Boris Johnson advocated an insurance-based healthcare system for non-essential treatments and pushed for patients to have more private care outside the NHS, a newly unearthed article shows.

In a 2004 column for The Daily Telegraph, Mr Johnson lamented how individuals were paying “more and more in their taxes for this ‘unimprovable’ universal service” while having operations cancelled at the last minute.

Labour seized on his remarks as support for an “insurance based system where they check your purse before they check your pulse”.

Offering a defence of the then-Tory leader Michael Howard’s policy, Mr Johnson said the Conservatives wanted to extend the “choice” of healthcare to the British public.

At the time, the party had committed to a target of ending NHS waiting lists, with plans to give patients the right to be referred by their GPs for treatment either in NHS hospitals or private institutions.

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Patients would have been able to opt for more expensive private treatment and receive half the NHS tariff for the operation, leaving them to pay the remainder through their own pockets or though private health insurance.

Describing one friend’s experience, Mr Johnson wrote in his column: “While the affluent liberal middle classes use their clout and their contacts to get the best from the system, and then feel all gooey and warm inside because they have participated in the socialising marvel of free healthcare.

“My friend may think her experience marvellous, but I think it outrageous, and for what it is worth it is also unjust, surely, that the taxpayer is coughing up for Rice Krispie removal, the kind of cosmetic operation that in France or Germany would almost certainly be covered by insurance.

“What my friend fails to understands is that she has a choice in healthcare, where millions have none; and what the Tories want to do is extend that choice.”

He went on: “Why not let people chose when and where they will be seen, rather than being mucked around by the bureaucrats?”.

In the same column he criticised Labour for believing they have an “ideological freehold” on the NHS and that there no hope of reform under the then-prime minister Tony Blair’s government.

Jonathan Ashworth, the shadow health secretary, said it’s been “crystal clear” in the election that people do no believe Mr Johnson on the NHS.

“Now the truth has been exposed,” he said. “Johnson has written in support of an insurance based system where they check your purse before they check your pulse. The election is a battle for the future of a free and universal NHS. Only Labour will protect it.”