NHS SCOTLAND officials have refused to release details of a controversial meeting where a “two-tier” health service to charge the wealthy was discussed, saying it was an “ideas workshop” where no formal minutes were taken.

A report that NHS leaders had talked about abandoning the founding principles of the health service sparked huge controversy when it was published by BBC Scotland in November.

The broadcaster said the discussion of the "two-tier" health service was mentioned in leaked draft minutes of a meeting of Scotland's NHS leaders in September.

It sparked headlines in newspapers that there were “secret plans” by NHS bosses to charge the wealthy and NHS Scotland could make wealthy patients pay for treatment, prompting attacks by opposition parties.

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First Minister Nicola Sturgeon subsequently dismissed the leaked document, saying the Scottish Government was "unequivocal" that it would not start charging people to access care.

In response to a Freedom of Information request from The National for full details of the meeting, the Scottish Government said it was “neither led or attended by” its officials and referred the request onto an NHS support body.

NHS National Services (NSS) Scotland has refused to release any further information on what was discussed.

It said the group that met had consisted of the chair of the NHS Scotland board chief executive group, along with medical directors, nurse directors, public health directors, finance directors, HR directors and planning directors from the different health boards.

While it normally meets every quarter, the meeting on September 21, 2022 was an extra session to “capture initial ideas that might help improve sustainability in NHS Scotland” and was for the purpose of “generating ideas”, it added.

The response went on: “A minute of the session was not taken. However, notes were captured to enable further discussion of ideas to determine if they were of value or benefit.

"As none of the ideas had been substantiated or scrutinised by any other NHS Scotland group, the document was given the appropriate security and confidentiality markings."

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NSS said releasing details of the meeting would cause “prejudice to the effective conduct of public affairs” and “substantially inhibit the free and frank provision of advice”.

It added: “NSS believes that it is important that NHS Scotland staff can freely, frankly, and openly exchange ideas for deliberation and consideration by others to help inform policy or service improvement.

“The session was at the start of a process that would have seen ideas scrutinised and either supported or rejected by other NHS Scotland groups.

“Free, frank, and open discussion ensures that staff can raise ideas and ensures that NHS Scotland is considering and assessing all possible options for a problem or opportunity.

“Releasing all information relating to ideation workshops may mean that staff censure their ideas and may not share them due to personal concerns for how they may be presented to the public if released at such an early stage of ideation.”

The controversy sparked by the “two-tier” NHS discussion comes as concern grows over the pressures on the health service.

Dr Iain Kennedy, chairman of the British Medical Association in Scotland, warned this week there is “no way that the NHS in Scotland can survive” in its current form and renewed calls for a national conversation on the future of the service.