Why is Scotland’s Health Secretary facing a vote of no confidence?

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alex neil snp health

On the face of it, the Alex Neil scandal is quite straightforward.

In 2009, before Neil, the SNP Cabinet Secretary for Health and Welllbeing, took on that post, NHS Lanarkshire undertook a review of acute psychiatric services. The findings of that review were that acute facilities at Monklands hospital in his constituency should close, and the resources used to create improved provision based at Wishaw.

At this stage, Alex Neil was not Cabinet Secretary for health etc., so his mandate was very clear: to represent his constituents. This he did, by registering his opposition to the proposal with his predecessor, Nicola Sturgeon.  In turn, she endorsed the view of the Board, which she approved on 27th July 2012.

The order of what happened after Neil’s appointment as Health Secretary on 5th September that year has been recorded precisely.

At 9.43 on the morning 26th September, his private secretary emailed NHS Lanarkshire:

“Mr Neil is clear that acute mental health facilities should be retained in both Wishaw and Monklands. The Cabinet Secretary has asked that you seek agreement with NHS Lanarkshire to reconfigure its plans accordingly. ”

(It has since also emerged that the most senior official at NHS Lanarkshire insisted there was ‘no alternative option’ to the proposed changes on the same morning that Alex Neil overruled him, and insisted ‘service users and carers are fully supportive of the proposed developments’.)

In other words, the policy decided by his predecessor after due consideration and made in the light of both clinical judgement and his own earlier objection, was to be overturned.

This at least suggests a conflict of between his local interest as an MSP and the interest of the wider public good which is demanded by his appointment as Cabinet Secretary. On the afternoon of the same day, however, Neil took a further step, that of passing over responsibility for the review to his junior minister for public health, Michael Matheson.

This gave the impression to the public and to Scottish Parliament that he was avoiding a potential conflict of interests. Prime facie, it looks like he did the dirty work in morning, and then washed his hands of it in the afternoon.

SNP MSP Jim Eadie, on Newnight Scotland last week, tried to explain that the  request on the morning of the 26th September had been to” review” the earlier decision. However, most reasonable people would have a problem swallowing that ‘reconfigure’ and ‘review’ are even close in meaning , let alone synonyms.

And in civil service-speak the anodyne-sounding “ask” is heavily underscored by the unambiguous “Mr Neil is clear”. This is an order to do his bidding … or else.

Readers elsewhere in  the UK should know  ‘Westminster’ (aka ‘WM’ or ‘Westmonster’) is seen as a dysfunctional pit of corruption by Scottish Nationalists, and indeed many of them hold their UK parliament in the same contempt as UKIP holds Brussels and the Tea Party holds Washington, even using identical language about government by “people from elsewhere who we didn’t elect.”

So it is deeply ironic that if Neil had been a UK minister caught in the same situaton, he would have been pretty rapidly out of office, either through resignation or sacking by the Prime Minister.

This is where Johann Lamont took up the cudgels at First Minister’s Questions on 15th May: “if Mr Neil would not resign, would Mr Salmond sack him?”

The answer from the First Minister was that Mr Neil had acted impeccably and so he would not be sacked. The SNP backbenchers stormed their approval as usual, which is one of the giveaways as to the nature of the SNP and  Holyrood itself.

The most notable feature of the SNP group of MSPs is its supine, mindless support of its government.  At Westminster, a large majority is seen as a liability, as this increases the MPs who win unexpectedly, and these are usually from the fringes of party opinion. They also not expect to get back in, so speak their minds.

So might be expected that the SNP’s Holyrood landslide in 2011 would have brought in a cohort of fire-breathing, anti-establishment Young Scots who would question the leadership at every turn – and would stand no nonsense from the Old Guard if it was found to be compromised.

It only needs to a few minutes of any Holyrood debate to see how this has not happened.

In fact it is quite the reverse: the serried rows of SNP MSPs sit motionless and frequently expressionless, passively soaking up every word from the Leadership, and only bursting into life to when called upon for ‘spontaneous’ acclaim.

The temptation is to make comparisons with politburos and party congresses under communism, and there is serious a parallel to be drawn: these SNP backbenchers know that their careers could be blighted by the nomenklatura process of the party lists. They know that their career would be over if they say what they really think.

But what may be more remarkable is that these people actually believe that they are fulfilling a destiny: theodicy is alive and thriving in the SNP. So if there is a mistake by a minister, or their leaders act against the interest of those they represent, they will either ignore it. Or they most likely believe that it must be part of a greater plan yet to be revealed.

This episode also reveals the flaws in the nature of the Scottish Parliament.

Holyrood was set up to be as non-confrontational as possible, most notably through the PR system which encourages coalition-building and its semi-circular Chamber. In fact, it has proven to be an unsuitable design in both ways, especially in a small and tribal polity like Scotland.

The blight of party lists has already been pointed out above: and if even the late and now Sainted Margo Macdonald could be damned to unelectability on the regional list in 2003, SNP backbenchers know it could happen to any of them.

And the shape of the Holyrood Chamber has already played its role in keeping Neil his job. There can be few more telling sights in British politics than a Prime Minister who knows that they cannot command the Chamber if they continue to support a minister who has become a liability.

This position is brought about by the directly confrontational nature of the House of Commons. Scotland could do with more of it, not just to test and develop policies through robust debate, but in order to hold our ministers like Alex Neil to account.

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