But, as Oscar might have remarked, had he lived to the age of a hundred, if there is one thing worse than not having a bed in an NHS hospital it is having a bed. When night falls, it isn't pleasant. There was a bright light over my bed which I was told had to be on for H & S reasons, though it was off on the second night. The man opposite me had gangrene and was, quite literally, trying to crawl up the wall. The man next to me screamed and cursed with pain, though I was told this was because of his mental problems rather than because his pain was any more severe than that of the rest of us. The old boy beyond him was shitting himself and playing with the shit. Nurses remonstrated with these characters throughout the night and the clichéd image of Bedlam came all too readily to mind. It was only later that I discovered that there are an estimated 30,000 people hanging around NHS hospitals who aren't actually being cured of anything, but have nowhere else to go.

Anyway, there's much to think about as you lie there connected to the pipework and the most unavoidable subject is the NHS itself. It seems to be two different things: the excellence of the surgical wards and the rambling weirdness of the rest. For Conservative politicians it will always be a problem, being too popular to attack directly but far too expansive and expensive to be allowed to develop naturally. We all know the story: an ageing population, constantly developing technology and a potential financial black hole. If only more people wanted to die! Thus governments must always be seen to be doing something with the service whether reorganising it, ring-fencing it, assessing it, cutting it, etc. This goes right back to the very beginning and Labour's "teeth and spectacles" debate.

But I am not a politician, Conservative or otherwise; I am a writer in what I consider to be a conservative tradition and I don't need anyone even to agree with me, let alone vote for me. Nor am I committed a priori to any principle which would suggest whether health sevices should be provided by the state or not. In general I am in favour of private enterprise, but that would not necessarily include the American model of private enterprise medicine where the public weal is held to ransom by parasitic lawyers and drug companies. The crucial utilitarian argument is about what Bentham called "security" and the benefit to human happiness of dreadful fears diminished by the availability of universal health care. The most complete misconception I have come across when arguing about socialised medicine in the USA — which I have done in university seminars, bars and on the top of a mountain — is that it is compulsory. The impression gained from much American coverage of the NHS is that there is that in the "UK" there is no other health care. Very few people realise that you can have personal or institutional health insurance as in the US. Or, for that matter, you can just pay. Or go abroad. Some confusion with the Soviet Union, I think. On many occasions the argument has come down to an image of a socialist bureaucrat deciding whether you are worth treating, whether you live or die.