HEALTH: NHS chiefs in Scotland have discussed ‘two tier’ health service

Free prescriptions could go and wealthy would pay for treatment – reports

By Lucy Adams

Discussions regarding having the wealthy pay for treatment have been discussed by NHS leaders in Scotland according to a number of reports.

The BBC for example are reporting that they have seen draft minutes of a meeting of NHS Scotland health board chief executives in September that mention a “two-tier” health service and that health service chiefs in Scotland have discussed asking the wealthy to pay for treatment.

According to the BBC, the minutes of the meeting which were marked “in confidence not for onward sharing” also raised the possibility of curtailing some free prescriptions, and suggestions that hospitals should change their attitude to risk by aiming to send patients home more quickly, and pause the funding of some new drugs.

The minutes have been seen by the BBC

The minutes of the meeting  have been seen by the BBC
The minutes described a “billion pound hole” in the budget and warned that it “is not possible to continue to run the range of programmes” the NHS currently offers while remaining safe “and doing no harm.”
It is reported that those in attendance had been given the “green light to present what boards feel reform may look like”

The minutes note “concern” about an alleged lack of clinical input into political decision-making which and suggested that “fundamental reform” of the primary care model “must be on the table”, and that the success of the NHS has been built on a model “that no longer works today”.

There was also a warning that “Unscheduled care is going to fall over in the near term before planned care falls over.”

Speaking to the BBC, SNP Health Secretary Humza Yousaf, right,  said “The Scottish government’s policy could not be clearer, our National Health Service must be maintained to the founding principles of Bevan – publicly owned, publicly operated, and free at the point of need.”

UK Immigration minister Robert Jenrick has suggested the Government has no intention of introducing charges to the NHS in England.

Mr Jenrick told Talk TV: “I haven’t seen the story about Scotland. We certainly don’t have any intention to introduce charges to the NHS.

“There is an issue with people still not coming forward post-pandemic with conditions and the NHS has been surprised by people’s reluctance to present themselves for a range of different conditions.”

Scottish Conservative Shadow Health Secretary Dr Sandesh Gulhane MSP, left, said: “These revelations are deeply alarming. It’s clear that the NHS leadership are talking about abandoning the founding principles of our health service and introducing patient charges – and that they feel they have the political cover to do so.

“Despite Humza Yousaf’s protestations, the privatisation of Scotland’s NHS seems to be under active consideration by the SNP.

“This is outrageous. Healthcare must remain free at the point of use for everyone.

“The SNP cannot be trusted with Scotland’s NHS. Humza Yousaf has lost the trust of the workforce and the fact that such radical proposals have been taken forward shows the despair felt across Scotland’s health service as it approaches a winter crisis.

“Humza Yousaf must take responsibility for this lack of leadership and resign – or be sacked.

“The SNP Government must also come clean over their plans for our health service. Scots already pay more tax than the rest of the UK for our public services, so there’s no excuse for this Doomsday scenario being on the table.”

Political editor Glenn Campbell told BBC Good Morning Scotland: “Well, the clue is in the minutes, they had recent discussions with the chief executive of the NHS Caroline Lamb, who is a senior civil servant who works directly for Humza Yousaf and thought that they had the green light to have this kind of conversation.” (Glenn Campbell, BBC GMS, 21 November 2022).


GP appointments and prescription charges were also part of the discussions.

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