In today’s newspaper, there are reports of powerful healthcare lobbies in the US using our National Health Service and its apparent ‘ failures of choice’ – God, how I am coming to despise that word – as a means to oppose Obama’s proposals for more widespread access to healthcare.

I am incensed when I read this, particularly as today of all days, I am revisiting the NHS myself, for some routine scans and checks.

My first visit is to a slightly scuffed white van parked behind an ugly municipal library. Ten minutes early, there are no signs of life within the van and I worry that I may be about to witness the absence of a small, local ( but always crucial) piece of the NHS jigsaw. But no, at 9.30 am on the dot, a key is turned, and a white coated woman, who looks like Parminder Nagra, the actress who plays a doctor in ER, welcomes me into a warm, light space, for my mammogram. It’s all over in fifteen minutes; by the time I leave, I pass a group of understandably subdued middle aged women of every ethnic origin, waiting patiently for their breast check.

Stepping out the van, I feel deep gratitude, not just to the efficient women who have made a painful process as pleasant as possible, but to the founders and footsoldiers of the NHS who have kept the idea and practice of free medical care alive over so many decades and which is of direct benefit to this group of diverse women, now, today, in May 2009.

That feeling of gratitude continues as I travel to a big teaching hospital where my appointment takes longer, involves fancier machines, more personnel; again, I wait in a warm, clean space, this one enjoyably bustling. Everyone is pleasant. I am not kept waiting extra time; the doctors are friendly, keeping me informed at every point in the process.

I know there are many who are unhappy with run down conditions in parts of the NHS, who fear angry nurses, stressed doctors or whose elderly relatives risk life threatening infections in grubby wards.

But when I contemplate the alternative I still give heartfelt thanks for the NHS. A couple of days ago, I heard the last recorded interview of Irish writer Nuala O’Faolain, who was diagnosed with inoperable tumours in New York last year. Before flying home to Ireland to die, O’Faolain had several scans in these same US hospitals and calculated that without health insurance, they would have cost her sixty thousand plus dollars.

Yet an incredible forty five million people in the US do not have health insurance nor – pretty obviously – do they have anything approaching a thousandth of that kind of money.

It is for that reason that I retain a fierce pride in, not mere residual sentimentalism for, a public service that, however inadequately at times,promotes parity between people of every age, social background, profession etc rather than divides a nation into the entitled rich and the desperate poor.