Free prescriptions and eye tests, along with other universal benefits, must be considered for the axe, public sector chiefs have said.
A period of “entrenchment” lies ahead in public spending, Holyrood’s Finance committee was told, with all council services at risk.
The Scottish Budget is forecast to be cut by as much as £35 billion over the next 15 years, prompting Labour’s David Whitton to suggest putting a “limit” on free prescriptions, free pensioner travel and free school meals.
On this, Ronnie Hinds, from the Society of Local Authority Chief Executives, said: “That question really has to be asked. It’s not going to be easy.”
He claimed: “It won’t be easy decisions for politicians to make or get acceptance from the population but we do have to go there.”
Mr Hinds said in his area of Fife free concessionary travel was axed.
Robert Calderwood, chief executive of NHS Greater Glasgow and Clyde, said health service bosses have called into question the provision of universal benefits, while giving evidence at a Budget review committee.
He said spending which enables benefits such as free eye tests could instead be used in other areas.
“We have highlighted that it is important to look at choices going forward and the issue as to whether free eye tests, free prescriptions universally available should be more targeted as a choice to be compared to the other opportunity costs of that money,” he said.
“I do believe that the Parliament needs to address these issues in relation to future years’ opportunity costs.”
Prescription charges will be abolished entirely in Scotland from April next year.
Public expenditure will be cut by an average 3% a year until 2014-15 and may take between 12 and 15 years for spending to return to the level of the last financial year, the report said.
During that period between £25 billion and £35 billion may be cut in real terms from Scottish expenditure.