NHS: back to the 30s

It is unlikely that the NHS will completely disappear ( Comment , 17 July). Much more likely that, using the economy as an excuse, it will be reduced by our present government to a safety-net service so that even the poorest will get a minimum level of GP and hospital care. Those that want more will need to pay more. With "foundation trust" hospitals able to offer private care as well as safety-net care, people who can afford it will be able to choose their doctor, be seen sooner and have the whole of their sequence of diagnosis and treatment completed in hours or days instead of the weeks and months of appointment queues. Inevitably, the cash customers will get first attention and, as there is finite skill in the system, this will have to be at the expense of those less able to pay. Thus, the underlying principle of social solidarity which gave birth to the NHS, treatment according to clinical need rather than ability to pay, will have been defiled. It will be an NHS, but with a feel of the 1930s rather than the 2010s. Liberals, with their proud history of Beveridge, should hang their heads in shame. As for Labour, I am speechless. Professor Harry Keen President, NHS Support Federation