Star comment: Our health service is defended

There is a striking phrase in a new report by a think-tank which looks to the future of the NHS.

"Even with major changes to care, it is now irresponsible to pretend to the public that current forms of taxation alone will be sufficient to provide a good quality health and care system," it says.

It is a message principally directed at those politicians who trot out fine words about the NHS and yet are in institutional denial. There is a nettle that is politically hazardous to grasp because the NHS is an issue which stirs the emotions.

Do anything that is perceived to be a threat to health care, or the principle of a free health service, and you will find yourself in a war zone. Taxes too are an emotive issue. A political platform in which the promise is of higher taxes is not a natural vote-winner.

Meanwhile in Shropshire a new group has been launched called the Defend Our NHS Campaign, which fears the closure of one of the county's accident and emergency departments, which is says would be a disaster. This new report published by Reform suggests people should be charged a £10 monthly membership fee for using the NHS alongside hotel-style charges for hospital stays.

Everybody would gain "NHS membership" at a monthly fee of £10, to be collected alongside council tax. Membership would entitle people to certain health perks.

Another way of bringing in extra money would be to slap big taxes on food and drink which contains lots of sugar. These are ideas which will raise eyebrows and there will be people who automatically declare themselves against them. In its response, the Department of Health holds firm to the principle that the NHS should be universally free at the point of use. Yet that is already a big lie – there is an admission charge in the form of parking charges in hospital car parks. It is a stealth tax slapped on patients and their loved ones alike. It is easy to be against things, but with the NHS matters have moved past the point where objecting to any change is a reasonable position. People have to decide what they are for, what they want from the NHS, and crucially, how that can be achieved.