr Rose Marie Parr on the new strategy for Scottish pharmacy

All the things that could go wrong - looking ahead to the SNP conference

Ask Once, Get Help Fast? Pharmacy and Mental Health

Automation and Delegation in Pharmacy: Understanding the Moving Parts

Initiatives Highlight Potential of Community Pharmacy

Pharmacy First in Forth Valley One Year On

Trying to concentrate on the day job

Health and the Local Elections – a strange silence

The Pharmacist Will See You Now – The Growth of GP Pharmacy

Montgomery’s Review – Dr Brian Montgomery answers questions on access to new medicines in Scotland

An afternoon with SMC

Pharmacists at SMC

SMC – are drug firms voting with their feet?

Radical Surgery on the Horizon for Scotland’s NHS

The Future’s Bright – in General Practice

Community Pharmacy in a Changing Environment

Disclosing payments to doctors – has Sir Malcolm done the pharma industry a favour?

Health and Care in the First Minister’s Programme for Government

CMO: Scotland’s pharmacists “absolutely ideally placed” to practice Realistic Medicine

Profile: Maree Todd – MSP and Pharmacist

Scottish Parliament Health Committee Work Programme

Scotland’s new NHS – a Summer of Speculation

Scotland’s New Health Committee

Two million voices in Scotland – is integration the big opportunity to listen?

Medicines – levelling the playing field

Key appointment raises the bar for health & social care partnerships

What did our new MSPs do before?

SMC says no then NICE says yes – three times

SNP promises single formulary and a review of Scotland’s NHS

More Generous than the CDF – but less transparent

Comparison of Funds: New Medicines v Cancer Drugs

Bonfire of the Boards? SNP signals NHS Review

A tribute to five retiring MSPs

New Medicines Review - Health Committee sends findings to Government

Medicines New & Old in the Scottish Cancer Strategy

Great Ambitions, Slow Progress – New Models of Care in Scotland

Scottish Minsters Demand Up-Front Medicine Price Negotiation

Opportunity and Disappointment: MSPs Investigate New Medicines Access

Scottish NHS Strategy calls for 'Realistic Medicine'

The Scottish Model of Value for Medicines: Taking Everything into Consideration

When SMC Says No: An Access to Medicines Lottery

Reviewing the Review: Access to New Medicines in Scotland

A day of psephology and kidology

Insulting the Lifesavers

Worthy of Mention – Health and Science in the Honours List

News Silence from North of the Border

A Christmas PPRS Present from Pharma

Friday, May 25, 2018: Which Referendum to Choose

Published at PubAffairs

The Growth Commission set up by the SNP reports today on how an independent Scotland would prosper. Their vision is of a Denmark-style Scotland that encourages immigration, invests in growth sectors like technology, and levies higher taxes to create a fairer society. The Commission’s job was to address the questions that the independence campaign failed to answer for too many voters in 2014 – and help kick start the debate.

As the Scottish Conservative and Labour leaders were pleading with the First Minister to stick to the day job of fixing education and the NHS, the Governor of the Bank of England added to the mood music when he told the Treasury Select Committee in the Commons that a currency union between an independent Scotland and the rest of the UK was economically possible if there was a lot of matching of fiscal policies. Such a suggestion was dismissed out of hand by then Chancellor George Osborne in 2014. But now, seeking to square the circles to achieve Brexit, the UK Government says high levels of policy conformity between the UK and the EU will be perfectly possible in order to achieve frictionless borders and to maintain trade.

Four years ago the idea of one country, Scotland, allowing big decisions about something as important as its currency to be decided around a table where it did not have a seat was dismissed as absurd. Now, UK negotiators are asking that decisions about our medicines – arguably also quite important – will continue to be taken by the European Medicines Agency after we have left full membership.

In 2014, there was talk of a hard border that would cut Scotland off from its biggest trading partner, England. Now we are told that the much longer Irish Border can operate as a frictionless, virtual boundary. 

As an aside, one wonders whether the border between a pro-immigration Scotland and a choosier England would remain virtual or frictionless for very long. 

All conversations about Scottish independence inevitably move to the subject of another referendum. Brexit has changed the argument fundamentally. After all, Scots were told voting ‘No’ to independence was the best way to stay in the EU. Interestingly, as Mark Diffley reminded us here last week, polling does not suggest a surge in support for Scottish independence.

The logical next step for the Scottish Government would be to support a referendum: not on independence, but on the EU Brexit deal. Ministers would be on safer ground given the 62% vote by Scotland to remain in the EU, coupled with an inescapable feeling that Scotland is voiceless in Brexit negotiations.  

As all constitutional matters are reserved to Westminster, Scotland cannot hold a referendum on independence without the okay of the UK Parliament. Theresa May is clear that that won’t happen. But a second referendum on the Brexit deal might be harder to resist if the opposition parties at Westminster were to unite behind one.

For the Scottish independence movement, if England voted to accept the Brexit deal and Scotland to reject it, Scotland’s status as a ‘vassal state’ would have been confirmed and another important step would have been taken to their destination.