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NHS needs radical change to prevent collapse, say Scottish leaders

BMJ 2022; 379 doi: https://doi.org/10.1136/bmj.o2813 (Published 21 November 2022) Cite this as: BMJ 2022;379:o2813
  1. Bryan Christie
  1. Edinburgh

The scale of the crisis facing the NHS has been laid bare in a leaked discussion among health service leaders in Scotland exploring radical changes to the way services are run.

A report of the discussion among the NHS chief executives, which was leaked to the BBC, includes “designing in” what would in effect be a two tier health service, with wealthy people asked to pay for their treatment. Other suggestions are to halt the use of new drugs unless they save the NHS money, embarking on “fundamental reform” of a primary care system that “no longer works today,” increasing the “risk appetite” in hospitals to discharge patients home after a …

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