Scotland’s NHS could face billions of pounds in additional costs under a pharmaceutical agreement between the UK Government and Donald Trump’s administration, with ministers confirming that no direct discussions took place between the British and Scottish health secretaries.
The admission has prompted fresh criticism from the SNP, which is demanding an explanation of how the agreement will affect Scotland’s health budget and the services patients depend upon.
Seamus Logan, SNP MP for Aberdeenshire North and Moray East, raised the issue through a parliamentary question to the Department of Health and Social Care.
Responding, Labour minister James Frith confirmed that no such ministerial discussion had taken place, although engagement between officials was continuing.
The agreement, announced in December 2025, commits the UK to increasing the net prices paid for certain new medicines by 25 per cent while doubling expenditure on new medicines as a proportion of national economic output by 2036.
In return, the United States agreed to protect British pharmaceutical exports from tariffs for a specified period.
The financial consequences have attracted serious criticism from health economists, with research published in the British Medical Journal estimating that the agreement could impose additional costs of £54.6 billion across the UK by 2036.
According to the researchers, at least £9.9 billion of that total could fall upon the devolved nations collectively, including Scotland, Wales and Northern Ireland.
The study also estimated that diverting NHS resources from existing services to meet higher medicine costs could contribute to 229,000 additional deaths in England by 2036.
That figure is a modelling projection based on assumptions about future NHS funding, rather than a prediction of deaths directly caused by medicines, and the UK Government disputes the analysis.
Ministers argue that the agreement will improve access to innovative treatments and protect the country’s pharmaceutical industry.
However, the SNP believes Scotland’s interests have not been adequately considered.
Seamus Logan MP said:
“Once again Scotland and our NHS is not even so much as an afterthought to the UK Labour Government.
“Our NHS has been put at risk.
“The Labour-Trump pharma deal is designed to lure investment into England, but it seems it is Scotland’s NHS and Scottish patients who will pay the price.
“Andy Burnham must not leave Scotland’s NHS in the lurch and immediately outline the impact his deal will have on our health budget– particularly if Scotland will face a bill of almost £10bn as a result.
“Through a fresh start with independence, Scotland’s NHS will never play second fiddle to the will of Westminster and the SNP will never stand by as deals with Trump are carved out that put our NHS at risk.”
There is an important distinction between the UK wide financial projections and Scotland’s actual liability, which has not been established at the level suggested by the SNP.
The £9.9 billion estimate covers all three devolved nations, not Scotland alone.
The UK Government has also stated that changes to the medicines assessment system in England do not directly apply to the Scottish Medicines Consortium.
Nevertheless, the agreement raises important questions about future pharmaceutical spending and the financial implications for Scotland’s health service.
The SNP is now demanding that Prime Minister Andy Burnham explain what the agreement will mean for Scotland’s NHS budget before additional costs place further pressure on health services.
