Chris Lancelot on ... the ethos of the NHS

The NHS is the envy of the world, we are told, because of its underlying ethos.

From the cradle to the grave patients receive healthcare which is free at the point of need and paid for out of general taxation.

Indeed, so attractive is this approach that the BMA has long considered the NHS to be the only way to provide the nation with proper healthcare. Those who go private are frequently considered to be leeches, diverting good healthcare from the rest of us.

'Free at the point of delivery': I wish. Those who believe this fantasy need to open their eyes a little more widely. Many patients have to contribute to their treatment costs: some are even forced to go entirely private.

To begin with, there are charges for glasses, dental work and prescriptions. Some treatments are excluded from the NHS and only obtainable at a price - many varicose vein operations; certain drugs for cancer care; and perhaps most cynical of all, drugs for wet macular degeneration, which are only available on the NHS for those who are already blind in one eye. The rest can pay. How convenient this is for the Treasury.

Worryingly, the worst of all is the treatment of the elderly and the dying. Unfunded carers save the state £70 billion each year. Nor is the hospice movement an NHS department: it is voluntary, privately funded as a charity. So are Marie Curie nurses.

What about the elderly? They receive free permanent care only if they have savings of less than £20,000. Otherwise they have to pay, which may mean selling their home. Far from being 'free at the point of need', this is the enforced private provision of care. This is not just an anomaly: this is cynical exploitation of the old and vulnerable - and it stinks.

Save for your old age - then find the government confiscates your savings to pay for your so-called 'free' care. How convenient for the Treasury when patients are required to pay extra charges, or are forced to go private. How hypocritical of socialist politicians to promote the lie that the NHS is free at the point of need.

I'd like the NHS to be completely free from cradle to grave - really free. But as it is clearly not then perhaps the politicians and pundits could do the decent thing and shut up?

Dr Lancelot is a GP from Lancashire. Email him at

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