The small book by Enoch Powell “Medicine and Politics 1975 and after” (his period was 3 years as Health Minister) should be obligatory reading for all doctors. He could less politely have said that the Emperor has no clothes. . Read a review by retired BMJ Editor Richard Smith.
He tells us that of course the health care is rationed, and that this is deliberate but covert. He (page 37) discusses some methods of rationing, but since his day we have invented many more than the waiting lists and waiting times that he refers to.
Parkinson’s Law of Hospital Beds (page 43) “asserts that the number of patients always tends to equality with the number of beds available for them to lie in”. But he was not aware that clever administrators can use trolleys, but not count them as beds. Therefore more and new covert rationing….
Finally I wish to quote his last word on rationing:
“It is unfortunate that the nature and value of rationing by waiting and by ineligability in the NHS are not recognised, at least by the professions (and by implication the rest of the country). For these are the features that make it possible to avoid invidious discrimination in administering the service and, at the same time, secure a certain rational allocation of priorities. Instead, these features are treated as evidence of “inadequacy” and as blemishes that it lies within the power of politicians to remove, given the will.”