Reform UK recognizes that the NHS is possibly the most loved healthcare system in the world. It also recognizes that being free at the point of delivery is at its core and must always continue.

That does not mean that we should close our eyes to the difficulties that the NHS is now facing and the effect of these challenges both on NHS morale and on patient outcomes.

The problem is not, as is sometimes lazily suggested, purely a question of funding. As the King’s Fund (an independent charitable organisation) reports, NHS England spending is up from £130 billion in 2018/19 to £158 billion in 2021/21. That is a huge increase. And yet hospitals are performing fewer operations and scans each month than before Covid. According to the Institute for Fiscal Studies, the health service in England carried out 600,000 fewer procedures in the first nine months of 2022 compared to the same period in 2019. The NHS has more funding and more staff than it had a few years ago, but is treating fewer patients.

As in so many other areas of life in Britain, what is needed is a willingness to consider bold new approaches rather than merely tinkering at the edges. The mainstream political parties seem unwilling, however, to do anything other than mouth the usual stale old platitudes. They are afraid of the slightest criticism from the mainstream media and vested interests. But this is merely to kick the can down the road.

Reform’s starting point is that we should aim for zero waiting lists. Many other countries can do this – why not us? We’ve simply become accustomed to waiting lists through decades of low expectation.

Healthcare must always remain free at the point of delivery. Reform’s plan, however, is to put the patient back in charge by establishing a voucher scheme to ensure that they are seen and treated promptly. So:

• If you cannot be seen by a GP in 3 days, you get a voucher to go private elsewhere.

• If you cannot be seen by a consultant in 3 weeks, you get a voucher to go private elsewhere.

• If you cannot have an operation in 9 weeks from Day 1, you get a voucher to go private elsewhere.

Dr David Bull gave an inspiring talk about this at the conference in October.

When we talk about healthcare in Britain being “free”, it is worth bearing in mind that it is, and indeed should be, “free at the point of delivery”. It is not, however, “free” in the sense that we have not paid for it. British taxpayers have paid, and do pay, very considerable sums of money in taxes which are used to fund the heath service. We owe it to ourselves to make sure that this service is the very best that it can be.