Shaming obese pupils’ parents is not the way to get our NHS in better shape

fact that the costs of our choices are socialised and the benefits privatised would justify any number of initiatives – from compulsory exercise classes to full-scale prohibition of popular products – that are unacceptable in a free society.

The problem is two-fold. On the one hand, the health service, by being entirely funded through general tax revenues, protects people by design against the consequences of their own mistakes. It is therefore a safety net but also deleterious to personal responsibility, in the sense that we all know someone else will pick up the pieces if we abuse our bodies. On the other hand, progressive declines in individual responsibility create expensive health problems that the NHS is duty-bound to address. It is already struggling for money, as demand rises, partly because of “lifestyle” illnesses.

Politicians are currently debating how to create a lasting financial settlement for the health service involving tax rises and potentially even a special NHS tax. But this discussion should have another dimension: do we continue with a socialised health system that increasingly demands that we too are socialised through state lifestyle interventions, or do we resolve the contradiction in another way, perhaps by introducing co-payments for particular treatments, so that more of the cost of our errors falls on our own backs?

It would not stop people from making unhealthy choices – doing that would require appalling levels of authoritarianism – but my preference would be for the latter. And it is a system that is used widely in other countries that have healthcare that is just as universal as the UK’s.