The NHS was recently told by the High Court to fund a new drug for treating HIV, after some senior officials claimed it wasn’t their responsibility. At what point, if any, should we limit universally free healthcare?

Nobody in their right mind would argue that a new treatment to serve a devastating illness such as HIV shouldn’t be made available on the NHS. However, the sentiment behind the opposition raises an interesting point in the role of the state and the provision of free healthcare.

After all, the UK’s closest international ally, the US, still has private healthcare with the exception of government aided insurance.

In the UK, there is likely a general consensus that broken bones, the flu and the common cold should all be treated for free by GPs and hospitals. However, what about self-inflicted illnesses?

Free treatment of smoking-related illnesses, obesity, plastic surgery for non-medical reasons can often cause upset. One might argue that the state should be a ‘nanny state’ that provides far more than a safety net, but also an active repositioning of citizens onto the right path.

On the other hand, this comes at the cost of tax payer money. One might believe that the system as it is, punishes those who have made the right decisions i.e maintaining a healthy weight, with heavier taxation, and rewards those who have made the wrong ones with free treatment.

Before the outrage takes over – consider this for a moment. You work hard, you earn a decent salary and you don’t rely too much on the NHS, if at all. Yet because of your salary, you pay a fair amount towards tax, to fund treatment such as obesity or plastic surgery. Should you be paying for someone to get a free nose-job on the NHS? You wouldn’t pay for a total stranger to do it directly, so why is it different when your taxed money is used to do so?

The issue is, too many people feel they are entitled to free treatment, and therefore once we feel we are entitled to something, we stop appreciating it. We should feel extremely thankful that our own, and mainly the tax of others, pays for us to have free healthcare.

If you continuously smoke in the face of all the health warnings, should you get a free lung transplant on the NHS, over someone who also needs one, but has never made decisions to deliberately induce their condition?

Of course it is unproductive to raise such an issue without offering a solution.

Firstly, there needs to be a change of mind-set in the UK. We must start, once again, appreciating the NHS as a luxury that not all countries have, and appreciate that our tax alone does not pay for our treatment. We require the tax of others, maybe those who never even use the service, and so we must treat the service with respect and cast aside this feeling of entitlement.

Secondly, there should be a restriction of some treatment provided free of charge by the NHS. Unless it is immediately life threatening, the patient must be told to consider life-style changes they can make before medical help is sought needlessly.

Moreover, to help to reduce obesity, which is a big (pardon the pun) problem in the UK, children in particular need to be encouraged to take part in more sport. People need to actively look for more local opportunities to play sport in their local area. But it must be stressed, the responsibility is on them to do so.

The responsibility of treating illness should be the role of the state. It is also the job of government to create the sports facilities or health campaigns to raise awareness. But these are in place if one can only be bothered to look. The responsibility for keeping oneself healthy by reducing all possible risk of illness or disease is ours, and as long as it is in our power to do so, it is a right we should use.

The state should not be there to hold our hand from cradle to grave. We don’t need Mother Government to tell us what food is unhealthy or that cigarettes cause cancer – we already know. Everyone knows, nobody can claim ignorance. Just like a child that fails to heed its mother’s warning, we should be made responsible for the outcome we choose. How else are we expected to learn?


  1. We should stop saying treatment on the NHS is free, that is the main problem. The treatment on the NHS is not free, it is paid for as you say via taxation. All the NHS is or should be is a paid for service free at point of that service. Everyone should have to show their NHS card to receive treatment without need for payment. Just like people travelling to Europe show their EHIC card when needing treatment in continental Europe.

Leave a Reply

This site uses Akismet to reduce spam. Learn how your comment data is processed.