08/11/2013 10:57 GMT | Updated 23/01/2014 18:58 GMT

Patching Physicians' Pay

I am soldier in the Syrian army fighting for Assad. Not the best job in the world at the moment. In the evening, I have a change of heart and go and fight for one of the rebel groups instead. Come morning, I spot that the Syrian Army might be winning this particular battle; so I change sides once more and fight for my er, comrades. There's a word for such activity: turncoat. You wouldn't be happy to have one of them in your foxhole now would you? Why then do we risk our lives with them?

It might sound ludicrous but I am talking about doctors. Bevan stuffed their mouths with gold. Your gold. And John Reid polished it until it gleamed. The most effective trade union in the country, the British Medical Association, has careful nurtured and created a very lucrative profession. But I don't begrudge our physicians being suitably rewarded. I do, however, have an issue with their ability to moonlight from their NHS work and ply their trade in the private sector at the same time. That's not what we, collectively, supported their education via expensive medical schools for them to do.

Outside the public sector, the majority of us work for businesses that compete with one another. How would your venerable operation react to you showing a bit of ankle for your rivals? Banker at Barclays? Why not be a banker for Lloyds after lunch and then work, while it's still there, for the Co-operative Bank over dinner? A P45 would be in your hands faster than Glastonbury tickets would sell out. I don't think that Red Bull would be too happy to see Sebastian Vettel racing in blue one week, and then for Mercedes the next.

Perhaps you think it doesn't matter. That it's more important that we just damn well get treated as best and quickly as possible. I concur. But there's the rub: it does matter.

If you can make more money for the same job somewhere else, most people take it. And if I can make more money carrying out operations on my paying customers, I might be inclined to put their needs first before others. I have a mortgage to get rid of. Where will my focus be? That's why Bevan took ability to pay out of the equation: it's too dangerous to our health to have it otherwise. You only need to look over the pond at the untreated, uninsured poor to see where that crumbling brown brick road goes.

While there are shining ethical beacons within our surgeries and hospitals, we simply should not have an arrangement that enables our physicians, who we pay, to work for other people while in our employ. They should be putting our needs, as their customers, first. At all times. If they have the time to carry out private work, then they should be spending that time serving NHS patients in need. That's what the S in NHS must mean. Seven days a week service would be a good addition too.

Of course, that's not to say that doctors should solely work for the NHS. If they only want to work in the private sector, fine. But then you can't work for the NHS and tap up a portfolio of clients. And you will have to pay all the costs of your training too. In the same way that our armed forces sign-up to a minimum length of service, we should ask the same of our junior physicians.

The turgid rebuttal is that the poorer paying NHS might lose the best doctors and harm our own health. Hogwash. You don't become a doctor to become a billionaire. And there's a whole world of bright medical practitioners out there. If people will not work for the NHS, there's plenty who would want to work in one the safest and richest countries in the world.

It's not their fault. Our doctors are only human. When it comes to cash, physician heal thyself isn't going do it. Let's help them take their medicine. Pay them well: they earn it. But only when they abide by monogamy too.