James Forsyth James Forsyth

When will we able to have a mature conversation about the health service?

Nigel Lawson described the NHS as the closest thing to a national religion that this country has. The NHS is certainly like a national religion to the extent that it is pretty much impossible to have a rational debate about it. There is often a choice posited between the NHS and no healthcare at all.

One can see this mindset in today’s Guardian article on the news that the Thatcher government in 1982 held Cabinet discussions about fundamental rethinking the size and shape of the state. Here is the section on the health service:

‘But the earlier version’s most controversial privatisation proposal concerned the health service: “It is therefore worth considering aiming over a period to end the state provision of healthcare for the bulk of the population, so that medical facilities would be privately owned and run, and those seeking healthcare would be required to pay for it.

‘”Those who could not afford to pay would then have their charges met by the state, via some form of rebating or reimbursement.”

‘The only exceptions might be the long-term institutional care of the “mentally handicapped, elderly” who “clearly could not afford to pay’

What’s worth noting here is just what is still covered; the proposal is clear that the state will still pick up for the tab for those who can’t afford to pay. Those who could afford to pay would be doing so not through taxation but from their own income, presumably via various insurance schemes. One might not agree with such a system. But it is hardly immoral however much people try and denounce it as heretical.

I sometimes wonder when this country will be prepared to have a serious discussion about healthcare.

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