Just recently I examined a GP. During the examination she told me how she had had enough of the NHS and that she was, as she put it, ‘getting out’.

I have known this lady since she was at school and I have known the struggles she went through to qualify as a GP and therefore I was shocked to realise just how she has been brought down by the NHS system.

For someone who has fought for years to do the job they desperately would love to do to give in made me realise just how bad this NHS really is. It also made me reflect on how resilient I must have been over the years. But then I began to think about which one of us was really the resilient one.

The reason that this GP had given up was that she was not able to treat people in the way she wanted to. She was not able to put the needs of her patients first. She had to cow tow to the authorities, always prescribing the cheapest drugs, always cutting corners on care, not being able to provide suitable mental health care.

One comment made me smile as she said that at least when it came to eyes she could pass them over to me and she didn’t have to worry from then on. But then I stopped to think about those patients. Could I really give them the care that they had a right to under the NHS?

Was I having to compromise on their care? Was I cutting corners? So often we have been told that the purpose of an NHS sight test is ‘to correct or remedy a defect of sight’. Oh and by the way, whilst you’re at it could you check they eyes are healthy too.

We have been made well aware that the patient seeking our advice on, say a flashing light they see, or a painful dry eye, or even wanting advice because the local eye clinic has not given them proper advice and they are frightened they may go blind, do not qualify for ‘free at the point of need’ NHS care but must pay for it privately.

By charging for my services I am making sure I put bread on my table but had I ever stopped to think that I may be denying that person putting bread on their table? Just where do my principles lie?

For years many of us have complained about the General Ophthalmic Services and their parlous fees. But then we have settled back and been happy to overprice the goods we sell to offset the loss that the NHS causes us to bear.

We have been a willing part of the so called good will that allows the NHS to keep running. But by doing this we have allowed generations of governments to get away with ripping off NHS users. We have, as a profession, been complicit in running a system that is not fit for purpose.

For years our professional bodies have told us they have tried on our behalf to change things but that they have singularly failed. Yet each of us has done nothing really to change things.

Having listened to my GP friend about the string of things she has had to deny her patients and having listened to how she cannot reconcile her conscience with these omissions, it left me wondering just how much I have allowed my own concerns to be sidelined over the years.

As I write this today there is in the news a report that the NHS should not be given any new money because of the astronomic waste of money that currently goes on and that there is enough money if only it were used properly. How many times have we heard that and indeed how many times have I said that in this column?

Our own regulator tells us we have a duty of care to our patients. Does that duty of care extend to making sure we can deliver a proper service to them via the NHS? If it does then all of us, including the regulator have fallen woefully short in delivering on our duty of care. The time has come in the NHS when all who work in or for the NHS must make a stand for the rights of our service users and must change how this NHS delivers care.

Too many good clinicians have left and been lost to patients due to the failings of both politicians and also leaders of the professions. Unlike my GP friend I do not intend to leave the NHS yet but I need to see our profession and our professional bodies summon up some fight to publicly hold this government to account for the dreadful state of eye care delivery in this country.

If we really care about the welfare of our patients we should be striving to give them the highest possible level of care through the NHS and not through ‘top ups’ paid for by the patient.