FM: NHS founding principles are not up for discussion

NICOLA Sturgeon has said the principle of the NHS being free for all is “not up for discussion” despite NHS leaders discussing the potential creation of a “two- tier” system that would charge the wealthy.

Leaked minutes of a September meeting with high- ranking health officials, seen by BBC Scotland, say they were given the “green light” by NHS Scotland chief executive Caroline Lamb to discuss reform of a service which finds itself in crisis.

One suggestion in the minutes is to “design a two- tier system where the people who can afford to, go private”, the BBC reports.

The Scottish Government immediately sought to quash the discussion, with the First Minister stating yesterday she was “emphatically” against the idea of making the wealthy pay for their care on the NHS.

“The founding principles of the National Health Service are not up for discussion,” the FM said.

“It’s democratically elected governments who decide the policy basis of the NHS.”

When asked if she or her ministers knew NHS leaders were taking part in these discussions, Sturgeon said: “I don’t dictate to NHS chief executives what they can and can’t discuss – we live in a democracy.”

Other suggestions included changing the “risk appetite from what we see in hospitals” by setting a target of discharging patients to their home for treatment within 23 hours.

But the minutes of the meeting accept that “it is not gold standard but what other countries can do without an NHS”.

Leaders also considered a review of the cost of long- term prescribing of drugs, pausing the funding of new drugs, applying a charge for freedom of information requests and sending patients home for care, according to the document, while saying there was a £ 1bn hole in the service’s finances.

The First Minister said the NHS in Scotland was outperforming those elsewhere in the UK and pledged the support of her government for the service.

“Let me be unequivocally clear, we will do that within those long established, well accepted and, I think, almost universally supported principles of a public service free at the point of use and need,” she said.

The document also took aim at the National Care Service – an initiative to centralise social care using a system similar to the NHS – saying “£ 800m for NCS does not make sense”.

The true cost of the NCS is not yet known due to the Scottish Government’s commitment to pass a framework bill, with the service to be the subject of “co- design” later.

The minutes claim there is a “group within SG ( Scottish Government) who recognise that it may not be possible to provide what was initially proposed within NCS”.

The document added: “Their challenge is how to get off that promise and do something different.”

Health secretary Humza Yousaf reiterated the Scottish Government’s commitment to the care service.

“In our five- year NHS recovery plan we have outlined our commitment to continued investment and reform of the NHS, alongside delivering the National Care Service.”

Scottish Tory health spokesperson, Dr Sandesh Gulhane, said the report was “deeply alarming” and called for Yousaf’s removal.

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

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