NHS bosses in Scotland discuss having wealthy pay for treatment

As reported by the BBC, NHS leaders in Scotland have discussed abandoning the founding principles of the service by having the wealthy pay for treatment

The discussion of a ‘two-tier’ health service is mentioned in draft minutes of a meeting of Scotland’s NHS leaders in September.

They also raise the possibility of curtailing some free prescriptions.

Scotland’s first minister Nicola Sturgeon said the principles of the NHS were “not up for debate”.

She acknowledged the “very significant pressure” facing health services worldwide but added that the process to “redesign and reform” would “take place – for as long as I have got anything to do with it – within the confines of these founding principles”.

The minutes of the meeting seen by BBC News are marked ‘in confidence not for onward sharing’ and highlight the degree of official concern about the sustainability of Scotland’s NHS in its present form.

They include suggestions that hospitals should change their appetite for risk by aiming to send patients home more quickly, and pause the funding of some new drugs.

According to the minutes, the meeting began with an update about ‘recent conversations’ with NHS Scotland chief executive Caroline Lamb.

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’.

Describing a ‘billion pound hole’ in the budget, the minutes warn that it ‘is not possible to continue to run the range of programmes’ the NHS currently offers while remaining safe ‘and doing no harm.’ And they warn that: ‘Unscheduled care is going to fall over in the near term before planned care falls over.’

The minutes note ‘concern’ about an alleged lack of clinical input into political decision-making which, they say, leaves some Scottish government suggestions feeling ‘divorced from reality of life and purpose of service.’

Last month the BMA in Scotland said Scotland’s NHS was in a ‘perilous situation’ and urgent action was needed to tackle work load pressures. Official figures show about 6,000 nursing and midwifery posts are unfilled while A&E waiting time targets continue to be missed.