Mal Fletcher considers the future of the NHS.

Recently, we saw junior doctors striking to stave off Government changes to work contracts. A second strike was called off when the BMA advised against it, sensing a change in the public mood.

Until now, the medical professions have managed to escape the worst effects of a creeping trust deficit which has impacted almost every institution central to British life.

The public's relationship with society's foundational institutions has arguably taken a turn for the worse.

Trust in business leaders was perhaps at an all-time low in 2007-8, when business - particularly banking - was seen as responsible for the worst recession since the second world war.

Not long after that, members of Parliament were caught up in an expenses scandal, the impact of which is still being felt today. Opinion polls taken in the closing stages of the recent EU referendum campaign reflected that large swathes of the public could not decide on their vote. This was partly because they didn't know which political voices to trust - or which ones to distrust least.

Meanwhile, our courts and police were held to question because of their conduct during or after England's riots of August, 2011. The police service has also taken a hammering over its various bungled investigations into child sexual abuse, especially those involving public figures.

The press were held up to scrutiny and found wanting when it came to the hacking of telephones and the worlds of media and entertainment saw their reputations besmirched by ugly and painful child abuse scandals.

It wouldn't take much for the healthcare community to be added to the list. And when it comes to the trust stakes, medicos have more to lose than most other professionals. An Opinium study earlier this year suggested that nurses and doctors are still the two most respected professions in the UK.

A fall from grace for healthcare professionals would be especially quick and painful compared to that of other professions, partly because we expect of them a greater degree of selfless commitment to the common good. After all, we show them such unusually high levels of respect, which at times border on (and often become) deference.

Already, there are signs of public impatience with medicos. In the eyes of the public, the fact that a GP consultation under the NHS lasts for an average of just ten minutes - and the fact that five of those ten precious minutes are spent with the doctor consulting a computer screen - suggests a fundamental loss of interest in the customer.

This problem has a financial component, to be sure. But it also raises a question of essential values. How much does the GP actually value the patient? Has the client now become little more than a retail customer, to be dispensed with as quickly as possible and with the bare minimum of attention and care?

Unless we opt to see our health system take on a slightly more "free enterprise" tone, tax rises to guarantee its future are inevitable. I'm not an economist, but I see no reason why those rises wouldn't be substantial.

Yet the future survival and shape of the NHS is not a purely a matter of public finances. It also has to do with the values; the culture within the healthcare community. This should also form a key part of our debate on the future of the NHS.