I’m a fan of the NHS too, but it does need a rethink

The NHS has always provoked polarisation and choosing the wrong side in the debate can result in much indignant spluttering into wine glasses at dinner parties. Some of our politicians and areas of the media hold the view that even to contemplate using a private hospital rather than our beloved NHS is akin to asking King Herod to work in childcare.

In the UK, grumbling about our GPs and our NHS care has become a British tradition, like talking about the weather, but they are only gentle, affectionate grumbles. We don't really mean it. And that is part of the problem. The NHS is traditionally sacred, and not something to be criticised. This was illustrated beautifully when Sarah Palin waded into the argument and gaggles of our politicians spoke out in its defence. But the truth we are so reluctant to admit is that while the pool of want is bottomless, the NHS is only a finite resource.

It is now inevitable that the private sector will become involved if the system is to continue. Our NHS does have flaws, it does need a rethink, and too many British supporters of the NHS seem a little too carried away in their enthusiasm. So loathe as I am to admit it, Sarah was right to criticise. She just got her facts wrong, bless her.

Medicine is expensive, and good medicine is extremely expensive. And unless we want to be crippled by taxation there will never be enough money. The UK is one of the few western nations that insists that the state provide everything. Trying to offer unlimited treatment for free is just not possible. If the market cannot set a price in cash terms for a treatment, it will set it in terms of a waiting list.

Here are my thoughts: I think our general sense of entitlement is wrong — just because we pay taxes we feel that everything should therefore be free. But instead we should look at our taxes as a form of insurance — used, for instance, if we are hit by a bus and need major surgery to put us back together again, or require hugely expensive cancer treatments, but not for a general visit to the GP for a cold or a bruised toe. That should be charged for.

If everyone was charged 10 quid for a GP visit it would solve a lot of financial problems and remove a lot of the unnecessary dross that GPs have to see every day. It's the system that they use in Ireland and by all accounts it works well there (and yes, chronic conditions can be made exempt and it can be means tested). But which political party will dare to make these sorts of changes? They are reforms that, although they are much needed, will never win votes.