The first guiding principle of the NHS states :-
The NHS provides a comprehensive service, available to all irrespective of age, gender, disability, race, sexual orientation, religion or belief, respecting their human rights.
No one can disagree with that statement in principle...but it needs to have some qualifications...there is simply no bottomless crock of gold at the end of a rainbow somewhere guarded by mischievous leprechauns.
Here is a list of 10 such qualifications.
No transplants for smokers.
Its that simple.
If you cannot speak English,pay for your own care.
If you have lived in the UK for longer than 5 years and you plan on living here for the foreseeable future,and you have not been bothered to learn enough English to answer basic life-saving questions such as "do you have any allergies?" about your own health but particularly about the health of your children,then pay for your own care.
At the very least,you should pay for the costs of Language Line interpreter services...and the translation of every patient information leaflet I will need to give you, from English into your language.
If you are here on holiday and need emergency medical care,then pay for it....just like you would have to do in any other country...probably just like you do in your own country.
We will resuscitate you and take care of you...but honestly....why should it be for free?
You've paid for your hotel....and the alcohol that caused you to fall and break your wrist.
If you have a chronic health problem and you come to the UK for a holiday, then arrange for sufficient medicines or supplies before you come over on holiday.And if you forget to bring them with you,then pay privately to see a GP and pay privately for your medicines,not just the Prescription Charge.
Its really simple....if you have not paid tax here,you should not get free medical care.
Stop funding alternative health care except in palliative care.
Massage and acupuncture may work for some people...but lets just agree that most 'alternative care' such as aromatherapy and homeopathy are not scientifically provable...and the placebo effect is too expensive to fund ad inifitium.
Stop funding IVF treatment but continue to fund IVF research.
I love my children and cannot imagine my life without them...and I feel desperately sorry for people who are unable to have children for biological reasons over which they have no control...but there is really no a priori "right" to have children...its always been a natural selection issue.
By all means use NHS hospitals and staff for IVF procedures,but pay for the actual treatment.
And...by the way....when you have those children,get them vaccinated.
Insist that people living permanently in the UK buy travel insurance when they travel out of the country...and with sufficient cover to pay for repatriation and rehabilitation.If you can afford to travel to the USA you can afford to pay for insurance.
If you are a smoker and develop a respiratory disease as an adult,such as asthma or COPD ,then pay for your own medication and treatment if you do not stop smoking post-diagnosis, after a reasonable time frame,such as 2 years, during which the NHS will send you to smoking cessation clinics.
No NHS funded cosmetic surgery expect as part of a reconstructive process or to enable the patient to live as normal or functional a life as possible.
By all means use NHS hospitals and staff for cosmetic procedures,but pay for the actual surgery yourself.
Open up more psychiatric hospitals.
Lets stop pretending that every patient can be cared for in the community.
Every single day,every A&E in the country sees the same group of patients who are not able to cope by themselves and who keep self harming so that they get admitted,where they feel safer... they need to be admitted to a more supportive environment,not necessarily a secure lock down ward.
It would improve their quality of life,normalise their relationship with society,and ultimately be cheaper for the NHS.