However, just as the Russian ideals fell victim to bureaucracy and corruption, so has the NHS.
For a while, in the 60s and 70s, the NHS was a highly innovative and revolutionary health care delivery system. It provided universal healthcare to the whole population, equal to the best in the world. However excellence in medicine has become expensive, there is almost no limit on what can be spent to keep a body going. There is no natural line in the sand. Modern communications mean that gaps and postcode lotteries can no longer be fudged in the way they might once have been.The principles upon which the NHS are inconsistent in the modern age. For example, "Free at the point of delivery" Free to whom? Healthcare tourists, or just the locals? For everyone or just the people who have contributed? Everything free, or just the essentials? and "Free to what standard?" Minimum or optimal care? "To each according to their need" Does that include fat people, unfit people, unhealthy people, smokers, old people? What do people need? an inhaler for their asthma, a kidney transplant, better social benefits? a new life, a job? Disease is as much a social condition as a medical condition. Does "Universal Health Provision" include IVF for the over forties, cosmetic dental work for the permanently insecure, health education in schools, mass vaccinations? Where does prevention fit?
The hallmark of a totalitarian system is control. Access to the NHS is still largely controlled by General Practitioners. Once these were benign, everyone's uncle, best interests at heart, social, generous sorts of chaps. Nowadays they receive ample financial reward, may not know you from Adam, but will generously check your biometric data at every opportunity.
Is Johnson's latest step a move towards a patient-centred service? Or does allowing patients to bring their own drugs into the NHS, paper over the worst and most vocal cracks of a failing system? Is this another example of putting lipstick on a pig, or a genuine move towards allowing patients a wider choice of treatment?