From 'Sick Man' to 'Living Lab':The Narrative of Scottish Health Since Devolution

The road to the independence referendum may have begun with devolution in the late 1990s, but a key question is: what have been the impacts on health and clinical research since the process of devolution was initiated? The impact of devolution on key areas of life, such as health and medical research is undoubtedly important. Building high quality medical research infrastructure in Scotland and retaining healthcare and research expertise is a priority in terms of improving understanding of the aetiology of disease and diagnosing and developing therapeutic treatments to benefit the Scottish population. In some cases, the research drive might include pharmaceutical companies investing and/or collaborating with Scottish facilities to bring both health and wealth benefits to Scotland.This paper identifies and interrogates the change of narratives, relevant to the health debate under devolution, which frames discussions around potential Scottish independence. Pre-devolution there is a strong sense of Scotland as having unique health problems and hence, the ‘sick man of Europe’ label, which required policy responses from the devolved government and the new powers it acquired. Under devolution, this engendered a second narrative built around the ‘living lab’ concept. So here, we see a significant change in narrative emphasis from the pejorative Scotland as the ‘sick man of Europe’ to a more positive rhetoric about the many opportunities for clinical research that emerge from a sick population and could attract inward investment to a devolved Scotland.This Working Paper is one in a series as part of Innogen’s work with the ESRC Future of the UK and Scotland programme.