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Evening Standard
Evening Standard
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Anna van Praagh

OPINION - It’s time to think radically about how much the state spends on the NHS

It’s often said that the NHS is the closest thing we have to religion. It defines us, it unites us, you won’t find anyone who disagrees with its founding principles of healthcare for all, free at the point of use — and yet, it is failing us. And it might be that the people who love it most are its biggest obstacle to reform, because by refusing to allow it to adapt to the modern world we might be hindering its ability to survive.

Seventy-five years on from when Aneurin Bevan founded it, the NHS is one of the largest organisations in the world, with 1.6 million employees. In 2000 the health budget was 27 per cent of government spending — next year it will hit 44 per cent. Still, when compared to health outcomes from similar countries, the NHS always comes up short.

Tony Blair said at the weekend that the NHS is currently “not serving its purpose” and called for more private sector involvement, saying there should be “complete cooperation between the private and public sector”.

If it was your parent in pain needing a hip replacement, would you honestly let your principles stand in the way?

Brave words, because any mention of using the private sector is politically toxic. But with 7.3 million people on never-ending waiting lists, it’s time to think the unthinkable. If it was your parent in pain and in need of a hip replacement, would you honestly let your principles stand in their way?

We need to be allowed to have difficult conversations. Despite being offered a six per cent rise, NHS consultants have announced new strikes over pay, yet 80 per cent of them earn more than £102,000 a year while 50 per cent earn over £126,000 and the top 10 per cent more than 176,000, not forgetting whatever they earn through private work and their sizeable annual pensions. Junior doctors are still asking for a pay rise of 35 per cent.

No one disputes these are heroes who deserve to be paid exceptionally well, but how much more can the state realistically afford, and shouldn’t nurses, hospital porters and ambulance workers be first in line for a rise?

It’s not just the workers who are dissatisfied. You only have to speak to the doctors at my excellent GP surgery to realise that people’s expectations of what the NHS can deliver are completely out of control. The provision also seems horribly patchy — my dentist offered me free orthodontic work which costs thousands while others are pulling out their own teeth as they can’t even see a dentist.

Are there easy wins? How about stopping giving away free paracetamol in hospitals, something which apparently costs up to £100 million a year. I’d also be happy to pay a voluntary £10 to see my GP — and why not charge for missed appointments, of which there were 7.8 million last year.

What we can’t do is say we love the NHS but won’t allow any changes. Because we’re now in a situation that isn’t working for anyone.

The Princess of Wales at Wimbledon (Javier Garcia/Shutterstock)

If in doubt, keep your hands to yourself

The poor Princess of Wales was hugging people at Wimbledon. She probably feels she has to after Meghan Markle said she was cold and told everyone: “I’ve always been a hugger, I didn’t realise that is really jarring for a lot of Brits.”

You betcha it is. We Brits are cold fish and that’s how we like it. Hugging strangers is impolite, intrusive, possibly dangerous and certainly to be avoided at all costs. Though we speak every day, I’ve never hugged my mother in my entire life — I wouldn’t dare.

Being touchy feely and American doesn’t make you a nice empathetic person, far from it. It can be glutinously patronising.

Who didn’t wince at Joe Biden patting the King last week? If in doubt, keep your hands to yourself I say.

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