I was born before the NHS.  My Dad was a window cleaner and Mum a shop worker.  He saved the equivalent of 3 week's wages to have a 'midwife' come and help his young wife through 12 hours of labour.  No gas, no air and no prospect of going to hospital.  Her first born died and she nearly bled to death.  A woman at risk but determined to start a family.

When the 1948 NHS Act came along it lifted, from the shoulders of working people, the anxiety of sickness, injury and accident.  It was an heroic piece of politics, built on belief and vision.

Today, that young wife is a frail widow being cared for, in her own home, by a hospital in-reach team.  Her husband died years ago but his life was extended by an aortic valve replacement.  At the time it was innovative, new and must have cost thousands.

I started life without the NHS and I expect to meet my end without it.  Today's politicians are driven by balance sheets, not beliefs.  There are no visions or convictions, just focus-groups and practicalities.  The eagerness to get the costs and liabilities of the NHS off the nation's books will become more urgent.  The damage to the economy has hobbled the NHS and the grim economic prospects with cripple it.  The NHS is running up the down escalator of time, costs, and demand.

Can we learn or legislate to make fat people thin?  Can we find a way to help old people remember who they are?  Can we turn the feral into families?  Probably yes; but we don't have the time or the money or the know-how.

Yes, the NHS has to be efficient and safe and clean but it has to be central to a political desire to promote, encourage and endorse social medicine and its values.  I judge it is not.  If we want an NHS we have to pay for it.  No politicians have the courage to ask for the money.

We can fiddle with technology, jiggle with data and lean care-pathways but the truth is; the NHS is about smart people with a strong sense of vocation.  There is no shortage of them but the places that can employ them will become scarce.

In ten years we will be well on our way to 20 giant hospitals, vertically integrated with privately run health and care shops in the high street.  Basic services will be available, top-ups common and a major source of NHS income.

Nurses will provide their own uniforms, patients will buy their pills on-line and in-patients pay for their meals.  As maternity is a condition and not an illness, mums will pay for their deliveries - just like my Dad did when I was born.

My message comes from the past, delivered in the present but meant for the future.  'We tried, we did our best but they wouldn't listen.  Not enough of us saw it coming and too few noticed it going.  I'm sorry'.