Reflections on funding the National Health Service: from illusion to reality?

Opinions differ about how best we organise our services to promote and preserve it, meet their costs and apportion them between the individual and the state. The well-being of the NHS is imperilled and its development is impeded by underfunding, a state of affairs likely to persist as long as it depends exclusively on Exchequer monies. To break the impasse the public should reconsider its attitude to the imposition of health charges, the marketing of health services, and coll raboration between the NHS, public bodies and private groups. The able-bodied might well, within their means, bear some of the costs of the services they use. The NHS would profit from a rapprochement with private medicine. A more prompt and positive response by the NHS to clinical and social challenges might be facilitated if its ties to government were loosened and it was overseen by an independent agency. Free health is a Utopian ideal. In the real world the best we are likely to achieve is an up-to-date health service which gives a fair deal to patients, who are its raison d'etre, and to those who provide the money to pay for it; it should syncretise the art and science of medicine.