Sexually transmitted superbugs are never considered as newsworthy as regular superbugs: at the first whiff of MRSA the nation’s media are on red alert, while a drug-resistant strain of gonorrhoea could stay under the radar until “gonorrhoea symptoms” starts trending on Yahoo.

The agenda is based on the probably correct assumption that once people start reading newspapers they’ve definitely stopped having sex, and yet, any disease that stops responding to antibiotics becomes a problem for the nation. However pristine your own behaviour, you’d still have to acknowledge the public health implications of this super-strain, the new world we are moving into, in which the arsenal of drugs that has protected us for nearly a century suddenly evaporates.

Super-gonorrhoea was first identified in 2011, in a discovery that the Swedish scientist Magnus Unemo called “both alarming and predictable”. Sexual health professionals in the UK soon had other threats on the horizon: under the last government, as part of the Health and Social Care Act, sexual health services were reallocated so as not to fall under a GP’s commissioning purview, and instead be the responsibility of local councils, as part of their leisure spending.

The immediate anxiety was that elected officials are often not public health experts: you might get a very enlightened council, who understood the needs of the disenfranchised and prioritised them; or you might get a bunch of puffed-up moralists who spent their syphilis budget on a new aqua aerobics provision for the overweight.

In a way, the former would be no more helpful than the latter, since the principle remains the same: it shouldn’t be a matter of opinion whether or not people with transmissible diseases have access to health services. It undermines the principles under which public health systems are conceived and designed, viz, when you want to know what’s needed, you ask people who know. Underneath what sounded like quite a technical and complicated funding issue (HIV services were hived off and paid for separately) was an apparently deliberate return to an era before evidence.

In practical terms, the problem immediately identified was that people don’t have sex within only one borough; in some cases, this forced local authorities to cooperate; in other cases, it left some councils picking up the tab for their neighbours. It is a near-perfect example of why balkanisation is more expensive than collectivism, creating both waste and under-provision.

The figure typically given is that, for every £1 spent on sexual health services, the NHS saves £12.50, taking into account that the major work of decent local provision is in the prevention of unwanted pregnancies. What that calculation doesn’t hypothecate is the cost down the line of people who’ve been left infertile by untreated STIs. I guess it would be melodramatic to try and cost that in, and it might also draw unfortunate attention to how monumentally damaging it is to a population when the government takes their painstakingly woven blanket of universal healthcare and sets fire to it.

It is a relatively easy political sell, at least for those in opposition, that the NHS is in crisis. However, both the causes of the crisis and its illustrations are almost always sought in the wrong places. There is endless debate about the cost of agency staff, of managerial layers, of GPs – as if the problems of this institution had been created overnight by a cadre of crooks and profiteers who had undertaken medical training in an act of supreme cunning.

The PFI deals that are, in most cases, at the root of the cash crises hospitals are facing are presented as deeply unfortunate and misguided, but not for mortals to examine, occupying a kind of Mephistophelian space where a deal’s a deal, regardless of proportion or legality (it is scarcely credible, when many of these deals are scrutinised at a granular level, that they would stand up to legal challenge).

But at a more profound level, the threats to the NHS’s long-term viability are always framed in one of two ways: either we can’t afford it because we are an ageing population, or we can’t afford it because we are obese. It is statistically undeniable that we are living longer, but rather than celebrating this as a triumph of medicine, we use it to signal collectively funded medicine’s inevitable demise. Obesity, meanwhile, signals that something has gone wrong with our individual behaviour, our willingness to take responsibility for ourselves, and therefore it would be impossible to design a public health system when the population is so feckless and immature.

In fact, a much better place to start a conversation about public health is at super-gonorrhoea: the coming challenges of the post-antibiotic age are significant – the reliable certainties of the past are coming to an end, and it will take original discovery on an epic scale to recreate them, a task that would be daunting were it not for the fact that we know we’ve met such challenges before. The consequences of hunkering down and seeing this as an individual problem will be that it simply worsens and affects more individuals; before innovation, it will take collectivism – medical, political and social.

It is not possible that doing nothing will be cheaper than doing something; that budget cuts, pared-down services and postcode lotteries will yield anything but higher costs and more human misery. Antibiotic-resistant STIs are a way to remind ourselves of the dignity of the NHS project, its elegant combination of generosity, ambition and meaningful thrift, investing in a population because they’re worth it, whatever they’ve been up to.