Hard pressed, with his patients dying while waiting for heart operations, he told me he was just relieved when any patient opted to go private. It is easy to sympathise with this doctor's day to day dilemma, but in the long term such thinking would destroy the service. Alan Milburn gave all such talk of private insurance the expected robust retaliation, but he went much further than that. He made a hard pitch for more money. With a third of health authorities in debt this was welcome honesty.
Doctors always say there is but recently their cries of anguish have hit higher decibels.
If we want to improve our low standing in the international health league then tackling poverty, smoking and unemployment gets a bigger bang for every buck spent. But politics is not rational. The reality is that if the NHS doesn't get more money the privatisers will win by default. Public demand has to be met even if social scientists know it means spending money less well. It shouldn't be hard to persuade the middle classes to hang in there, with middle-class America crippled and immobilised by their health insurance bills.