So the BBC reports that hospitals are already allowing top-up healthcare. Frankly, most people have known this for a long time, but politicians and the media have largely ignored it, in much the same way that they have ignored the costly failure of the NHS.

Of course, professor Mike Richards will present his review of co-payments at the end of this month. Given the pressure coming from the general public, one can only assume that this will formally allow them.

The results of this will be twofold. Firstly, it will finally lay to rest the hugely misguided idea that government could ever provide a comprehensive health service completely free at the point of use. Secondly, it will transform NHS care from an open-ended entitlement to a defined benefit. The inevitable spread of co-payments and private top-up insurance that follows will surely lead to a revaluation of the future role the NHS.

Certainly, a safety net should always exist to guarantee a basic standard of healthcare for all UK citizens, but beyond that minimal guarantee the state, and politics, needs to be taken out of healthcare altogether. People should be free to take control of their own healthcare by redirecting largely wasted taxes into personal health saving accounts, and paying their doctors directly for services rendered. That would be far more efficient, and far more likely to encourage healthy living, than the bureaucratic monolith we have at the moment.
Systemic NHS failure is starting to force the hand of politicians, yet they are not keeping up with events. Labour has poured money into healthcare to little effect, the Conservative’s are not prepared to rock the boat, while the Liberal Democrats have a long way to go in their tentative exploration market based solutions.

In fact it is the Liberal Democrats who are best placed to put healthcare reforms on the agenda. With the Conservatives focussing on the less divisive educational reforms, health reform could (and should) form the central pillar to sell the party to the nation. Now where did that orange book go?