The Barnett formula, a mechanism established in 1978, was intended as a temporary method to allocate funding from the UK government to Scotland, Wales, and Northern Ireland after the devolution of certain powers. Its purpose was simple: to adjust the block grants for devolved governments based on changes in spending for comparable services in England, scaled by population. Over 45 years later, what was meant to be a short-term measure has effectively become permanent, shaping the way billions of pounds are distributed across the UK.
Scotland, with a population of around 5.5 million, relies heavily on the block grant. While it can collect revenue through taxes such as income and property taxes, these sources alone are insufficient to fully fund devolved services like health, education, and social care. The Barnett formula ensures that Scotland receives a per-capita funding boost for these services, often resulting in higher per-person spending than in England.
One striking example is healthcare. The Scottish NHS can provide treatments that are unavailable on the same terms in England, despite identical clinical need. A notable case is the prostate cancer drug abiraterone, which has been approved for NHS use in Scotland for high-risk, non-metastatic prostate cancer. Clinical trials, including the landmark STAMPEDE trial, show that abiraterone saves lives, and its cost is modest—roughly £2.75 per day. Yet, NHS England has not approved it for the same patient group, citing cost and affordability concerns. As a result, English patients may face delayed access or must pay privately, at a significantly higher cost.
This disparity illustrates a broader moral issue. While the Barnett formula itself is a neutral funding tool, its consequences—differences in access to life-saving treatments—raise serious ethical questions. Two people with identical medical needs may receive very different care depending solely on which side of the border they live. Critics argue that this situation challenges fundamental principles of fairness and equity in a modern healthcare system, especially when the treatment in question can significantly extend or save lives.
Supporters of the current system point to political and bureaucratic realities: altering the Barnett formula or reallocating budgets is complex, and devolved governments have the autonomy to set spending priorities. In practice, Scotland has chosen to prioritize healthcare, abolishing prescription charges and investing heavily in the NHS, while England faces tougher cost constraints and more bureaucratic hurdles.
Ultimately, the Barnett formula exemplifies how a long-standing, originally temporary financial mechanism can have far-reaching human consequences. It is a reminder that funding formulas are not just numbers on a spreadsheet—they directly affect people’s lives. Many argue that the UK government has a moral responsibility to ensure basic life-saving treatments are accessible uniformly, regardless of geography, so that access to healthcare is guided by need, not by where a person happens to live.
The debate continues, as advocacy groups push for reforms that would eliminate these inequalities, highlighting that in matters of life and death, fairness and equity should come before procedural convenience.
More: Scotland
Scotland’s devolved government like to consider themselves as ‘progressive’ meaning they spend more money than the country earns! Despite the fact that they receive billions of pounds from the UK as a form of gift which results in the Scottish receiving free and better services compared to the English. Another example is free university education. In England the poor students end up with tens of thousands of pounds of debt after their often next to useless degrees. Many elect to go to uni in Scotland for this reason.
The Scottish wanted independence but how would Scotland survive financially if independent!? The country’s deficit (more spent than earned) is so large that the country would be barred from joining the EU on becoming independent.
More than 50 per cent of the citizens of Scotland are net receivers of the country’s wealth with less than half contributing. I sense that the Barnett formula has made them soft and created a false and unrealistic expectation.
