Only a non-partisan Royal Commission can rescue UK healthcare

Is the Government’s message on the NHS really: “If you don’t like it, go private. We’ll show them just how bad the NHS is. Then let ’em pay. That’ll teach ’em.”

That would be unbearable to all true Conservatives. The Tory Party is supposed to look after your money; it works out the finances for we the people. But something is now wrong.

All current discussions about the NHS – nurses, ambulance drivers, A&E waiting time, unavailable GPs, cancer deaths – return to the same painful subject. Money. Conservatives should have no fear of that word. They say flat out that caring that works costs cash.

Somebody has to step up to solve the endless problem of the NHS. No political party can do that. Their proposals will immediately be denounced by their opponents. The NHS is now the ultimate post-truth world – fake news and alternative facts.

In 2016, I successfully manoeuvred my Access to Medical Treatments (Innovation) Act through Parliament to advance medical innovation and save doctors and patients from the “standard procedure” for cancer, usually leading to poor life quality followed by death.

During its long medical and legislative process, I encountered two different kinds of people with two distinct cultures. Pessimists and optimists, realists and idealists looked at each other as if they were creatures from another planet. I saw first-hand the glow of pride in the NHS slowly darken to ambivalence from both groups amid concern about the present and anxiety for the future.

However optimistic one is about its current performance, the looming challenges facing the NHS present a unique opportunity to think seriously about what kind of healthcare we expect in 21st-century Britain and what steps we need to take to get there. It would be reckless not to seek a full body check-up if we want to guarantee more decades of world-class healthcare.

A Royal Commission on the NHS would provide the circuit breaker needed for serious NHS reform. One of the reasons this is necessary is that the NHS has increasingly become a political third rail. Touch it and die.

While NHS reform is unlikely to ever come without some political cost, the non-partisanship, authority and expertise of a Royal Commission would go a long way towards detoxifying the best reform proposals. Royal Commissions are uniquely trusted by the public for their independence and thoroughness. Sustainable policy change in the NHS depends on securing that kind of legitimacy. It’s imperative that any substantive proposals for change enjoy as much cross-party support as possible. Chaired astutely, a Royal Commission would be best placed to find the kind of solutions that won’t disappear with the first change in Downing Street. While it may be tempting to opt for a shorter ad hoc inquiry, the immense investigatory powers of a commission (eg summoning witnesses under oath, offering indemnities, seizing evidence) are vital if we are to surmount the incentives that keep many NHS stakeholders from speaking out, as evidenced by the closed-shop culture identified in the 2010-2013 Francis Inquiry. A Royal Commission may be just the circuit breaker that is needed.

Whereas piecemeal reforms may end up lasting only the lifetime of an individual government, a Royal Commission is an opportunity to find common ground on the serious problems the NHS is facing today.

Whether one is a pessimist or an optimist on the current state of the NHS, all should welcome the chance for a system-wide investigation of its current and the future challenges, in a forum uniquely capable of leading public opinion and providing legitimacy for the hard policy decisions that lie ahead. The NHS cannot afford to miss this opportunity.

Lord Saatchi is a Conservative peer