One of the country’s most sacred cows - a free national health service at point of use - should now consider charging patients.

That's the view of Susan Acott, chief executive of Dartford and Gravesham NHS Trust which runs Darent Valley Hospital.

Speaking against the backdrop of a bulging record deficit of some £2.5 billion among NHS trusts in England, Ms Acott said: "The financial position is increasingly pressurised and probably much more challenging than I’ve experienced in my entire career."

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Speaking on BBC's World at One, she called for a national debate about the prospect of charging.

"I think it’s something modern countries need to consider and, because we have our cherished NHS, I don’t think that should prevent sensible and intelligent discussions around whether free at the point of use is always the right thing to do.

"If you look at examples like dentistry and ophthalmology we often contribute. So I certainly think it’s a question that needs to be asked."

She said financial cracks were beginning to show, making it difficult to plan services in an area of significant population growth.

Her remarks came this week as Justice Secretary Michael Gove warned net migration from the EU was putting unsustainable pressure on the NHS.

The only way to protect the valued institution was to leave the EU, said Mr Gove who is part of the ‘Brexit’ campaign.

Ms Acott’s comments resulted in both criticism and a note of caution.

Dr Paul Hobday, a Kent GP for over 30 years, said: "There should be no place in the NHS for a manager to interfere politically and be a mouthpiece for a privatising government.

"She is in effect calling for the end of the NHS. Her job should be to fight for more resources centrally, not from the individual."

Dartford MP Gareth Johnson (Con) who favours leaving the EU, said: "We must never get to the stage where people are unwilling to seek medical treatment because they cannot afford it.

"The strength of the NHS is the principle of being free at the point of delivery and that should not change."