Radio 4, the BBC’s semi-intellectual talk channel, ran an interesting programme, the Private World of the NHS. Presenter Adrian Goldberg went through the various ways the NHS works with the private sector, which spends (gasp, shock, horror) 8p in every pound on services provided by the private sector. So what does it tell us about attitudes?

UK readers click here to listen.

Goldberg seemed to get the idea of outsourcing dialysis to efficient private operators. He was less sure about Private Finance Initiative (aren’t we all, really if we are honest with ourselves?) and the plans of various NHS organisations to create wholly-owned subsidiaries which will employ porters cleaners and catering staff. The idea seems to be to dodge sales tax and that over time (a long time) new staff will not enjoy NHS perks.

The British Social Attitudes Survey found in 2016 that 90% of the population think the government should provide healthcare services while just 2% thought it should be private companies. But Goldberg was amusing on how Brits who have had the NHS pay for treatment in the private sector loved it, whilst almost everyone else in the country regard making profits from health care services as immoral.  So why do we let supermarkets make money out of selling us food, eh?  Seriously, this statement about immorality comes up at every dinner party I attend.

Inevitably, Babylon Healthcare, the UK’s largest play in telehealth for primary care, came up. GPs accused it of cherry picking fit, young people who subsidise the older, less educated, frequent flyers. There is something in that accusation (the youth do chose digital), but the programme missed the point that telehealth means that it is the per capita payment approach that needs to change.

It was a little hazy on the financial benefits that come from outsourcing stuff like dialysis (we hear that allows trusts to retain 20% of the payments). As ever, you can not find any one in a senior management position inside the NHS who is willing to defend (on record) working with the private sector.

Goldberg didn’t let anyone get away with the lie that the Tories want to turn the UK into the US healthcare system. But it would be so useful if someone, somewhere, could point out that lefty countries like Sweden, France, Finland and Germany, use the for-profit sector far more than the Brits, to deliver health care.  Always the NHS debate is framed purely in the context of the USA. Would any liberal Guardian reader believe that half surgical procedures in France are carried out in the private sector? Firstly, the Guardian would never print it and secondly, they would all choke on their organic muesli.