If ever there were a defining moment for the NHS this is it.
As a society, we must accept that as the population becomes more affluent, the demands on our health service grow until we have a demand growth curve that is exponential. The aging population will also increase demand on our health services, and with fewer resources available, there will be a massive deficit between what the nation requires and what it can afford. Investment in the NHS will fall behind inflation rate of around nine percent, which is higher in the medical world than the standard inflation rate.
As individuals and 'consumers', we have difficult choices to make; a new sports car or a hip replacement; a cruise or a heart bypass operation.
What will the NHS look like in 10 years? Many more services that are currently available on the NHS will be found only in the private sector. The patient will have some choices to make about where they buy those services, but pay they will.
As the private sector gets more involved, quality, convenience and price will influence buying behaviour. As much as 'buyers' rate 'sellers' on ebay and Amazon, benchmarks of service and 'user satisfaction', based on patient feedback, will be introduced to differentiate suppliers.
Dedicated primary care providers will appear on the healthcare landscape, adopting many of the duties once performed in hospitals. Access to these primary care services will move to out-of-town supercentres, possibly funded and run by Tesco or Sainsbury's, including every type of healthcare service, plus complementary therapies.
One thing is certain; the changes in the NHS will offer massive opportunities for private health. We will see service and choice improve, but at a price. The famous slogan of the defunct poll tax of the eighties - "can't pay, won't pay" - will probably resurface and will be met with as little sympathy. With retirement age pushed back, rather than paying in to pension plans, we will be paying into a pot to cover our costs when we need care when we eventually stop working in our very old age. A whole new industry will emerge to look after us in our dotage and which will replace pensions; we may even find investors moving out of equities and property into elderly care services.
The NHS will never be the same again.
