This is the column I was almost too embarrassed to write: I woke up this morning in the wrong bed – the wrong hospital bed, that is.
As I came to the surface, I felt suddenly ecstatic. All that pain was gone. My temperature was back to normal. I had the blood pressure of a 20-year-old. I had undergone a routine procedure to solve a routine problem (kidney stone, agony – avoid!), and since it had plainly been a total success I was bursting with gratitude to the doctors, nurses, staff, anyone involved in restoring me to health.
How can I thank them, I wondered. I know, it’s Friday. I’ll write about them in the Mail. Then I shuddered, and an icy dread gripped my heart, and I remembered where I was.
For the first time in my life – at least while living in the UK – I had broken the ultimate political taboo. I had done something that Keir Starmer deems so morally repellent that he would never – under any circumstances – do the same himself.
I was using private medicine. No, I thought. Life is sweet. Why stick my fingers into that particular electrical socket? Why give the Lefties another stick to beat me, another excuse for their paroxysms of hate?
Much simpler to clatter out a number on the doom loop economics of Rachel Reeves, or the asinine posturing of Sadiq Khan, regaling the world with his fatuous pensees on the Middle East, while doing nothing to solve knife crime in London.
But as I settled down to scribble on my hospital notepad, I had a nagging sense that I was being somehow cowardly, and that I was shirking my fundamental job – to level with the reader. No columnist likes that feeling.
So, I decided to explain, to marshal the arguments and set out the case for the defence.
I had undergone a routine procedure to solve a routine problem (kidney stone, agony – avoid!), and since it had plainly been a total success I was bursting with gratitude to the doctors, nurses, staff, anyone involved in restoring me to health, writes Boris Johnson
About a third of patients have used private healthcare at some time or other, and of the gargantuan £317 billion spent by this country on healthcare, 20 per cent already goes through the private sector
The worst charge I face is of course that I have acted unfairly; that by deciding on this occasion to go private, to treat a kidney stone, I have secured a valuable advantage over other users of the NHS.
I have today pressed my doctor on this point, and he is adamant. Given my circumstances, anyone in the NHS would have been given exactly the same treatment, and with no undue delay.
Perhaps if I had just gone to A&E my treatment would have been a bit less discreet; perhaps the general atmosphere on the ward might have been a bit more hectic (though perhaps not); perhaps I might have noticed some differences in the room service menu. But the medical procedures and timetable would have been basically the same.
Even as I type these words, I can feel my opponents bristle. Why should there be any difference at all, even in the choice of puddings? Why should we allow even the trappings of medical elitism? Why should there be a special type of healthcare, available to a tiny affluent few?
Well, it depends on what you mean by an elite, because the numbers with private medical insurance are growing fast and now comprise one in eight of the population.
About a third have used private healthcare at some time or other, and of the gargantuan £317 billion spent by this country on healthcare, 20 per cent already goes through the private sector.
It is nonsense, therefore, to say that I was in some way weakening or undermining our beloved NHS. For most of the big hospital trusts – especially in London – the mixed healthcare economy is already a reality, and a necessity.
Almost half the NHS consultants in the country are legitimately topping up their incomes with private sector work: surely a better solution than trying to pay them more out of NHS budgets, and there are plenty of agency nurses who do shifts in the private sector, but who also work substantially in the NHS.
Look at the budgets and business plans of our great hospitals. In one famous London trust, about 45 per cent of the hospital’s income derives from private patients.
Tell me, Starmer, is that a good thing for the NHS staff and patients, or a bad thing?
It is plainly sensible, justifiable, and vital – and yet Starmer says it is immoral. The private sector is essential for sharing the huge and growing burden of healthcare today. I admire the junior doctors, but I disagree vehemently with the current demand – under the ultra-left wing BMA leadership – for a further 29 per cent pay increase (following an already agreed 28.9 per cent rise over three years).
To this Spartacist cabal, with their hatred of private medicine, I would point out that for as long as I can remember the number one concern of junior doctors is workload. So surely it is a good thing, when a colleague goes unexpectedly sick, if we have the private sector to pick up the slack.
Surely it is a good thing if junior doctors can pick up work as locums in the private sector? Surely, we need more integration, not less, between public and private.
I look back at the sheer quantity of cash the UK state – that is you – has lavished on the healthcare of my immediate family. We have been born in the NHS, we have seen our children brought into the world by the amazing maternity teams and, surrounded by its comforts and mercies, some of us have inevitably died. We love the NHS, and we want to protect it, because we know that for all the big medical disasters – trauma, cancer, heart disease – the NHS cannot be beaten.
We must fund it properly and cherish it properly. But if you look at the demographic trends in this country – the vast number of senescent baby boomers – and if you look at the state of the public finances, you can see what every doctor really knows: that we are not going to fix the problems of the NHS, in the long term, if we rely on taxpayer funding alone.
People should not be abused for using private medicine. They should not be told that they are being somehow immoral or disloyal to the NHS – not by any politician, and certainly not by Keir Starmer.
As ever, the public is ahead of the politicians, and they can see the truth, that some measure of private funding, or co-payment, or insurance, will inevitably be part of the long-term future of healthcare in this country, and people who pay themselves – and relieve the burden on the state – should be praised, not pilloried.
It is time to end the craven and pathetic political culture that means sensible people are too terrified to admit that occasionally – just occasionally – they have used private medicine.
As for the Prime Minister, he should recognise that he presides over a vast healthcare economy that is increasingly mixed, and the NHS is employing a growing number of wonderful and caring people whose personal income actually depends on both sectors, and who move pretty seamlessly between them.
I used to have hopes of Wes Streeting, the Health Secretary, who once claimed he could reform the NHS. If he is to have any chance, he needs to tell Starmer to drop his odious pretence that public is good and private is bad, and that one type of healthcare payment system is morally better than another.
