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Matt. I suspect you're goading the usual suspects here, but do you really believe that total privatisation is the likely to be the right answer? I agree it's an option that needs to be considered, but I'd be extremely surprised if it was the right solution.

If the NHS is to survive though, two safe bets though are that:

- More aspects of service provision will need to be privatised - More of us are going to have to start paying for (or contributing to) the costs of our own direct health care.

To deny that is completely unrealistic. I am a strong believer in the NHS and I want to see it survive. However as the statements from the NHS Confederation make clear, continuing 'as is' will threaten that. The real enemies of the NHS are those who won't accept the need for change.