Dr Kennedy’s reaction is accurate, almost certainly – the NHS as we know it is indeed dying before our eyes. His reaction is also instinctively negative and extremely common. Patients are sick of waiting, ergo patients are abandoning the NHS, ergo the NHS will die.

Far less common, but no less worth considering, is whether this is, in fact, good news for the future provision of universal taxpayer-funded healthcare.

Read more by Andy Maciver

I find our moral framing both fascinating and entirely out of kilter with the moral framing of healthcare choices in other countries.

Using private healthcare in this country is seen as an act of selfishness. A grotesque display of privilege. Two fingers to the little people waiting in the queue. Immoral and un-Scottish. 

We don’t have to travel far, though, to find countries whose moral framing is entirely different. Far from causing moral panic, using private health care in other countries is seen as an act of moral propriety. A display not of privilege but of empathy and decency. A helping hand to those now one space further up the queue for state provision. Intrinsically decent.

Fundamentally, this is a consequence of the structure of healthcare in other countries compared to here, and furthermore a consequence of our national superiority complex when it comes to the NHS.

In the many “national conversations” we have on the NHS, fantasy does a lot of heavy lifting and reality tends to play second fiddle. There are three myths which infect those conversations; firstly, that our NHS is free and other countries’ health services are not, secondly that our NHS is underfunded and other countries’ health services are not, and thirdly that our NHS is of high quality and other countries’ health services are not.

None of these myths is hard to bust. Firstly, all across Europe, countries provide their citizens with a universal, taxpayer-funded provision of healthcare. If you break your arm in Austria, or need a scan in Spain, or get a new knee in Norway, you don’t lie outside on the pavement until you produce your credit card.

Secondly, those countries tend not to allocate a significantly different proportion of their expenditure to health than we do here. Throughout the UK, we spend a fairly similar amount per head on health as the average OECD country.

And finally, far from being world-leading, the world is laughing. In the NHS we have fewer beds, fewer scanners, fewer nurses and fewer doctors per capita than comparable countries, and therefore it should be no great surprise that we have longer waiting times, longer waiting lists, and poorer mortality as a result of killer illnesses such as cancer, heart attack and stroke.

This need not be inevitable, but it will be inevitable for as long as we treat the NHS as we currently do. For as long as we protect the system rather than protecting the patients, the system will always win and the patients will always lose.

We witness myriad outpourings of love from people who say “the NHS saved my life”. They have, I am sure, a sincere belief that they would be dead in any other country, but, I am afraid, they are completely wrong.

The NHS has saved the lives of precisely zero people ever; when their lives have been saved, they have been saved by doctors, just as they would have been in Austria or Spain or Norway or any other of our European neighbours. We should be proud of our nurses and doctors (I am – my wife is one of them), whose goodwill largely keeps the doors open. However there is no rational reason to be proud of the NHS. This is not a national conversation. This is a national cult.

Our bizarre infatuation with the system rather than the people who keep it ticking is largely the reason we appear to be unable to reform it. And so, we should see the findings of this opinion poll not as a reason for moral panic, but as an opportunity for moral propriety. 

Use of the private sector (which countries in less of a tizz call co-payment) is increasing, and will continue to increase as night follows day, as an entirely reasonable and understandable reaction to unacceptable queues in the NHS.

The provision of employer-provided private healthcare is mushrooming, and even small companies now find themselves offering it as a bog-standard perk, alongside the cycle-to-work scheme and the Christmas hamper.

Dr Iain Kennedy chair, the BMA, this week said The NHS is dying before our eyesDr Iain Kennedy chair of the BMA, this week said “The NHS is dying before our eyes” (Image: BMA)

Good. Let’s encourage that. For every person who gets that hip replaced in a private hospital, there’s a space freed up in the NHS queue for the person who can’t. Both patients win; the only losers are the cult leaders struggling to stop everyone unzipping the tent.

There is a snag. In other countries which have always used a co-payment system, often involving a form of social insurance, state provision and private provision work hand in glove. The patient is able to exercise a degree of choice over their provider, and this plural provision is one of the reasons they have far more health professionals per head than we have here.

In the UK, on the other hand, the surgeon who replaces that hip privately on a Friday has replaced a hip on the NHS the day before. He or she can’t be in two places at once. In other words, the supply of healthcare professionals needs to rise substantially to meet the demand for their services. 

That is a problem which can be tackled relatively quickly, initially through migration and then through an increase in domestic training. And it is a problem which we will find far easier to tackle when we remove the blue-tinted spectacles and see the health service we have before our eyes, rather than the one which only exists in our national imagination.

Andy Maciver is Founding Director of Message Matters, and co-host of the Holyrood Sources podcast