Fever Pitch: Neil Gray and the battle over Scotland's NHS
When asked if he retains confidence in his health secretary, First Minister John Swinney told reporters, “Yes, of course I do.”
Neil Gray has had to apologise twice to MSPs after using government cars to attend football matches on hospitality tickets. The trips were “official ministerial business”, Gray said, and though he initially stated that minutes had been taken at “all” events, he later conceded that was not the case.
Gray had “set out the accurate position twice” before uttering “one word too many, and that word was ‘all’”, said Swinney, who has resisted calls to sack the minister. “It was a mistake, and he described it as an inadvertent error, and I would accept that.”
The matter is not one related to NHS waiting times, staffing levels, drugs deaths or patient outcomes, but it is one that has focused minds on the performance of the SNP government more generally.
Neil Gray on a visit to Queen Elizabeth University Hospital in Glasgow | Alamy
For the SNP, the matter – an unforced error – is a distraction from the work it is doing to heal the NHS, which has remained in a concerning condition since the pandemic. For the opposition, it is a bruise which can be pressed to increase the pain for Swinney’s party over its record of public service delivery during almost 18 years in power; a way to suggest that the minister has his eye off the ball.
More than any of Swinney’s other rivals, it is Scottish Labour leader Anas Sarwar who has, week after week, picked away at the SNP’s handling of health at First Minister’s Questions. From cancer treatment to dentistry, Sarwar’s subject matter has been informed by statistics and often anchored by the personal stories of patients who have endured painful waits, or whose treatment came too late. Yet despite the latent power of such material, and the fact that the NHS is routinely named as a top three issue for voters in polling, it has failed to put as much pressure on the SNP as Labour would have liked.
It’s not because the SNP is doing an amazing job, it’s because Labour is doing a shit job
Perhaps that is now changing. Earlier this month, Swinney – who has now stepped into weekly meetings with Gray and health bosses – said he was getting more directly involved in addressing NHS problems. The public would see “full-on John Swinney” in action, he said after apologising in the chamber in light of a damning report from the Royal College of Nursing (RCN) revealing the extent of “corridor care” in overcrowded hospitals. His “unrelenting focus” would be on ensuring Scots “get the care they deserve”, he said.
Within the ranks of Scottish Labour, there has been acknowledgement that Sarwar’s unrelenting focus on health has not resulted in the cut-through that was hoped for. It doesn’t help that parliamentary maths means he must go second to the Conservatives at FMQs, sometimes retreading ground that has already been covered. But while the former dentist has continued to inject sobering statistics on waiting times, budgets and staffing issues to the debate, it has proven difficult to really land a blow on chamber veteran Swinney.
And so, behind the scenes changes are being made. Sarwar’s presentation has to get tougher, it has been decided, to strike those definitive blows against Swinney, with those real-life cases put to better use. And Ross MacRae, former Better Together staffer and ex-head of news and media to Greater Manchester mayor Andy Burnham, has joined Sarwar’s team to handle strategic communications. The addition comes as Sarwar’s well-regarded chief-of-staff, Kate Watson, continues in that role even after becoming the party’s general secretary.
The SNP is reorganising too. Long-serving lawyer Scott Martin has left his headquarters job, as has Sue Ruddick, who served as deputy chief executive under Peter Murrell. His old job, currently held by former Stirling Council head Carol Beattie on an interim basis, has now been advertised. Candidates must have what it takes to lead “a professional, modern, dynamic election-winning party”, the listing says.
With around one year to go until the ballot opens for the Scottish Parliament elections, both parties are trying to get themselves ready for the polls. What neither team needs for that is more headaches. Recent polling suggests a recovery in the SNP vote after its general election disaster, predicting Swinney’s side will take around 50 seats to roughly 20 for Sarwar’s Labour.
John Swinney and Anas Sarwar debate before the general election | Alamy
Reports have suggested the parties could pool their numbers to form the next Scottish Government in what would be a return to the coalition rule the voting system was supposed to deliver. But realistically, neither side wants that. And with a year to play with, there’s an acknowledgement that those poll results could change significantly.
“It’s not because the SNP is doing an amazing job, it’s because Labour is doing a shit job,” says a source from Swinney’s party, pointing to the UK Government’s handling of Waspi compensation, the two-child cap, winter fuel payments and employers’ National Insurance contributions. “If Labour hadn’t shot themselves in the foot would that poll still be saying the same thing?”
“People are still disgruntled, despite the polls,” Holyrood is told, while lower turnout in July’s general election and the string of council by-election defeats that have followed have generated a sense that the SNP, once so clear in its mission and messaging, has lost both clarity of purpose and the ability to connect. “What is our motivating call to those SNP supporters?” one former elected member asks. “I don’t think the core vote has disappeared, I’m just not clear that we are going to get the same turnout.”
I’m sick of tweets and headlines. We need action
Mission and messaging are also ongoing problems for Labour both north and south of the border. Sarwar has struggled to articulate a vision for Scottish Labour against UK Labour decision-making which has caused incoherence over issues like social security – political territory in which Labour’s flag was once firmly planted. While the UK Government will not lift the two-child cap on benefits, Sarwar has said his MSPs will abstain from voting on the Scottish budget because, although the SNP says it will lift the cap, a potential 2026 start means it’s not quick enough for Labour’s liking. It’s a position many voters may well find inexplicable.
According to Professor John Curtice, Sarwar’s performance has so far proven “insufficient to counteract the adverse impact on his party’s standing of voters’ disappointment with the performance of the UK Labour government at Westminster”, despite widespread concerns about public service delivery in Scotland. “While voters, including many of those who voted SNP in 2021, have their doubts about the SNP’s record in office, and especially so in the case of the health service, they are even more doubtful about Labour’s record at Westminster,” he said. “Even many of those who voted Labour last year are critical of the UK Government’s economic record.”
Writing in the Sunday Mail, Labour MSP Monica Lennon wasn’t far off that mark. “I admit my own party is not good enough right now,” wrote Lennon, who ran against Sarwar for the Scottish Labour leadership in 2021. “Like many people I speak to in my role as an MSP, I too feel disillusioned”, she went on. “Many political activists are tired of the spin and soundbites and the performative side of politics. People are sick hearing about waiting times, delays and crises. They just want something done about it.”
There is a sense of frustration from some within Labour that the momentum generated before the general election is being lost. “We need a distinct Scottish voice, but it’s not happening quickly enough,” says one elected member, who says party unity must also be emphasised as differences over policy and performance deepen factions. “I’m sick of tweets and headlines,” Holyrood is told. “We need action.
“Where are the big ideas? I don’t see where they’re coming from.”
It’s that kind of criticism from party benches that Starmer is looking to avoid. Having acted decisively and suspended seven rebels at the start of his tenure to quash potential backlash later on, he has yet failed to eradicate unrest from the ranks of his MPs. But that may be set to change, according to reports that Labour will use AI to foresee trouble brewing in the future.
It hasn't been an easy six months
The system, known as Parlex, is reportedly being developed by the government to advise politicians and civil servants. It is the reaction of MPs that is to be predicted to allow the formulation of response strategies, not that of the public at large. But as unease grows within the Labour ranks, perhaps the move will pay off.
Speaking publicly, most of Labour’s 37 Scottish MPs – nearly all new to parliament – have toed the party line. Scottish Secretary Ian Murray has defended so hard that it has almost come off as an attack, saying that the UK Government had warned that “it will be tough” and “maybe the public don’t like honesty after all”. Backbencher Brian Leishman, on the other hand, has hit out at the failure to save jobs at Grangemouth and to compensate Waspi women. Vowing to vote against the government on the latter, Leishman said he was “horrified” by its handling of the former.
Away from the cameras, the opinions of the Scottish Labour group run that gamut. “Things are going just as we planned,” one says with marked sarcasm. “It hasn’t been an easy six months,” remarks another with definite understatement, while a colleague repeatedly refers to the increase in employers’ National Insurance contribution – another measure that has sparked outcry over increased costs to business, the public sector and charities – as “the right decision for this government to take”.
That move was taken to raise funds for investment in health, which is also a major focus in England. A hospital building programme inherited from the previous Conservative government has been deemed undeliverable, with facilities that are overcrowded and waiting lists causing delays to much-needed treatment. But while Starmer has time on his side to address the issues, Scottish leaders need to come up with answers now.
In Holyrood last week, MSPs were seemingly more concerned about the accuracy of Gray’s answers about trips to the football in his taxpayer-funded limousine than with aspects of his performance as health secretary.
Stephen Kerr MSP addresses the chamber | Alamy
While not full, the chamber was busy as Conservative Stephen Kerr accused the minister of having “knowingly misled” parliament for months and broken the ministerial code. Gray was “duty-bound to correct the record” on the fact that not all football events had resulted in summarised notes, and “this shows nothing but contempt for this parliament”. “At a time when the NHS needs proper leadership, how can the public be expected to have any confidence in a health secretary who is unable to be completely honest with this parliament and the people of Scotland that we represent?”, Kerr went on.
Representing the government, parliamentary business minister Jamie Hepburn said Gray had been “meeting with representatives of the royal colleges of the various medical professionals to discuss how we can continue to improve our National Health Service”, adding that “that is exerting leadership in his role as cab sec for health”.
It's not just soundbites
Gray, known within government for his graft and loyalty, took up the health post less than a year ago. He was parachuted into the role – one of the cabinet’s trickier briefs – after the iPad data row cost predecessor Michael Matheson his credibility and sources say Gray expected a tough time. Over the months since then he has defended his government’s record while also acknowledging problems within the system. “I know that some people are waiting too long and finding it difficult to get appointments – we have listened, and we are taking action,” he said as winter recess approached, and medics prepared for additional pressures from seasonal illnesses.
As we approach spring, those pressures on the system should ease, but political pressure will not. As Sarwar prepares to take the gloves off, how will Swinney respond? After all, health is one of the few portfolios he has not held since entering government in 2007. “John is in listening mode,” a senior SNP source says. “He spends the time trying to understand the issue and come up with solutions – it’s not just soundbites. People want to feel secure with their politicians in a world that’s crumbling around them, and he offers that when the other parties don’t.”
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