'From introducing small fee to see GP to paying for food in hospital, it’s time to make tough decisions to fix a broken NHS'

I was lucky, the service was fantastic, but for over seven million people on the growing NHS waiting list the story is not good.

Many have been waiting for years for simple operations.

Worse still, the average ambulance and A and E waiting times have been getting so dangerously long that people have been dying as they wait.

And it’s not just the hospitals in crisis. Try to get a GP appointment, you can wait weeks, try to see a dentist and you're forced to go private, try to access mental health services and you're told to wait and take anti-depressants.

t’s a depressing list of problems on the desk of new Health Secretary Wes Streeting. But how will Labour respond? More money is only part of the solution.

It’s time to have an honest conversation with voters about the tough choices needed to fix our broken health service.

The first harsh reality is that the NHS problems are not due to immigration.

Instead, it’s because we are all living longer, and medicine is getting smarter, with the ability to cure more people.

Back 50 years ago you would work and pay your taxes then die a few years after retirement. That was very efficient for the NHS.

Thankfully we live longer but that’s creating a time bomb, particularly when my baby-booming generations start to need more health and social care. The problem is going to get worse.

The second reality is that we can’t just pay for the NHS with more tax. Tough choices are needed.

For example, I earn a good salary but now I have turned 60 I get free prescriptions. It's madness. I can afford to pay £9.90 and would rather that money stay in the system.

So, it’s time to ask some difficult questions. Should we make a small charge to see a GP, pay for the food we eat while in hospital and even start to remove certain procedures from the NHS?

No elected politician would dare to utter these words during an election campaign.

So how can these tough decisions meet the voter test?

Voters are not stupid, if they can be shown a clear choice and the consequent advantages, they will support change.

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If there were a £5 charge to see a doctor, this would raise almost £2billion a year.

If that money was re-invested back into GP services and you saw the benefit of quicker appointments, then suddenly the pain of a charge brings with it a benefit.

It’s a horrid choice to end the principle of free at the point of delivery - but if we don’t make change then the principle is meaningless – what’s the point in having it free if it doesn’t work?

Will the Labour government have the courage to hold a grown-up debate?

Tinkering at the edges is going to solve nothing. It’s time for honesty.