LEAKED plans to design a two-tier Scottish NHS where the better off would be charged for services are “sickening and shameful,” health unions warned today.

SNP Health Secretary Humza Yousaf faced calls to resign after minutes from a September meeting of high-ranking health officials appeared to show NHS Scotland chief executive Caroline Lamb giving the “green light” to discuss changes to crisis-hit services.

One suggestion, according to BBC Scotland, which has seen the document, was to “design a two-tier system where people who can afford to, go private.”

The Scottish government immediately sought to quash any suggestion the reform would be introduced, with Nicola Sturgeon claiming she is “emphatically” against the idea of making the wealthy pay for their healthcare when using state-run services.

The First Minister said: “The founding principles of the National Health Service are not up for discussion.

“It’s democratically elected governments who decide the policy basis of the National Health Service.”

Asked if she or her ministers knew NHS leaders were taking part in these discussions, Ms Sturgeon said: “I don’t dictate to NHS chief executives what they can and can’t discuss — we live in a democracy.”

But health union Unite said that this is “even being discussed by those that have a job to protect the NHS is shameful.”

The union’s Scottish secretary Pat Rafferty said: “While we welcome the comments made by the First Minister, the reality is that [this change] is being privately discussed among appointed civil servants of the Scottish government.

“Unite in Scotland is now calling for an inquiry into why income-based care was on the agenda and who supported it.”

Other suggestions in the minutes 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 a review of the cost of long-term prescribing of drugs, pausing the funding of new drugs, applying a charge for freedom of information requests and sending patients home for care, according to the document.

Mr Yousaf was asked about the leak as he visited Victoria Hospital in Kirkcaldy yesterday.

He said: “First of all, it ain’t gonna happen — I couldn’t be more clear that there has never been a discussion with me.

“I’m happy to discuss reform and I think we should be discussing reform given the pressure of the pandemic.

“But that reform will never, ever contradict the founding principles of the NHS.”

However, Scottish Labour deputy leader Jackie Baillie reiterated her calls for the Glasgow Pollok MSP to resign from the Cabinet, warning that the changes would be an attempt to “slowly privatise” services.

“These damning minutes show just how much harm Humza Yousaf and the SNP have done to our NHS,” she stressed.

“Across our country hospitals are overwhelmed, staff are demoralised and patients are being put in danger.

“It’s time Mr Yousaf did the right thing and went.”