NHS or private? It's a silly question, in a way. As with Blur or Oasis? it prompts the counter-query: why the hell not both? The fact is that you'll probably need both, as private medical schemes rarely cover things such as GP services and A&E, and if things go wrong, with a surgeon confusing a toenail with an appendix, the NHS will probably have to pick up the pieces anyway.

Moreover, NHS or private? is a particularly daft question coming from me, given that I took the private option some time ago. But I want to pose it anyway because a) I've been ill, and when you're ill it's impossible to think of anything but illness, and b) reports suggest that while medical insurance subscriptions hit an all-time high of 6.5 million last year, cancellations are accelerating. As Dr Mark Porter recently put it in this newspaper: “The economic turmoil, combined with a better, faster health service, means that private medical insurance is looking like an unnecessary luxury.”

Dr Porter has a point, of course. Despite the revelations last week that deficiencies in care at Stafford Hospital resulted in some 400 needless deaths, the NHS has improved. I don't want to go on too much about my medical travails because I did so last week and the subsequent lack of floral bouquets reminded me that listening to people witter on about minor ailments is about as interesting as listening to your hairdresser discuss his or her star sign. Also, when it comes to health, people are irrational - invariably over-emotionalising their experiences and patronising their assigned medical professionals.

But before I retired, for the second time in as many weeks, to a North London private hospital as a result of a tediously persistent bug, I had my first dealings with the NHS in a decade and was impressed. A doctor in an A&E department did, admittedly, try to get me to stop screaming while stitching me up by reminding me of “the children in Palestine” who were going through worse things without the luxury of anaesthetic. And a GP's receptionist did try to make me fill out three forms when I had my right arm in a sling. But the casualty doctor had a point about Palestine, sadistic staff are prevalent in the private sector too and, while there was a time when I would have no more relied on the NHS than spent a night in a room with Charles Bronson, the experience was encouraging.

New Labour may have cocked things up in most respects, dragging us into an unjustified war, bringing the economy to its knees and overseeing a depressing expansion in the gap between the rich and poor, but it has improved the NHS. However, does this mean that we should put ourselves in the hands of the service, if we can afford the alternative?

I would say no, for three reasons; the first being simply that private hospitals have a much better record on infections such as MRSA than those in the NHS. The extra money is worth paying just to ensure that treatment doesn't make you even more ill than you already are.

Second, despite gimmicks such as “The NHS Choose and Book scheme”, which supposedly allows patients to choose their hospital and consultant and even the date and time of the appointment, the patient-doctor relationship is much healthier in the private sector. In the NHS, getting time with a consultant from a standing start is still about as straightforward as arranging tea with Madonna, and meetings with them are mainly arranged on their terms. The fact that with Bupa you can often call, text or even e-mail a consultant directly when you need to takes away a great deal of the hassle of illness.

But the clincher for private health is waiting times. It may be true that most people in England are now seen and treated within 18 weeks for certain non-emergency treatments, but this is only for some conditions, and frankly 18 weeks is a very long time when you're sick. Indeed, it is a reflection of the NHS's lack of ambition that a wait of more than four months is considered acceptable.

People deserve to be seen as soon as possible when they get ill, and it is notable that in the regular health-based questionnaires that the Daily Mail and The Observer put to celebrities, the response to the “NHS or private?” question for most subjects, such as Mathew Horne (“I had to go to hospital the other week and it was rank, so I'm going Bupa”), Griff Rhys Jones (“Private: it's philosophical... To say we can't have a two-tier system is to deny the ingenuity of human beings”) and Richard Wilson (“I'm very proud of the health service because I worked in it for ten years, but I'm private, for selfish reasons, really”) is “private”.

The only recent example I've found of someone remaining loyal to the NHS when being able to afford the alternative is George Galloway. And, frankly, when I read his remarks (“I don't think people who've got more money ought to be able to buy better healthcare”) I felt as I did when a friend who had gone out of his way to purchase a bungalow announced that he was arranging a loft conversion. Confused.

Surely it's a good thing if people who contribute towards the NHS in taxes pay for their own healthcare as well. Doesn't the fact that they don't use the NHS take pressure off a system struggling to keep up with demand? Shouldn't they be applauded? I'd argue the opposite: if you can afford it, the altruistic thing to do is to take up private medical insurance.

sathnam@thetimes.co.uk

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