The NHS in Scotland could charge patients for services if plans recommended by an influential adviser to the Scottish Parliament finance committee are implemented.
Professor David Bell, Professor of economics at the University of Stirling, believes the action could save £300m from the Scottish health budget and also questions the ring fencing of NHS funding by Holyrood.
Responding to the parliament's Independent Budget Review (IBR) report, Prof. Bell argued that adopting some of the principles used in Sweden's health service could provide a significant benefit to Scotland's funding problems.
"An alternative to reintroducing charges for personal care might be to extend charging in the NHS," he says.
"While Sweden's public services are usually thought of as exemplars of universal provision, it is not generally known that the provision of services is more competitive than in Scotland and that, for example, user charges provide around 3% of the health budget.
"Thus, for example, hotel charges for hospital stays and other charges in Sweden provide what would be the equivalent of £300m to the Scottish health budget," he adds.
Prof. Bell joined with the IBR panel review in criticising the decision to protect the NHS in Scotland budget from the cuts which are required in other departments.
"This view is largely shared across the media and other informed opinion, which struggles to understand why health spending should be accorded particular protection," he says.
"If health is ring fenced, then the review predicts that in 2011-12 there will be a real cut of 6.7% in non-health current expenditure and 26.1% in non-health capital expenditure for 2011-12.
"By 2014-15, the accumulated cuts will amount to 17.6% and 34.7%," he adds.
He explains that Scotland already spends 10% per head more than England on health care and has not seen the improvements in health outcomes that have been observed south of the border during the last decade.
Prof. Bell also argues that safeguarding the NHS budget will further expose the younger population who he believes have been the hardest hit by the recession.
"Youth unemployment is at record levels and the young have a low demand for health care," he says.
"Yet the ring-fencing of the health budget will mean that even less support will be directed to this group, increasing intergenerational inequity."
