THREE CHEERS for Patricia Hewitt, the Health Secretary. In a revolutionary break with the past, she has made clear that she wants to launch a “national debate” on the importance of introducing charges into the health service.

It is important, she says, that something is done before the entire system collapses under the weight of patient demand. She points out that it is only because GP visits are free at the point of use that so many frivolous visits are made.

She sees her job as to start “building a political consensus”, while winning the acceptance of 28 million patients on the merits of charging. “We need to decide in the course of this Parliament whether this is going to be feasible.”

Although there are some minor examples of charges, such as for dentistry and ophthalmic treatment, Ms Hewitt points out that: “Nothing on this scale has ever been attempted.” But the ever-greater demands placed on the NHS mean that “going on as we are is not going to work. Too often in the past, governments have concentrated on fixing the problems of the past 20 years. We must concentrate on dealing with the problems of the next 20 years” — a clear reference to the demographic changes that will make the existing method of NHS funding unsustainable.

Oh, hang on a minute. I have got my wires crossed. The Health Secretary said nothing of the sort. The quotes above are not from Ms Hewitt but Alistair Darling, the Transport Secretary. It is not Ms Hewitt who wants to launch a national debate about charges, but Mr Darling. And it is not NHS charges to which he is referring but road pricing.

How silly of me. It is the Transport Secretary who believes that the solution to too many car journeys is to put a price on them (typically, his idea of a market price is one set by Whitehall). As for the existing charges, he means the congestion charge, not NHS dentistry.

When Mr Darling came out with this yesterday, the thought crossed my mind that such an approach might be considered by other ministers responsible for public services that are funded by the taxpayer but free at point of use.

As if! How absurd of me to think that joined-up government might mean something.

Stephen Pollard is a senior Fellow at the Centre for the New Europe