Draft minutes of a meeting of NHS Scotland health board chief executives in September, leaked to the BBC, showed that the possibility of creating a “two-tier system” was mentioned as well as the possibility of ending some free prescriptions.
NHS care has been free at the point of use since the inception of the health service in 1948 – a fundamental principle that no Government has ever challenged or sought to reform.
In the minutes, NHS officials discuss a range of policies that could help ease pressure on hospitals and frontline staff. These include trusts sending patients home more quickly and pausing funding for new drugs, according to the BBC.
Officials describe a “billion pound hole” in the NHS budget and warn it is “not possible to continue to run the range of programmes” currently offered by the health service without doing harm.
“Unscheduled care is going to fall over in the near term before planned care falls over,” they warn.
One suggestion in the minutes is to “design in a two-tier system where the people who can afford to, go private”.
Leaders also discuss applying a charge for freedom of information requests and sending patients home for care within 23 hours. The meeting is said to have begun with an update about “recent conversations” with Caroline Lamb, NHS Scotland’s chief executive.
Responding to the report, Scotland’s Health Secretary Humza Yousaf said: “Our National Health Service must be maintained to the founding principles of Bevan – publicly owned, publicly operated and free at the point of need.
“The provision of health services must always be based on the individual needs of a patient – and any suggestion that this should in some way be based on ability to pay is abhorrent.
“Prescription charges are a tax on illness, they were scrapped by this Government and they will not be returning in any shape or form.”
The Department of Health and Social Care (DHSC) has been approached for comment.
Immigration minister Robert Jenrick on Monday denied that the Government had any intention of introducing charges to the NHS in England.
He told TalkTV: “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.”
Chancellor Jeremy Hunt on Thursday said that the country must ask “challenging questions” about how to reform the NHS as he outlined his Autumn statement.
Speaking to the BBC’s Laura Kuenssberg on Sunday, Health Secretary Steve Barclay acknowledged that the NHS was under “severe pressure” but insisted this was “predominantly” to do with the Covid pandemic.
On Sky News, he also signalled plans to scale back the number of NHS targets.
“There is a place for targets but if everything is a priority, nothing’s a priority,” he said as he responded to a report in the Mail on Sunday suggesting the Government was eyeing up a “bonfire” of NHS red tape and targets.
He said that at a local level officials are “better able to tailor the priorities for their local needs”.
“No-one is suggesting we don’t have any targets,” he said.