It will not have escaped the notice of many people who live in countries without a national health service that in the UK we're having major problems with this service.

At the moment we are subject to strikes from all sorts of public sector workers who are dissatisfied with pay and conditions. The magnitude of these strikes have not been seen in our country since the 1970s and nurses have also gone on strike — which has never happened since the NHS was created after the Second World War.

I'm a huge supporter of our national health service. I believe it's one of the greatest assets we have in the UK and I believe it is admired the world over. The aim was that health care would be provided free at the point of delivery and anyone in society who works and earns a living would contribute to its cost. That remains the mission.

My comments also do not relate to the pay of frontline workers including nurses, health care assistants, porters, ambulance drivers, paramedics, doctors, GPs, social care professionals and many others. They all do vital work and some do it for very poor pay and work very unsocial hours. I have no argument against being fairly paid based on the parameters of the job.

For far too long in the UK we've relied on the goodwill of people who have chosen a vocation — rather than a job. Successive governments have felt that this is enough and that is now all imploding. The mental health toll of long hours, not being able to fulfill that vocation, the public weight of expectation has led to a huge number of vacancies within our NHS. Younger people will not put their vocation ahead of their mental wellbeing and that must be recognised.

Having said that I'm of the view that no one in the public sector, whatever their role, should be paid more than the elected Prime Minister. Anyone paid more than the person deemed to represent the British public at the highest level — and paid for from the public purse — should have their pay cut immediately. Want to earn more? Go to the private sector. That's where the pay level should stop, that's where the ceiling should be, in my view.

Yet throwing money at the British NHS to increase salaries will not in itself solve the problem we now face. The problem is bigger and wider and more embedded than various salary levels. It's about an organisation which has become too big, too unwieldy, too top heavy and too slow.

How do I know this? Well I've seen it from a distance over many years now and it's only getting worse. However in more recent times, I've become privy to the view of very senior and well-respected voices within our current health system and I've learned that it's much worse than I could have possibly imagined. Our UK NHS is broken, it's unsustainable and it has to change — and we, the British public, have to accept that and change with it.

As a user of the NHS, here are some recent experiences which show that the NHS cannot continue in its current form. We went to the dentist recently — we've not been as a family for over two years as our check-ups kept being put off due to the pandemic.

When we arrived there were notices all around the clinic about teeth whitening and straightening and the hygienist appointments which are all private services. This also included notices which said that without these private services, this practice would not be able to offer any NHS services. At every turn, as an NHS patient we were made to feel second class ie. these private services are funding your ability to be here as an NHS patient. That was how it felt. It felt pretty awful and it didn't stop there.

Dentistry in the UK, under the NHS, is not free. It is subsidised yet it's not been free for adults for many years.

You have to register as an NHS patient and I suspect this is increasingly difficult. For most practices they are not taking on new NHS patients instead they offer a private insurance service which you pay for monthly. I suspect our practice will go the same way soon and will divest itself of the 'pain' of NHS patients like us. I believe as a family we'll be 'forced' to take out private insurance for our dental health needs. I believe we'll have no choice but to do this — as we do for our pet insurance!

And if you complain or make a fuss in many of these practices, you can be given notice of being thrown out of the practice. I've seen this many times in stories in local papers — if you voice your discontent (I'm not talking about unacceptable abuse here) you'll be thrown off the list. There is increasingly an air of emotional blackmail which is relevant if you are an NHS patient.

Now as an NHS adult patient, you see the dentist who looks at your teeth, pokes around a bit, tells you what's right and wrong and then directs you to the hygienist for cleaning at £75 a pop. A private service.

No longer does the dentist do a deep clean on your teeth as they have in the past. They will do this for children — yet not for adults. Not even for a student. Therefore the cost for four of us to have checkups was over £70 and then if we'd taken the advice and booked for three hygienist appointments that would have been a further £225.

The truth is that dentists in the UK are increasingly opting out of the state-funded service and that means people will have no choice but to pay for private insurance or they will simply not visit the dentist.

I believe dentists as a profession will not offer NHS services for much longer. We saw the same with legal practices and legal aid services. Over time many legal companies simply dropped legal aid cases and will now only take private clients.

Another example is our struggling NHS emergency service. We experienced a perfect example of this on Christmas Eve — we became part of the problem which is happening on an almost daily basis.

Our son had been off colour for a couple of days and on Christmas Eve it was much, much worse. He's a teenager so to say he needs to see a doctor means he's feeling very poorly. We called our GP surgery. It was closed.

In the past, a teenager who was poorly would be re-directed to a youth service for under 18s in another part of our town. That no longer exists. A new building was created for it — and what the hell that new building is now used for — I don't know. Instead our options were call 111 or 999.

In the UK, 999 is our emergency number when there is a life-threatening situation and an ambulance should come. I was pretty sure our son didn't need that service.

111 is a service where you can call and get medical advice and then that person will direct you on to what you need to do next. On Christmas Eve, after 20 minutes of waiting, no one had even answered the phone — we could not even access the 'system'.

So what do you do as a parent? Well, you take your child to the local hospital. When we arrived there's a new 'urgent care' area and when we stepped inside it was packed. It became very clear that many people were there not because they had a life-threatening emergency but because they couldn't access any other medical service on Christmas Eve. Yet they were poorly enough to need some kind of treatment or medicine.

This was the start of a seven hour wait for us as a family. We went to the children's waiting area where we were triaged by a nurse after about an hour, then we waited for two hours to be seen by a 'practitioner' not a doctor. She then said we need to check he didn't have appendicitis which was an emergency (at this point I wondered if I should have called an ambulance). We had to wait again for about half an hour.

We were then taken to a children's ward where bloods were taken and we had to wait two hours for the results and then we had to wait for a consultant to visit (after surgery) to assess the results and make a decision. The staff on this ward were lovely. We were one of two on the ward and another young child came along later.

Therefore we were on that ward itself for the best part of four hours before we were told it was unlikely to be appendicitis — it was more likely to be something else. We left and got home at around 7.30pm. Our son was no better however we were thankful for the care we received over that long day. The medication given could easily have been given by a GP.

For me this shows were the problem lies. Our medical services in the community are failing and that has a huge knock-on effect. Our GP practices are increasingly not offering any out of hours services or urgent appointments within a reasonable period of time. This means that people are turning up at hospital waiting for treatments for hours because they know they need help and they have no other way to access that help. This then pushes hospital services to the brink alongside people who are coming in for planned treatments or who are in a life-threatening situation.

The pandemic has fed into this struggling system so that waiting lists are long for routine but vital treatments such as knee or hip replacements — which are chronically painful and debilitating yet not always life-threatening.

Then we have our social care system which is failing too. This often relates to older people who need care to live their best lives. The cost of social care in the UK for the consumer is very high — averaging around £25 an hour for care at home. Yet the people who deliver that care are not paid that sum per hour. It's a poorly paid role. If an older person needs to go into a care home then that cost to the consumer is astronomical. It is at least £1,000 a week in the UK and most people cannot afford that. So their house is used as a guarantee by a local authority to recoup the investment down the line — and families therefore do not inherit the assets their parents have built up during their life-time. And local authorities pay that bill for months or years before getting any of that money back. In the meantime our council tax is part-funding that cost.

When an older person needs hospital care and then is ready to be discharged and they live alone — or don't have family to care for them nearby — they end up stuck in hospital as there are no places in the community to take them.

We call this 'bed blocking' and it therefore means that many of the UK's hospitals will at any one time have a whole group of older people filling up beds (many with forms of dementia) when their 'emergency care' is over yet there is nowhere for them to go for their social care needs, even if that care is for a short time while they recover from the medical incident they've suffered.

We need to reassess the National Health Service in the UK from top to bottom and re-write the contract. This must be done by forward-thinking health professionals, consumers and with a huge dose of small business thinking and acumen.

An organisation where it takes a year to get agreement to fix a plug, turn down a radiator or change a number on a letterhead is not fit for purpose. The layers within our health service need to be reassessed as to what is necessary and what is not. Getting lost and bogged down into antiquated systems and processes — daft and ridiculous chains of command, laborious, protracted supply chains and procurement processes is a daft state of affairs. Often this 'organisation' is protected by those protecting their position so they are driven by fear of being 'found out'.

As a consumer of this health service, I wonder how many people are protecting their own arses when in effect their role is not necessary and they need to move out and on.

We saw this in television some years ago (ITV) when executive producers and other layers of management were stripped out. Often these layers simply protect the structure of an organisation which is not fit for purpose, does not serve the client (in this case the public) and actually soaks up cash which is needed for frontline services. There does need to be a management structure yet when that structure becomes too large and too heavy, the structure will fail.

Small business owners are among the most flexible, agile and forward-thinking people in our society. They can spot waste a mile off, they will invest to be more efficient and they are often passionate. They will weigh efficiency and money-saving against purpose and commitment. For many in the world of small business it's not just about turnover and profits — to survive all of these things must balance and align.

And yet this is the sector of business in the UK that is the most ignored, forgotten and undervalued. Also the small business sector understand something very fundamental to success — the value of collaboration to work towards a solution which works for all, even if it's the best possible compromise. And I believe our NHS needs that to survive.

We need to understand that the UK of the 1940s and 1950s is gone. We have a much bigger and older population. People are living longer with far more chronic conditions which need longer term care and commitment. In the younger generation there are far more incidents of poor mental health, disorders and conditions which also require a lot of health support which currently is not funded or recognised as being of value. Understanding this changing demographic is key to change.

Then the general public need to look at its attitude born of the 1950s — that attitude of 'entitlement' the 'I've paid in all of my life, I need to get something out'. The NHS is not a savings plan for someone's future. The money paid in now pays for services for people right now. It's not an insurance policy for our future care. I'm afraid that's something we have to face as a society.

We cannot expect as we get older that the NHS will fund our care, because it cannot. It's not doing it now — the price tag is far too high and will need to be even higher in the future to attract staff to the important roles which need filling. We need to absorb this fact.

The contract needs to change. I'm no politician however I believe we will all have to take out some kind of insurance protection for care in later life, for dentistry and possibly for other services so that the 'free at the point of delivery' is truly for an emergency situation and what counts as an emergency will have to be clearly defined. Perhaps things will be means tested in the future — who knows?

This discussion has to take place because our current system is simply not working, we're already paying out in a myriad of different ways and we're ignoring the fact that this is privatisation by the back door. Even one item on a prescription in the UK is now £9. It's often cheaper to buy over the counter.

I do believe the concept of the NHS is just and it is right however in our society it is simply unworkable in its current form. Therefore it's like the Titanic at the moment, blundering along with a massive hole under the surface and heading for spectaculr destruction.

To save it we must act together to make it more agile, more defined, smaller, more accountable and more streamlined. We need to understand what we need to pay for more clearly and what we can expect 'for free' and we also need to consider who should get services 'for free' and when.

There should also be an element of carrot and stick in my view — don't turn up for appointments then a fee is due, no exceptions. Call out an ambulance for a daft reason with no real emergency — a bill will be sent out. This will help restore value into the NHS.

We have taken this service for granted for far too long. We have not valued the frontline professionals for far too long. We need to do things differently to be fair to all, to create a responsive service and we will need to pay into the national pot as well as pay for some services ourselves if we have the means to do so.

If we don't accept this, our NHS will sink and become a memory and we'll all have to pay for private care anyway. And those who cannot afford it? Who knows what will happen to them….