This letter first appeared in The Times
Sir, A country that chooses to fund its increasingly expensive healthcare system will inevitably be highly taxed. If it then chooses to fund its national social care system through the same mechanism it will inevitably be very highly taxed. It does not have to be this way: most other countries with far better outcomes than our NHS or social care system use a mixture of taxation and social insurance, the latter permitting an increased contribution from the individual.
Unless and until this country has a fundamental review of the social, fiscal and political basis of our health and social care system we will continue to fail our patients and citizens.
Professor Stephen K Smith, FMedSci
Former dean of medicine, Imperial College London; London W12