Wealthy Nation, Healthy Nation

Scotland must focus on policy delivery over constitutional debate for the next decade to become the wealthiest, healthiest and best-educated part of the UK, according to a new essay collection spearheaded by former Scotland Office Minister Malcolm Offord.

The analysis in ‘Wealthy Nation, Healthy Nation’ brings together senior medical professionals, education experts and economists to examine the roots of Scotland’s historical prosperity and the country’s performance across key devolved areas since 1999. The research shows that public spending has spiralled from 43% of GDP when the Scottish Parliament was established to a historic high of 52% of GDP – rising to 55% if North Sea oil is excluded – yet outcomes in health, education and the economy have deteriorated.

In his opening remarks on devolution and the state of the policy debate, Malcolm Offord calls for a move away from constitutional wrangling that distracts from improving living standards and public services, and rejects the social democratic mindset that has held Scotland back in recent years. Rather than over-centralising in Holyrood and public service bureaucracies, as is currently the case, policymakers should instead see the insights of the Scottish Enlightenment and the timeless principles of Adam Smith’s ‘The Wealth of Nations’ – free markets, light-touch government and trust in ordinary people – as the key to improving living standards in Scotland. 

The extraordinary story of Scotland’s economic rise and the inventiveness of its people is told by economic historian Dr Anton Howes. He identifies deep levels of capital investment facilitated by innovative financial institutions adept at raising private capital as the key ingredient in the country’s success. Thanks largely to this factor, at one point Scotland was the fastest developing place not just in Europe, but the whole world, punching well above its weight in the global economy. 

In his analysis of Scotland’s economy today, Gerard Lyons shows how weak growth and high public spending has rendered Scotland’s current fiscal trajectory unsustainable, with a large budget deficit requiring fundamental reform. The research proposes a revamped Barnett Formula for greater transparency, a dedicated Bank of England Deputy Governor for Scotland to reflect Edinburgh’s importance as a financial centre.

Professor McNeill demonstrates how healthcare productivity in Scotland has declined relative to similarly wealthy countries over the last two decades. The research shows that Germany and Sweden achieve better outcomes through different models but share key characteristics including decentralised responsibility and focus on patient outcomes.

Tim Jones’s analysis examines how and why Scotland’s performance in the PISA international league tables has declined dramatically over the past quarter century. The research identifies the progressive nationalisation of education and lack of proper assessment as fundamental factors behind this decline.

The collection recommends that all political parties should agree to regular, decennial review of devolved powers while focusing day-to-day on making Scotland the most prosperous and best-educated part of the UK, with the best public services, before returning to constitutional questions.

Executive summaries of the collections’ policy chapters are also available online here:

• Economy chapter executive summary
• Education chapter executive summary
• Healthcare chapter executive summary

CPS - Tuesday, 2nd September, 2025