With all political parties pussy-footing around the issue, the medical profession has at last injected some much-needed realism into the debate over the National Health Service. 500 doctors signed an ad in the Times in which they called for a replacement of a taxation-funded NHS by compulsory health insurance on the European model. As they say, if we really want universal and equitable health care, insurance is the way to do it because taxation delivers the opposite:

‘Dr David Wrede, a gynaecologist and another of the group’s founders, said: “The NHS is like a huge lumbering supertanker, slow to change direction. And it isn’t equitable. There is really a four-tier service. Poor provision in poor areas, excellent care if you happen to be near a teaching hospital, health insurance for elective operations for those who can afford it, and cash. If you have cash, you can get treatment right away.”…Dr Maurice Slevin, an oncologist and a founder of the group, said: “I don’t think the NHS has a future when patients have no consumer power. At the moment, they are passive recipients at the mercy of the system and what it is kind enough to provide for them. We have to give patients power.” ‘

All too true. Instead, they want the high standards, equity and patient leverage found in Europe:

‘The group believes that a system based on compulsory social insurance would work better. In such systems, everybody pays for a basic insurance plan defined by law, with insurance companies competing for customers. The policies must provide a mandatory and comprehensive package set at the national level. Employers may or may not contribute: in France and Germany they do, in Switzerland they do not. Poorer people have their insurance premiums subsidised, or paid virtually in full. Patients can go to a wide variety of providers for care and operations. An alternative is a voucher system, as in Denmark, which patients can use to get care from wherever they want. Such systems can provide flexibility, genuine choice, and excellent healthcare, Doctors for Reform says, giving doctors and patients freedom and getting away from the centrally planned and politically driven NHS.’

The Tories are tiptoing towards this, but far too slowly. Labour is paralysed, and the LibDems… well, say no more. This doctors’ letter, however, crosses all these political lines to tell it how it is. Politicians, please note. The public are not stupid.