I catch him before he slips out of the NHS ahead of Christmas. After 46 years in the health service, no better time for an exit interview with a leading NHS trust chief executive, who has seen the best and worst of it. Nick Hulme is in brutal truth mode. He has one foot out of the door of his East Suffolk and North Essex NHS foundation trust, just as the resident doctors strike for the 15th time, amid a rampant flu crisis. But he’s off, his time is up.

“I can’t remember a time when the NHS was at such risk,” he says. Labour has put in more money and staff, productivity and activity has risen a bit, waiting times down a bit, yet waiting lists stay stubbornly high. “That’s dangerous ammunition for Nigel Farage and the Conservatives,” says Hulme, “a narrative for people who want to kill the NHS.”

Private practice is soaring, but it fell steeply when Labour last cut waiting to historic lows. That could happen again. He says that at the “top of Bupa’s risk register is the danger that NHS waits fall”. He scorns politicians promoting “choice”, when that would require spare capacity, and at the moment the system is running red hot. He’d be tougher on consultants keeping their lists long to fuel demand for their private practice, but the BMA and

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