The end of life as we know it

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Three years ago I sat on a train from Cambridge to London next to a person with whom I fell into conversation. As I recall he was an accountant. What he was quite sure about was that the state spent far too much. So I asked him what should be done about it and he said that if the old could not pay their way whether on healthcare or social provision then it should be down to their relatives to provide. And what if they had no such relatives, I asked? He shrugged his shoulders. 'Tough' was the response, in a nutshell.

It was a shocking sentiment: I pointed out people would die as a result of his philosophy and his reply was that society could not afford these people and if they could not provide for themselves it was no one else's obligation to do so. You get into some pretty weird conversations when you mention you campaign on tax issues on trains.

I hoped that the sentiment expressed was rare, but I suspected it was not: the man was of a type that was all too readily identifiable. And now that type is unambiguously in power in this country and the NHS is in  a funding  crisis. No doubt the reaction of the man on the train would be 'well they would say that, wouldn't they?' and 'if only we charged to limit demand the problem would be solved'. I thought of both such things when I happened to stand behind ANdrew Lansley in a queue in a Cambridge coffee shop on Saturday, because this is the NHS he wanted and from which, no doubt, many could profit.

It is not, however, the NHS we need.

And quite emphatically the NHS we're heading for is not national, or about health, or a service. When some will be denied access - whether on grounds of age, obesity, social habits or location - then the National will have gone from the NHS. And health will have ceased to be the priority for care. In which case any service elements will have gone.

The consequences are enormous - perhaps most specially for those about the person on the train spoke with such contempt. For them this might well represent a change to end of life as we know it. And this is only because a government insists it must try to balance the books as if it is a household when it is in fact a sovereign government with the power to create and cancel money to pay for services at will so long as it does not exceed to full capacity of the economy - from which point we are far distant at present.

A fatal culture of cold callousness disguised under a thin veil of economic theory that is dogmatic but based on nothing resembling fact is going to destroy the well-being of millions in this country and cost some their lives. Never say , in that case, that politics does not matter. It's life and death and more besides.