How I got caught up in the transatlatic health battle16 August 2009
How did a regular contributor to this excellent newspaper get to appear on television adverts in America slagging off the NHS? OK, I was duped, along with several others. A rightwing US group made a video in February interviewing people about healthcare in Britain and Canada. The video is fine, but I didn't know that clips in which I commented on the paucity of new cancer drugs available here compared with Europe would be used as adverts decrying the British system. "You're pissing inside the tent," was one of my colleagues' helpful responses.
I'm really sorry. I suppose I should now say that the NHS is the most brilliant invention of the 20th century. As part of the new orthodoxy, I should repeat that, just like cricket, it's quintessentially part of the British culture and still the envy of the world. It will cope admirably with the emerging onslaughts of an ageing population, expensive life-prolonging technology and a new demand culture led by an internet-informed public.
I ought to conclude with a confession that I was wrong to voice any criticism of these fantastic concepts or even suggest that something has to give. But the words would stick in my throat.
Faced by bizarre attacks from the US, British politicians of all colours have been stumbling over themselves to declare their profound faith in what is now a more successful national religion than the CofE. Twitter has never been more lively on proclaiming belief in the NHS. Rather sad for the priest giving sermons to dwindling congregations.
But blind religious faith does not provide a solution to the real problem. We need to face facts. Single-provider, single-payer, tax-based health systems are doomed. Most healthcare costs are spent on retired people, who pay little tax. So the younger working population inevitably have to pay more tax to subsidise the new gerontocracy. We could easily see the NHS budget double over the next decade if we don't do something now. That could be 30p in the pound more in tax for all of us - not just the rich.
And monopolies always become inefficient bureaucracies. Where's the incentive to evolve, to provide better services treating us as consumers with a choice, not merely service users? It's unsustainable, despite politicians' reassurances. Make no mistake. All these guys care about is your vote, not your health.
So America has to do something for its uninsured - it's a civilised society like us and has some of the best medical facilities in the world. So it should make them available to all. But it should not create a new government-run insurer based on one of our primary care trusts. Flash offices, well behind the frontline of healthcare, produce endless paperwork, not good medicine. Only by incorporating the uninsured into your mainstream and taking advice from healthcare professionals can you solve the problem. Using your competitive marketplace to drive value will bring efficiency and customer satisfaction.
And again, I'm really sorry about the advert. I can smell the smoke from the kindling wood in the courtyard now. But I was a consultant for nearly 30 years in the NHS before the religious police came after me. I just don't believe that unreformed monopolies are right for 21st-century society. I confess to being a heretic.
Cancer specialist Professor Karol Sikora is a founder member of Doctors for Reform and Dean of the University of Buckingham Medical School