Your Humble Servant: a glimpse of the future NHS

To: Don Wise, chief executive

From: Paul Servant, assistant chief executive

Re: Brave new world

Dear Don

The strangest thing happened to me during my recent MRI scan. Some sort of power surge occurred and the magnets went berserk. I don't really understand the physics, but the upshot was that time folded and I slipped through a vortex in time and space to find myself in 2068.

Life in 60 years has changed in many ways, although it appears that primary care trust chief executives are still wearing corduroy. Sadly, I didn't have too long to wander about but what I saw was fascinating.

I'd arrived in the closing stages of a general election campaign and the opposition Conservative Labour party had two key pledges, which were hugely popular. First, the UK would seek independence from the US and second there were radical proposals to create a National Health Service.

I was a little surprised, and although no-one I asked could remember how things had got to where they were, the healthcare system was now dominated by several corporations, Foundation Wealth, BMA Direct, Darzi Poly and Virgin Rock.

Healthcare funding was down to individual payment or barter. This was particularly hard on poor families who would usually have to provide an able-bodied family member as an indentured worker to the corporation until the debt was paid off.

A limited public health system operated through a network of polyclinics, but they were old, dirty and severely limited by poor IT which kept crashing and losing electronic patient records.

Out of hours was also still causing problems as it was now impossible to find a nurse to work nights or at weekends.

There had also been some interesting public health initiatives to address lifestyle issues.

It was now illegal under the Mental Health Act to have a BMI of over 30 and fat people were subject to section and starvation control orders, being detained in the old PFI buildings, now known as Psychiatric Fat Institutes.