I am delighted that Totnes MP Dr Sarah Woolaston is calling for the “urgent establishment of a ... commission to work on issues of NHS and care funding”.

I am less enchanted that she calls for a “cross-party commission.” As a politician, I suppose she would, wouldn’t she?

?But the most serious issues faced by any health service in the world are the rapid growth of population and of many living into late old age. The politicians have just not kept up.

A cross-party commission would be better than nothing but vested ideological interests would never be far from the surface.

Some politicians want to spend as much as needed for patients’ wants and desires to be met in full, but they fail to explain where the funds are to come from. Raising income tax only obtains money from those who pay income tax.

Other politicians are reluctant to offer largesse to any but the neediest and expect market forces to work a miracle. No politician is comfortable discussing health care rationing – no matter what funds we have, how should they be spent?

What conditions, patients, treatments, circumstances, should the state not fund?

The BMA Retired Members Committee, of which I am chairman, is calling for a Royal Commission. This would be independent of Parliament and political parties, and would restrain vested interests by a balanced, wide, membership.

Such commissions are created by the Queen, and once started, they cannot be stopped by Government whim.

We have had a Royal Commission on the NHS before (1975-79, under Sir Alec Merrison), but that concentrated on management of financial and manpower resources, and did not get to grips with wider issues such as how resources should be obtained and the need for rationing.

Yes, a Royal Commission might take longer to report, but nothing less will do.

Parliamentarians can still have their own commission to deliberate urgently if they wish.

The BMA first called for ‘A General Medical Service for the Nation’ in 1929. It is now time to take heed, take stock, and commission the widest and most extensive review of care needed, wanted and desired – and the funding required to meet those worthy ambitions.

Dr Richard Rawlins

Beacon Road, Kingswear