Monday 21 November 2022 05:47 PM What could a two-tier NHS even look like? trends now
The hugely-controversial idea of a two-tier NHS was thrust into the limelight today after it was revealed that health bosses in Scotland touted the idea of potentially charging the wealthy to access care.
This was just one idea discussed at a leaked meeting of senior officials on how to fix the health service's financial woes and boost its ongoing sustainability.
The idea goes against the very founding principal of the NHS that treatment should be free for all, whatever their means.
Scotland's First Minister Nicola Sturgeon has already shut down the prospect of a two-tier system, reacting to the leaked document by saying the idea was 'not up for discussion'.
And, while not pressed directly on the issue, Rishi Sunak vowed to 'always protect' the health service as being free at the point of use during a speech.
But political commentators say the concept has quietly been emerging over the past few years, especially in the wake of Covid.
It comes as increasing numbers of Britons opt to pay for treatment privately, to skip record-long NHS waiting lists.
But what could a two-tier system really look like?
Here, MailOnline looks at four potential models based on what is happening already in the health service and elsewhere in the British Isles, including one place where you could end up paying £200 to use an A&E at night, rising to over £500 if you're badly injured.
How could a two-tier NHS system work in principle, here MailOnline presents four basic scenarios based on already existing health systems in the UK and those used by British citizens in places like the islands in the English Channel,
Could wealthier mothers-to-be, cancer patients and the elderly pay for their own medications and dentist appointments?
One of the key differences between the NHS in some nations of the UK is if you pay for prescriptions.
In Scotland, patients don't have to pay a thing for prescription medication, while in England many patients must pay full price for most drugs.
However, there are exemptions.
Currently, regardless of wealth, people over the age of 60, pregnant women, children, patients with cancer and a range of other conditions in England are among the people who don't have to pay a thing.
People on low incomes are also protected from prescription charges.
There are also other perks, all expectant mothers for example get access to free dental check-ups on the NHS which continues for a year after their due date.
One way a two-tier system NHS could work would be to remove these exemptions for people who earn above a certain income or asset threshold.
This would be controversial and would likely see some people whose income just tips them into the determined threshold being significantly worse off compared to those who earn just under the limit.
But it would bring in billions for the NHS, which spends £16.7 billion on drugs last year.
The idea of people of means paying for some NHS services has been proposed before.
In his 1995 column, Mr Johnson said it seemed reasonable that the middle classes earners should be able to pay for non-essential services that they could 'well afford'.
Should the wealthy pay a special tax to access NHS services like the one we have for immigrants?
Another potential way to create a two-tier NHS would be to create a special tax that the wealthy could pay to access the health service if the
