It's all about health

Nevertheless, it is time to examine carefully the rows of moribund people being kept alive at public expense (and thus preventing other people getting care): this might force us to confront the troubled interface between medicine, nursing and religious belief. Pneumonia used to be called “the old man’s friend” - now we treat the condition too often and too well.

We are a small country and it is quite ridiculous to have the present administrative arrangements continue. One level of government (I do not care which) should take over “health” - it would end the “blame game” and sheet responsibility home to one lot of people who could not shift blame and so avoid taking responsibility. At the same time we need stronger regional arrangements close to where people live.

Finally, the agenda of the public is more important than the agendas of professionals and the groups that represent them. It would be great to have a system where difficult questions of resource priority were decided before citizen juries, instead of being decided secretly and off stage as they are at present.

The belief that citizens are not capable of understanding the issues is a conceit. If it is good enough for murder trials to be decided by groups of citizens, then it is imperative too that medical questions are decided by the people who have to bear the consequences.

At present great questions are argued passionately - but they are argued by elite groups and the public is shut out from those discussions. The public bears the consequences of all those decisions and should have a say in how the questions are decided - learned advocates could present opposing cases to groups of citizens who would then make a considered decision. The questions might be complex and complicated but the capacity of people to understand complex and complicated issues is greater than some professionals think.

But the debate stinks as it is. I want premiers and prime ministers to agree that it should be better.