So, “Professional advice” to the Herts Valleys Clinical Commissioning Group at a recent legal review has revealed: “The policy direction of the NHS generally is moving away from promoting choice” (May 3. ‘News’). No surprises there.

When Obama tried to introduce his version of the NHS to America, he promised citizens faithfully: “You can keep your doctor; you can keep your insurance provider”. He lied. Americans had been pushed towards Obama’s dangerous experiment by an expensive mix of public and private health provision. They thought things couldn’t get worse. They learnt their lesson the hard way. Wiser heads are now trying to undo the mess and guarantee the choice and excellence that only the market can provide.

When governments run things, innovators are always punished, the taxpayer always loses; the corporatists always win. Compared to countries that include greater choice, the NHS actually costs much more for much poorer care.

A beautiful and poignant group of statues stands between the Watford Town Hall and the library. Mary Pownall Bromet, who trained with August Rodin, created them to commemorate the fallen in the First World War. They dignified the Peace Memorial Hospital from 1928 until 1971 when they were moved to their new position. The money to cast the three figures in bronze and to build the hospital was raised through local subscription. That was a time when health schemes competed. Customers had choice; choice drove excellence; philanthropists were generous.

When medicine was nationalised in 1948, the state displaced the burgeoning range of medical provision and affordable insurance schemes that had been developing. (Income from ‘National Insurance’ contributions is not invested. It is spent immediately.) This represented no small loss to the capital markets; insurance companies are the number one providers of capital. Before the imposition of the NHS, family doctors would still treat patients who had fallen on hard times and couldn’t afford their modest premium - in the middle of the night, if it was an emergency. The Peckham ‘Pioneer Health Centre’ was established in the 1930s by two remarkable doctors as a radical experiment in promoting health rather than treating illness. The Peckham model was one of the more successful ideas to emerge from this innovative time.

Why would a doctor do this? Because medicine, at its best, is both an art and a science. Family doctors in those days knew their patients, their foibles, their hopes, their fears. They delivered babies, cared for the sick and were present at the end of life to administer an opiate for the pain and sympathy for the family. The family doctor knew when it was time to call for the priest, if that was what the family wanted. Death was treated with respect by all sections of the population.

Fast forward to our own time. The state provision of health care has unsurprisingly become a politicised, expensive and dehumanised industry. Prime Minister Margaret Thatcher wanted to look again at developing a competitive health insurance market. However, her then Secretary of State for Health, Kenneth Clarke, preferred partial privatisation, based on Bismarck’s 1883 model, and is largely responsible for the corporatist, bureaucratic mess which is our present day NHS. However, Clarke’s true legacy may just be emerging thanks to local solicitor, Des Collins, who spotted a grave injustice in 2017.

Des Collins is the senior partner at Watford firm Collins Solicitors. In July 2017, he encountered two victims of the contaminated blood scandal, since labelled the worst treatment disaster in the history of the NHS. There have been so many! In the 1970s and 80s, the bureaucracy-driven NHS had been running short of the blood-derived clotting factor that keeps haemophiliacs alive. Instead of relying on screened, UK blood donors and reliable plasma production companies, the NHS began importing a cheap, ready supply of blood products - from unscreened donors abroad! Despite warnings from the source countries and from observant clinicians in the UK, then-minister for health Kenneth Clarke in 1983 permitted the use of these blood products to continue. Many haemophiliacs contracted HIV and/or hepatitis - even passing the infection on to their partners unwittingly. By 1996 the majority of HIV victims had already died.

In July 2017, Collins decided to bring a group legal action against the Government on behalf of more than 500 individuals. In September 2017, a court ruling found in favour of the victims allowing them to launch a High Court action to seek damages - and prompting the recently opened Infected Blood Public Inquiry. Collins, now representing more than 1,000 victims, families and nine campaign groups,observes: “The sad fact is that despite 1,000 crucial files going ‘missing’, there is very little that will surprise me in relation to the facts in this important inquiry.”

Successive governments have been criticised for their handling of the scandal. Former health secretary Lord Owen has said there was a “cover-up” and “incriminating evidence” was suppressed by the Government to prevent victims taking legal action.

Prof. Christine Wheeler McNulty