Dr Helena McKeown, a GP in Salisbury and member of BMA council, explains why she'll be attending this week's welfare state rally in central London
The post-war creation of the welfare state was the realisation of a dream – of people having access to the services they needed from the cradle to the grave, including a robust state pension, a decent education system and a health service free at the point of use to everyone.
Central to the vision was a firm belief that these essential services should not be left to the vagaries of either philanthropy or the market, but were best provided by the public sector.
Sixty years on, I believe that our NHS is being privatised – slowly and covertly, and through an array of different national streams including the purchaser-provider split, Payment by Results, personal health budgets (currently being piloted), the private finance initiative (PFI), the imposition of Darzi centres irrespective of need, independent sector treatment centres, relaxation on the rules of top-up payments and social care budgets.
PFI makes me particularly angry. It is a guaranteed loan to property investors, where high-rate mortgage payments are kept off-balance to reduce the country's declared debt. In other words, it's the Enron of the NHS. This is money the NHS has committed to leave frontline healthcare for the next 35 years.
I'm also worried that if personal health budgets are brought in. People with comorbidities might spend their entire budget, wealthy individuals would be able to top up their care with extra medical insurance and poorer individuals would get a second tier of service.
In effect, this would be rationing. But it would not be open rationing with public and professional engagement on what the NHS should be prepared to pay for, but covert rationing by politicians who are perhaps too worried about their seats to lead on this debate openly.
In addition to the ongoing problems caused by such reforms, whoever wins the next general election will be looking at the welfare state and public services as a way of cutting public expenditure.
These are the reasons behind my decision to take part in this Saturday's rally defending the welfare state and public services. It is an opportunity for doctors to stand side by side with our colleagues and our patients, and demonstrate how much we care about the NHS as a public service.
I have discussed the issues with my 14-year-old daughter and 15-year-old son around the supper table and they have decided to join me. We all want to send a clear message to the politicians, and would-be politicians, that the public do not want to see further cuts and privatisation.Dr Helena McKeown: The NHS is slowly and covertly being privatised Dr Helena McKeown: The NHS is slowly and covertly being privatised