Doctors are calling for a public debate about rationing NHS treatment to be held in Scotland.

Professional body the British Medical Association said the country needs an open discussion about what the health service can afford to offer patients.

The move comes amid growing demand for the latest medical treatments for conditions ranging from breast cancer to Alzheimer's.

A spokeswoman for the BMA in Scotland said: "If we are to continue to provide a comprehensive health service, I think we need to look at what the health service can and cannot afford to deliver, looking at the health needs of the population as a starting point.

"It is no longer financially feasible to deliver everything to all people."

The way Britain's ageing population will add to the pressure on health authorities to prioritise resources is expected to be raised in a paper being published by the BMA in England tomorrow.

Fertility treatment, plastic surgery and operations for more minor problems such as varicose veins and glue ear are said to be on the long list of procedures which are at risk as budgets strain to cope. BMA Scotland said this report was responding to English issues and that its proposals may not apply to the devolved nations. The spokeswoman continued: "We need to have a sensible debate about rationing in Scotland in context of the Scottish health service."

Although a number of health boards in Scotland have faced budget pressures, there has not been the same round of cuts announced in England in the last 12 months. There have also been different responses to some treatment breakthroughs.

When breast cancer patients were taking legal action to obtain the drug Herceptin in England, most of Scotland's health boards reported that they had already prescribed the drug to appropriate patients.

However, the two health care systems still face similar issues when it comes to finance. Both have undergone periods of record investment, but both have seen much of the extra cash absorbed by new staff pay deals and the rising bill for prescription drugs. The BMA Scotland spokeswoman said: "We are coming to the end of a number of years when we have had constant increase in health service funding and we need to look at what we can or cannot afford to deliver. But it has to be a public debate, not just politicians acting alone."

Dr Andrew Walker, health economist at Glasgow University, said he would welcome a debate about rationing but first people had to recognise there was an issue to be discussed. He said: "We are going to face a growing mis-match between the resources we have available and the demands placed on them and people have no idea that it is even a problem."

Dr Walker pointed out the Scottish Medicines Consortium, which guides the NHS on new drugs, already performed a cost benefit analysis to determine what should be made available to patients.

"As an economist I would like to see the same sort of model for the other 85% of the health service," he said.