I was just thinking about tattoos, and I thought, 'I wonder if Alastair Campbell has a tattoo?' If only he did, at least there would be one thing right with my crush that is so wrong.

He's on TV tonight, Five News at 7. I'll try not to get over-excited (I last saw on TV briefly on the morning of the Labour election victory), but I'll fail.

I should maybe make a New Year's Resolution to stop obsessing over Campbell. It is pointless, it annoys my husband, and it is demeaning to be in thrall to such an alpha male, especially one who likes Tony Blair and actively assisted in his dismantling of socialism within the Labour Party.

But he is very sexy. It's the 'Selfish Gene' thing isn't it? Should I really fight what is only a natural, primeval gene-driven thing? Plus, of course, he has no idea I exist and have pseudo-baby-making thoughts, so where's the harm?

So Steven is now officially well enough to have his own hospital phone: you can direct dial him for a mere 50p a minute. Yet another money-raising idea from a cash-strapped NHS:

http://society.guardian.co.uk/publicfinances/story/0,12671,1655580,00.html?gusrc=rss

I am a huge supporter of the NHS, I vowed never to leave it. Then after 15 years I left because it had morphed into a massive rest-home for terminally incapable managers, combined with an experimental playground for sound-bite seeking politicians.

With the medical advances that have come since its inception, there is no way the NHS can remain 'free'. Of course, it hasn't ever been 'free', and it isn't even free at the point of delivery, as everyone who's had to pay for a prescription or dental care will know.

It's not an insoluble problem though. Those who talk like it is are just not wanting to face up to the solutions, or are unwilling to look at them because their plans for privatisation will then be blown out the back door.

First off, we need to get rid of the internal market. This is a huge paper-generating exercise and achieves nothing except more jobs for people to track payments and monitor contract performance. It decreases the amount of time available for patient care, and increases the amount of money spent on computer systems which invariably turn out to be utter pants.

Performance targets should also be scrapped. What happens is that hospitals and GPs cheat by diverting funds to those areas where targets are set. Or they divert patients who might cause them to fail to achieve their targets. Instead, all hospitals, GP practices etc, should be sent up to date guidelines on best practice expected (in all areas), and then spot-checks should be performed, at any time, on anything. This would be cheaper to monitor (the checks should be experiential checks, not paper-based ones), would prevent 'cheating' and would give a truer picture of what is really going on in the NHS.

Private healthcare should be made to either take a full part in the training of staff, or should be invoiced for every staff member who goes to work for them. At the moment, unlike in the US, our private system is completely parasitic upon the NHS. It gets the benefit of trained staff without having to train them. It gets to do the money-spinning ops, then passes on the expensive stuff to the NHS. Anyone who has private health insurance should be aware that if they get a major head injury, they won't be spending their sixth month of rehab in a private hospital. Or their sixth week of ventilation, come to that.

Next we need to take the massive step of linking 'freeness' of treatment to payments into the system, probably done most easily on length of payments into National Insurance or tax.

Life-saving, tried and tested treatments would be available free to all, so that no-one contracting leukaemia, having an accident or so on would have anything to worry about. Everything else would be available free only if you had enough years of paying into the system. NICE could earn its keep by deciding appropriate sliding scales.

Some things should not be available on the NHS. Here I would include a range of things from expensive, non-cost-effective treatments for non-life-threatening conditions (such as infertility treatment); hugely expensive treatments such as Herceptin (even though it may save the lives of some women with breast cancer, the money would benefit more people by being spent elsewhere, and this would encourage the drug companies to lower their prices); some screening programmes, such as cervical screening, which costs £100,000 per life saved (this doesn't include the costs associated with the treatment of false positives), and breast screening; and some other preventative programmes such as untargeted asthma reviews.

I know that this would be highly controversial. No-one would be unaffected, and some of the poorest would be most affected. Then again, more money would be available for things like smoking cessation programmes (£2,293 per life saved), and this would benefit those groups.

I will add that I put my money where my mouth is on this one. I refuse my GP's regular asthma checks because I do not believe them to be useful for someone like me. I refuse cervical screening because I do not believe it to be cost-effective. When I believed I was infertile, I would not have considered fertility treatment on the NHS. When I became pregnant, I didn't visit the doctor until after 14 weeks, because until then if you are losing the baby, they can't do anything other than watch you anyway. [NB! I do not recommend this to other women - doctors and midwives are a mine of information on how to care for yourself and your baby in pregnancy. But this is another instance of one size not fitting all, and the need ot treat people as individuals]

Everyone is bound to try to hold onto the things that are relevent to them, but I think this is where education comes in. People should be told how much their treatment really costs, and what else that could pay for. For example, a year's treatment with Herceptin is the equivalent to 100 people relieved from pain and immobility by a hip replacement, and a year's treatment for 3000 people with hypothyroidism.

There would also be room for many more services to be available through the NHS using the type of insurance schemes used by dentists and the private sector already. This may stick in people's throats at first, but I no longer have any problem with paying £17 per month to cover my dental treatment. I compare my teeth to a Sky subscription. I know what I value more.