Scotland’s health secretary has denied claims that the government is considering abandoning the fundamental tenets of the NHS by introducing a system where wealthy patients pay for healthcare.
Humza Yousaf says the SNP would “never” consider charging anyone for NHS treatment and that any system asking patients to pay would be “abhorrent”.
It comes as leaked documents suggest creating a “two-tier” system for healthcare “where people who can afford it go private.”
The considerations were included in leaked meeting minutes from September, seen by the BBC.
The meeting was attended by senior health officials who were given the “green light” by NHS Scotland Chief Executive Caroline Lamb to discuss reform of the service.
Nicola Sturgeon also denied the reports, insisting that her government was “strongly” against the idea.
She said: “The fundamental principles of the NHS are not up for discussion.
“It is the democratically elected governments who decide the political foundations of the National Health Service.”
Asked if she or her ministers were aware that NHS leaders were taking part in these discussions, the Prime Minister said: “I don’t dictate to NHS chief executives what they can and cannot discuss – we live in a democracy.”
He added his pledge of continued support for the service, saying: “Let me be unequivocally clear, we will do this within the long-established, well-accepted and, I think, almost universally supported principles of a free public service at the point of use. and need.”
Responding to the news in a tweet, Yousaf said: “ScotGovt, led by SNP, has never contemplated charging anyone, regardless of wealth, for NHS treatment, never will. Our track record demonstrates our commitment to the core values of the NHS; abolish prescription fees, eliminate dental fees for youth, continue to fund free eye exams.”
He added: “Any suggestion to the contrary is, frankly, complete nonsense.”
Other suggestions in the documents included changing the “risk appetite for what we see in hospitals” by setting a goal of discharging patients home for treatment within 23 hours.
But the minutes of the meeting accept that “it is not the gold standard but what other countries can do without a SNS.”
The leaders also considered reviewing the cost of long-term prescription drugs, pausing funding for new drugs, charging a fee for freedom of information requests and sending patients home for care, according to the document, though they said that there was a £1bn hole in the finances of the service.
Dr Iain Kennedy, president of the British Medical Association (BMA) for Scotland, said in response to the reports that a “proper and open conversation about the NHS and how we make it sustainable now and for generations to come” was needed to avoid sleepwalking”. ” in a privatized two-link system.
The paper also discussed the National Care Service, an initiative to centralize social care using a system similar to the NHS, saying: “£800m for NCS is nonsense.”
The actual cost of NCS is not yet known due to the Scottish Government’s commitment to pass a framework bill, with the service being ‘co-designed’ later.
The minutes state that there is a “group within the SG (Scottish Government) who recognize that it may not be possible to provide what was initially proposed within the NCS.”
The document added: “Your challenge is how to deliver on that promise and do something different.”
Dr Kennedy, from BMA Scotland, said: “We have been very clear that our health service must remain free at the point of need and true to its fundamental principles, and that should be a starting point for any broader discussion about its future”.
He added that doctors have been calling for a “national conversation for some time” and said “enough is enough” regarding discussions “that happen in some places and behind closed doors.”
He said: “It’s just not feasible for the Scottish government to say we have record staff and enough money and that we should all go ahead and deal with the perpetual winter crisis our NHS is in. The fact that we have more staff, doesn’t it, doesn’t mean we have enough – many services have already been stretched beyond their limits – healthcare workers can’t do more than they are currently doing – let’s be honest, the entire workforce is on its knees .
“NHS boards have an almost impossible task to make the budgets provided meet everything the Scottish government asks for. This is a dire situation for our NHS, with a massive lack of resources to meet the growing demand on primary and secondary care.”
Scottish Labor also responded to the news by repeating calls for Yousaf’s resignation, accusing his department of “secretly portraying privatization” amid a “crisis” in the NHS.
Party health spokesperson Jackie Baillie MSP said: “These damning minutes show how much damage Humza Yousaf and the SNP have done to our NHS.
“Across our country, hospitals are overwhelmed, staff are demoralized, and patients are in danger.
“Instead of dealing with this crisis, we now learn that NHS bosses are secretly outlining privatization and making people pay for their care.
“While the SNP does not provide support to staff or patients, we now know that those entrusted with protecting our health service speak of betraying it.
“We simply cannot go on like this and allow the SNP to slowly privatize our NHS.
“It is time for Mr. Yousaf to do the right thing and go.”
Scottish Conservatives called the reports “deeply alarming”.
In a statement, the party’s shadow health secretary, Dr Sandesh Gulhane MSP, said: “It is clear that NHS leaders are talking about abandoning the fundamental principles of our health service and introducing charges for patients, and they feel they have the political cover to do it.
“Despite Humza Yousaf’s protests, the SNP appears to be actively considering the privatization of Scotland’s NHS.
“This is outrageous. Healthcare must remain free at the point of use for all.”
He added: “Humza Yousaf must take responsibility for this lack of leadership and resign, or be fired.
“The SNP government must also clarify its plans for our health service. Scots already pay more in tax than the rest of the UK for our public services, so there is no excuse for this Doomsday scenario to be on the table.”
Responding to the reports, Yousaf stated: “Scottish Government policy could not be clearer, our National Health Service must be upheld by Bevan’s fundamental principles: publicly owned, publicly operated and free in time of need. The provision of health services should always be based on the individual needs of a patient, and any suggestion that this should be based in any way on ability to pay is abhorrent.
“Prescription charges are a tax on the disease, they were eliminated by this Government and they will not return in any way.
“I routinely meet with the Scottish Government’s senior clinical team, led by the chief medical officer, at least once a week and have further specific engagements on individual issues with these vital advisers.
“There is also frequent engagement between ministers and NHS board chief executives, and daily discussions between the Scottish government and individual health boards about service performance and pressures.”
He added: “Our NHS and care services are continually evolving to meet the changing needs of the people of Scotland and reflect changes in practice and medicine. In our five-year NHS Recovery Plan, we have outlined our commitment to continued investment and reform of the NHS, alongside the delivery of the National Care Service.
“As we continue our recovery from Covid, we must recognize the enormous impact the pandemic has had on our healthcare. As a result of the global pandemic, which has affected healthcare services around the world, a number of targets have not been met. We are grateful to the staff for their exceptional work under constant pressure.”
