A million miles away from the rhetoric of equality and all that top down pontificating beloved by our political class, the NHS and our wider welfare system is continually exposed for being a deeply dystopian and elitist operation. Its masters pretend otherwise. But, as Stephen Pollard and Andrew (now Lord) Adonis argued in their excellent book, A Class Act, Myth of Britain’s Classless Society,  the NHS is the microcosom of a class based system. That is what it is.

It has essentially white male doctors and administrators at the top and a raft of poorly paid ethnic minorities doing the auxiliary services at the bottom. As a system overseen by the ‘Royal’ Colleges, built on legislative favour, and which taxes ordinary people to the tune of more than £100 billion a year, is it any wonder that the poor are kept poor – and made ill earlier?

Forget social justice and equality. The key to making poor people healthier is to enable them to get rich. That is why government should get out of the way.  Indeed, it should allow welfare to flourish without the state. Forget politics and coercion. What we want is much more open, diverse and dynamic forms of health and welfare organised bottom up.