Poor women with large tattooed breasts will have to do the best they can.
Nearly six million UK adults pay around £500 a year each for private health and fitness club services, generating an annual revenue of about £2.84bn. Many millions more pay for the less exclusive but no less calorie-burning municipal health and fitness services up and down the country. We spend another £350 million a year on health supplements. I can't easily find the figure for private elective surgery, but think it's around the £3bn a year mark. I'm ignoring the seven million of us who are covered by private medical insurance. My point is that as a nation we're quite prepared to put our hands in our pockets or purses to pay for personal health improvements at the margin; for anything life-threatening, we rely on the NHS.
The problem is, there's no half-ground between public and private medicine in the UK. This has sparked a debate that I first saw on Menssana's old blog, reappeared on a health professionals site and now is the subject of a discussion paper to be published by the BMA on Tuesday. Despite the slightly hysterical tone of the Observer's headline that 'NHS treatments must be rationed', the reality is that ALL public services are and always have been rationed. The debate is only about where one draws the line between services 'on ration' and services 'off ration'.
Whilst I also believe that funding decisions should be made at the local level by local bodies of health professionals and citizens, rather than from the State central health bureau, I think the NHS (or rather the NHS at its local level) should be allowed the power generally to ask for top-up fees for a whole range of medical procedures; a charge that is somewhere between free and the cost of a wholly private option.
Fertility treatments, breast enlargement or reduction, tattoo removal, elective caesarians for mums too-posh-to-push, varicose vein removal, cosmetic plastic surgery, piles reduction and many other minor procedures are now seen as a 'right'. This is never what the NHS was founded for. What next? Baldness treatment for men 'psychologically damaged' by being slapheads? Buttock implants for women who see a phat booty as a 'cultural necessity'?
Of course we're all happy to get something for nothing. But I'm sure if given the choice between spending money a year's gym membership or getting our piles sorted next week, we'll go for rectal comfort. 'Unfair to the poor' I hear some say; yes, perhaps. But not life threatening. And poor women with large tattooed breasts will just have to make out the best they can.
(NB Apols for being behind with my blogrolling - this is the next task for today)