With a population not prepared to pay the going rate for modern health care, we have chosen a nationalized system of health care, forgetting that good medicine costs money. 

There are many iniquities within the NHS – keeping patients waiting for anything up to 18 months for a heart operation is one such iniquity.

There is a significant risk of dying on the waiting list. It is a long period of great anxiety, waiting for the letter or the phone call to offer surgery, combined with the chance of a last minute cancellation. Anxiety worsens physical health problems, which are, in any case, progressing relentlessly. Finally, operating on a patient 18 months down the line, reduces the chances of a successful recovery, both from physical complications and from the psychological complications of having lived with a life threatening condition for that length of time.

It is therefore excellent news that the government has taken responsibility for this situation and followed up with action to reduce the waiting lists to six months. Nonetheless, although a six-month waiting list is still too long and altering waiting list times does not solve any other NHS problem, it is a step in the right direction.

The initiative will cost £100 million pounds and benefit 14,500 patients. That is just under £7,000 per patient and close to the going rate for the job in the private sector. More people will die on the waiting list. These people are ill, without representation and depend upon the rest of us to step in and say – ‘tax us more so they can live’. Yet these unsung deaths are deemed acceptable; by the people who are waiting to die; by the government; and by the rest of us, who are not waiting to die in that particular fashion.

How many of these people could raise that money themselves and have the operation privately here or abroad? Unfortunately not only does the NHS make these deaths acceptable but it cripples peoples’ will to act independently. Most people would step out of the way of an oncoming train, rather than wait for the fire brigade to rescue them. For many people on that waiting list, the NHS will not arrive in time. The danger of the government’s offer is that it continues to makes the wait acceptable. It holds a distant hope of treatment in return for patience and apathy towards our health. 

The waiting list for cardiac surgery reflects the state of the NHS, within which resources are distributed with some degree of equity. It is symbolic of the overall state of the NHS. However the waiting time for cardiac surgery is a high profile, measurable and relatively remedial. If this marker is taken out of the equation and tackled independently, other less measurable atrocities can be treated as though they do not exist. Using a more holistic solution, standards within UK hospitals might generally be expected to improve.

As it is, those of you who abuse your own health without private health insurance, continue to drink, smoke, lie on the couch, refuse to exercise and eat what you see advertised on TV, are playing a dangerous game.

Dr Liz Miller