In contrast to South Africa's move towards a “free healthcare for all” National Health Insurance Fund, Scotland, home to the UK’s age-old National Health Service (NHS) system, appears to be changing policies as more and more people pay for their own healthcare, fed up with waiting lists, queues and access issues.
The Independent reports that the NHS across the UK is facing a “two-tier” system “by stealth”, according to an expert, after leaks of Scottish health policy plans.
The Institute of Public Policy Research (IPPR) says this is due to waiting lists forcing patients towards more “paid for” care.
The comments come after reports by the BBC revealing NHS leaders in Scotland have discussed creating a two-tier system, amid concerns over the sustainability of healthcare services in the country.
Chris Thomas, head of the Commission on Health and Prosperity for the IPPR told The Independent: “Even beyond it becoming (formal) policy, to have a two-tier system, we’re worried that that’s happening anyway, across the UK.”
IPPR research this year found despite a “universal support” from political parties and public for the “founding principles for the NHS” that it is free, comprehensive and tax-funded, there was a “growing movement to opt-out from NHS services” where patients face long waits or access issues.
Earlier this year, for example, Private Hospital Information Network (PHIN) estimated the number of people paying out of their own pockets for hip operations between 2019 and 2022 has increased by a remarkable 193%.
Thomas said he was concerned the NHS across the UK was heading for the equivalent of the English education system or, “at worst”, a similar structure to dentistry or social care, which he warned was “very much a two-tier system”.
However, he added: “I think it’s probably a symptom of the underfunding, rather than something that feels imminent, or particularly on the table, but if funding is low, if the NHS is struggling … to provide universal health care needs …
“My biggest fear, if the NHS were to become really conditional on the ability to pay…is dependent on it being one of the most universal health services we have, I’d be really nervous if it became more like Social Security, which only benefits a small number of people.”
Reports from the BBC minutes from a meeting with high-ranking health officials indicate they were given the green light by NHS Scotland chief executive Caroline Lamb to discuss reform of a service in crisis.
One suggestion, according to the report, was a “two-tier” system, where some people would pay for care.
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.
Leaders also considered reviewing the cost of long-term prescribing of drugs and pausing new drug funding, saying there was a £1bn hole in the service’s finances.
Immigration Minister Robert Jenrick suggested on Monday the government has no intention of introducing charges to the NHS in England, after the BBC reported that health service chiefs in Scotland had discussed asking the wealthy to pay for treatment. “I haven’t seen the story about Scotland. We certainly don’t have any intention to introduce charges to the NHS.
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