HEALTH: Audit Scotland probe needed on ‘two-tier NHS’ debate

Tuesday 22 November 2022

By Lucy Ashton

The Scottish Conservatives are today calling for Audit Scotland to investigate the meeting of NHS bosses at which the creation of a two-tier health service was discussed.

Leaked minutes of the meeting in September reference NHS chief executive Caroline Lamb – a senior adviser to Health Secretary Humza Yousaf – and point out that the group had the green light to look at reforms “which were previously not viable”.

The group discussed issues such as charging wealthier patients for NHS treatment, sending patients home more quickly after treatment and pausing the funding of some new drugs.

While SNP ministers have been quick to reject any suggestion of moving away from the founding principles of the NHS – that it is free at the point of use for everyone – the Scottish Conservatives believe we need to know why such radical proposals were up for debate.

Audit Scotland warned last week that parts of the public sector, particularly the NHS and social care, are “unsustainable and that there needs to be reform there”.

Scottish Conservative chairman and shadow health minister Craig Hoy, right, reckons an Audit Scotland probe is necessary to cast light on “the controversy surrounding this meeting”.

Scottish Conservative Chairman Craig Hoy MSP, said: “Nicola Sturgeon and Humza Yousaf may have been at pains to try to shoot these reports down but that should not be the end of the matter.

“We need Audit Scotland to investigate the controversy surrounding this meeting.

“The leaked minutes clearly suggest NHS leaders were given the green light to think the unthinkable – including patient charging. We must urgently find out why that was.

“Presumably this came from the top and senior ministers gave them the political cover to examine every eventuality to reform our NHS.  We need to know if they are now speaking with forked tongues. 

“This is a matter of huge public interest – and yet we have already seen the desperation of nationalists to close down the story, as the BBC were forced to defend even running it on Monday following a barrage of criticism.

First Minister Nicola Sturgeon and Health Secretary Humza Yousaf.

“Of course, it’s a reflection of Humza Yousaf’s rank mismanagement of Scotland’s health service that NHS leaders were forced to consider such unpalatable options.

“Rather than contemplating such a Doomsday scenario, Nicola Sturgeon should sack her failing Health Secretary and go back to the drawing board.”

Meanwhile, Scottish Liberal Democrat leader Alex Cole-Hamilton, left,  today warned that pressures on the health service are already “monumental” as new figures from Public Health Scotland estimated that the burden of disease is set to rise by 21% over the next twenty years.

The Scottish Burden of Disease study also warns that:

  • To achieve a similar level of crude disease burden as 2019, the forecast annual disease burden in 2043 would need to reduce by 17% which is equivalent to eradicating the entire disease burden of cancer in 2019.
  • Absolute increases in annual disease burdens are forecast to be largest for cardiovascular diseases, cancers, and neurological diseases. These three disease groups account for 68% of the total increase in forecast disease burden.

Mr Cole-Hamilton said: “The burden on our health service is already monumental. The SNP’s mismanagement is already taking such a toll that senior health bosses considered extreme measures including whether some patients should be charged for care.

“An aging population and increase in complex health needs will put staff and facilities under increasing strain unless action is taken to lessen the load.

“One of the key areas to get to grips with will be cancer care, yet under the SNP, patients are waiting longer for treatment than ever before.

“The Scottish Government need to invest heavily in preventative care and put together a blueprint for the shape of the service in twenty years’ time. They cannot continue to muddle through.”

NHS leaders in Scotland have discussed having the wealthy pay for treatment. The discussion of a ‘two-tier’ health service was mentioned in draft minutes of a meeting of Scotland’s NHS leaders in September, at which NHS Scotland chief executive Caroline Lamb is referenced.

The group were then advised that they had been given the ‘green light to present what boards feel reform may look like’ and that ‘areas which were previously not viable options are now possibilities’. (BBC News, 22 November 2022, link).

Top of page picture: Patients are having to be treated outside hospitals in the back of an ambulance.

One comment

  1. This idea needs to be dismissed immediately. Free at the point of need, is the cornerstone of the NHS.

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