This week a medical journal reported that the British 'stiff upper lip' contributes to its low cancer survival rate [3]. It seems that people simply don't want to bother the doctor when they feel ill. So their cancer goes undiagnosed, and the chances of survival diminish.

I know the feeling. I am registered with an NHS general practitioner, but now I usually go instead to a private doctor when I am ill Yes, it's expensive at £100 a go. Yet I find myself going to the fee-for-service doctor more than I ever did to the 'free' NHS one. It's not that I'm sicker. I am just more inclined to go.

Why? Well, there are costs other than money. With the NHS doctor, the first problem was getting through to the surgery on the phone. The line nearly always seemed to be busy. When you did get through, you could rarely get an appointment within the next two days. You did not know which doctor you would see. When you were seen, and discovered you needed antibiotics, the doctor would be reluctant to prescribe them. If you did coax out a prescription, you would have to traipse along to the chemist and wait to pick it up. Add up all that time and hassle, and visit to the 'free' NHS doctor became very expensive indeed.

For my £100, though, I get a phone that is answered immediately, an appointment the same morning, the doctor of my choice and, if I need medicines, they are handed to me there and then. Job done.

But there is something other than mere financial and time/effort cost in this equation. I reckon that there are many people with more serious conditions than my niggling cough. I can well see that, when medical services are rationed by queuing rather than by price, responsible citizens like me might well figure that we don't want to waste the doctor's time when there are much more deserving folk. It's another reason why I found myself simply not going, when I should have done.

I have no qualms at all, though, in going to my private doctor. It is a straight commercial transaction: I want medical treatment, this person is prepared to sell it to me. The price clears the market, and no other patients of that doctor are denied appointments or told to come back in three days. And I am treated as a valued customer rather than a necessary inconvenience.

Just maybe, if people were expected to pay for general practitioner services, they might forget the stiff upper lip and demand the medical care they actually needed.