NICOLA Sturgeon has warned “there is a real and present threat” to the NHS as she vowed to protect the service after Boris Johnson appeared to threaten the Scottish Government’s powers over it.

The First Minister made her intervention following reports that the service could be forced to pay a crippling £500 million a week more for medicines if thrown open to “Big Pharma” companies in the United States under a post-Brexit trade deal.

Its annual drugs bill of £18 billion could rise to £45bn – up £27bn a year, or half a billion a week.

The warning follows revelations in a documentary on Channel 4 that senior UK civil servants have been in secret talks with US firms to discuss the NHS in preparation for a post-Brexit trade deal.

The SNP MSP Emma Harper, a former nurse, raised the concerns at FMQs yesterday.

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She said: “The First Minister will be aware of reports by Channel 4’s Dispatches that the United Kingdom Government has had a series of meetings with US pharmaceutical firms to discuss raising drug prices as part of a post-Brexit trade deal.

“Donald Trump famously said that the NHS would be ‘on the table’ in trade deal discussions. Will the First Minister do everything in her power to protect our national health service from a Tory sell-out?”

The First Minister responded: “I know that the Tories are not particularly bothered about the real and present threat to our national health service, but there is one.

“I do not think that there is any doubt that if they are left to their own devices and if they get their way, a Boris Johnson-led government would open up our national health service to Donald Trump in the interests of trade deals.”

She added: “Yesterday we even heard Boris Johnson, in the House of Commons, almost threatening to take control of the NHS away from this parliament and this government, which should alarm people across Scotland.

“The way to ensure that we protect our health service – not to magic away all its problems and challenges, because health services everywhere have challenges – and invest in it, keep it in public hands and ensure that it remains the best-performing NHS anywhere in the UK, is to continue with the investment and reform that this government is taking forward.”

Despite Johnson’s assertion that the NHS is not on the table, sources with knowledge of the initial trade discussions between the two countries question whether the Prime Minister is able to keep to that promise.

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“Drug pricing” has been discussed in six initial meetings between trade officials from the two countries and secret meetings between US drugs firms and UK civil servants, according to the Channel 4 Dispatches programme.

Currently, the UK can block American drugs not deemed “value for money” and allow cheaper alternatives to be prescribed. In an interview on the programme, one of Trump’s former senior trade negotiators Stephen Vaughn said: “I would expect US negotiators to see what we could do in terms of getting increased access to the British market.”

Responding to a question at PMQs from the Scottish Tory MP John Lamont about the performance of the NHS in Scotland on Wednesday, Johnson said: “Mr Speaker I congratulate my honourable friend on everything that he does for his constituency in Berwickshire and he is absolutely right.

“That is why – as I said earlier – that is why they rant, to use his own word, so incessantly about independence. Because they wish to distract – they wish to dead cat as the saying goes – from the lamentable failures of the SNP government in Scotland and he’s entirely right.

“If this goes on I think the SNP will forfeit all right to manage the NHS in Scotland.”