Can't pay the doctor? What about luncheon vouchers? Air miles? Welcome to Labour's NHS, where nothing can be ruled out

"You do realise it's illegal?"

"What?"

"Calling out the GP when you can't afford to pay."

"I'm sorry, doctor, but you know what it's like when you've got kids."

"Yes and you know the rules. Think doctor, think money. We need every penny you've got."

"There you go ..."

"What's this?"

"Every penny I've got."

"But you were means-tested last year as Level A2."

"That was before Ralph lost his job. No job, no cash."

"We take Switch."

"Pass."

"Visa? Access? Luncheon vouchers? Air miles? You must have something of value."

"How about this? A Peperami stick. Mint condition. Original wrapping. Very collectable."

"What year?"

"1987."

"Hang on a sec. I'll just call Mr Dobson for a valuation."

"But what about Robbie? He's burning up, doctor."

"Have you given him Calpol?"

"Can't afford it."

"Well, blow on him ... Ah, hello Frank. A Peperami stick, 1987, mint condition ... how much? Thanks."

"What did he say?"

"I've got clearance to examine the affected part only."

"So what's new?"

"Now Robbie, show me the bit that hurts."

"Well, the pain started in the centre of my tummy, but now it's moved to the right."

"That's two bits. Which bit do you want me to examine?"

"This bit."

"Ow."

"I think he may have appendicitis."

"Can't you be more precise?"

"Not without examining him farther. Have you got another Peperami stick?"

"No".

"So we'll have to leave it there."

"What if I examine him myself? Temperature 38.5, pulse 90, furred tongue, lies still, flushed, shallow breaths, coughing hurts."

"That clinches it. He'll need to see a surgeon."

"Will I have to pay for that too?"

"No, emergency hospital treatment's still free. You've just got to get there. But don't bother to phone the London Ambulance Service. They've only got one. That's why they call it the London Ambulance Service. You could try a private ambulance."

"What's that then?"

"A taxi with a light on."

"It's no use. I can't afford it."

"Look, why don't you come with me. I'm going to the hospital anyway.

"To visit a patient?"

"No, to pay for one. They take discounts for cash."

"But you'll take me for free."

"On one condition: that you'll come and work for me."

"But this is wonderful news!"

"Yes, isn't it? You're going to be my practice nurse."

"Hang on, I've no qualifications."

"No matter. From the way you examined your son, you could give the superficial impression of nursing competence at a fraction of the cost."

"Is that legal?"

"Absolutely. It's called multi-skilling."

"But I will be paid?"

"pounds 2.10 an hour."

"That's half the minimum wage."

"Indeed, but Mr Blair's famous Social Chapter opt-out means it doesn't apply to public sector workers."

"I'll have to think about it."

"Fine. But remember your son is suffering."

"OK, I'll do it."

"Great. And for your first performance-related bonus, here's a prescription for some Calpol."

"Isn't it cheaper over the counter?"

"Much. But over the counter doesn't exist any more. Night Nurse, Lemsip, Hoffels one-a-day Garlic Pearls now only available on prescription."

"Why?"

"So we can charge you pounds 5.75 for something that costs nothing to make. The mark-up on these things is amazing."

"That's outrageous."

"Oh, it's been going on for years. Those water tablets your Ralph's been on for his high blood pressure ..."

"Bendrofluazide?"

"Yes. They cost 10p for 30 to make; he's been paying 57-and-a-half times over the odds for five years."

"What a rip-off!"

"Absolutely. And now it's a compulsory rip-off for every drug in the pharmacy."

"But whatever happened to patient choice?"

"That's a point. Shall we stick him in the front or the back?"n