Daily Archives: May 14, 2011


For as long as I can remember, the NHS has been a sacred cow for politicians on all sides, and indeed everyone in the chattering classes.  For better or worse, governments have reformed and updated it, their opponents have howled in protest over threats to the NHS, and governments have robustly denied any question of a threat.

But some fundamental principles have remained unquestioned, and tacitly supported by all sides.  The reality may diverge from the principle, but we still all agree that treatment should be according to the patient’s need.  We may moralise over lifestyle and self-inflicted conditions, but we don’t turn them away, unless on the basis that an extreme lifestyle would itself defeat treatment.

Neither do we turn people away because someone else is more important than them!  Getting priority is for private medicine.

Yet now, that principle appears to be suddenly under existential threat.  The threat is as yet hypothetical, but what is staggering is the lack of opposition to it.  Noone has stepped up to defend the NHS!  Where a technical reorganisation is commonly seen as threatening, an existential threat to the fundamental principles isn’t even generating controversy!

The threat is of course the so-called military covenant, on which the government wants to legislate.  One suggestion that has been floated is that military personnel should get priority in the NHS!  Priority for anyone of course implies someone else – perhaps with an identical or worse condition – losing.  The principle of treatment according to need is abandoned.

I’m purposely not commenting on what we should or shouldn’t do for military personnel.  If society thinks they deserve priority medical treatment beyond that afforded by their own facilities, then the obvious solution is to provide private insurance.  Or just expand the scope of the military hospitals.  Crucially, whatever is offered should be within the MoD’s budget, but I guess that’s exactly what they’ll be avoiding if they kill the NHS with this covenant.

What do we do for other public servants who risk Bad Things in the course of their duties?  For example, police, firemen, social workers, or even NHS staff themselves facing violence from Saturday night drunks?  Is this a slippery slope in front of us?