WHAT shall we do about the nation’s health and welfare?

When the NHS was founded, the interventions, medications and surgeries we have now did not exist. We need to have a conversation that is difficult.

We need to have a conversation about choices and fairness.

I wish the political parties would be clearer about their philosophy for funding healthcare. The Conservatives talk about ‘efficiencies’ as the path to improved service. What they mean are cuts and privatisation. The Labour party have a new key message which is about a ‘preventative model.’ This is hardly ground-breaking. Funding for public health promotion, delivering the message that prevention is better than cure, has been lamentable for decades.

The Liberal Democrat manifesto promise in 2019 to add a penny on income reserved for health and social care came from a social principle that communities should share resources. The Lib Dems however are unlikely to form a government in my lifetime.

So, what kind of choices can we make about funding healthcare and how should we make them? My wish is that nobody should live longer than their neighbour simply because they are rich and can afford private treatment.

In the real world though this is an impossible dream. People are free, in democracies anyway, to earn and spend as they wish. Unless we make private health illegal, there’s no way to stop rich people having greater access to life-saving treatments. So over to governments to decide the how and what for the rest of us.

Should we have a basic version of healthcare for the masses that’s free at the point of delivery and allow the private sector to provide a higher standard to those whose companies insure them or who are independently wealthy.

Every sinew and fat cell in me screams ‘no’ at that idea. If you don’t have health, you have nothing. Anybody enjoying medical insurance in their working years will have a terrible shock when on retiring not only do they lose access to the ‘best’ for themselves at the very point they are starting to fall apart, they also lose any linked cover for their families.

We should be having a national conversation about what kind of interventions we want to cover via our taxes.

Here’s an example of a heart-breaking question. If you had the choice of funding a drug that had say a 30% chance of extending somebody’s life by three to six months or funding a music therapist to work with Alzheimer Disease patients, what would you decide? I’m lucky that I’m not one of the people who has to make ‘either/or’ decisions at a funding level.

The idea of deciding that one person’s life should carry more per capita spend than another person’s is horrendous.

But these types of choices and decisions are being made by politicians and civil servants all the time. This is why we must push politicians from all parties to be direct with us about their vision, principles and policies so when it comes to an election, we are voting based on information not on bamboozling slogans.

PS: Yes, I’d love a general election right now. No, I don’t think the Conservatives are under any obligation whatsoever to call one. We have a parliamentary-based democracy. Mercifully, we do not yet have a US-style president (although I can think of one former Prime Minister who’d certainly revel in that role)!