What really matters if you are ill? What should a superb national health service give us? These are major political questions when the government is to provide huge funds for the NHS, and the prime minister asks to be judged on "delivery, delivery, delivery".

If you are ill, what matters first is the doctor. You do not focus on the fact that the health budget has risen to £100bn. You want a modern hospital, yes, and fine nurses. But what counts first is the doctor, a human being whose intelligence and instincts will try to treat you. A health service which does not cherish doctors is up in a balloon.

And a superb NHS? The test is that the heart of the system is the creativity of doctors and nurses. To state the obvious, efficiency will never be enough, crucial as efficiency is, because "everyone in medicine understands that a great deal of uncertainty about what to do for people will always remain. Human disease and lives are too complicated for reality to be otherwise."

The words are from Atul Gawande in his new book Complications: A Surgeon's Notes on an Imperfect Science. If medicine is not instinctive as well as knowledgeable, it is not human. It may be impressive, it may save patients from the worst, but it is less likely to secure the possible best. Yet a former head of the DHSS said to me that creativity was not a word that came up in discussion; the more likely word was if a doctor or hospital was "modern". This is a suggestive preference, even a displacement.

I come to medicine from a maverick angle. Nine years ago, I was diagnosed with a life-threatening cancer. The median survival time without treatment was less than a year; with treatment two to three years. I decided against chemotherapy and I follow instead a largely alternative route of breathing exercises, acupuncture, vitamins and the strict diet devised by Dr Max Gerson in the 1940s. I describe this in my book Living Proof, which I wrote at the suggestion of a former Royal Society professor and secretary of the Medical Research Council, Sir James Gowans. The purpose of Living Proof is not to recommend my course to anyone else, but there may be value in patients describing how they try to cope with life-threatening illness, whatever treatment they finally choose.

A turning point for me was when I was privileged to be seen by one of the most eminent molecular researchers, Sir David Weatherall. He emphasised that "what you must understand is that we know so little about how the body works". This is important in the context of current medical methodology. Shared information and technology have boosted evidence-based medicine in which the results of drugs and procedures are tested on huge numbers of patients. This is, rightly, the technique for the knowable in certain contexts. But what about the area of "uncertainty which will always remain"? What about you as patient now, if evidence-based medicine has not yet got to work on remedies for your illness? Or if it has none that you wish?

I believe, to take an instance, that acupuncture helps me. But is acupuncture understood? I am told not. And it is certainly not modern: it may have been used for 7,000 years. If our methodology does not validate acupuncture, I want open-mindedness to wait for creativity to devise new methodologies: I do not want acupuncture to be squeezed out of the system. And I salute Dr Julian Kenyon who, trained as an academic surgeon, got into China after the cultural revolution and came back to found in 1980 the British Medical Acupuncture Society.

Dr Kenyon, who is working to establish a British Society for Integrated Medicine, wonders whether current methodology has a built-in bias towards vigorous treatments which stand a better chance of securing results over very large numbers of patients. The problem is that the vigour of the chosen drugs may mean they are potentially dangerous, especially when viewed over a longer timescale than the initial surveys of the drugs' results. This is not to deny their value, but does the methodology mean that more gentle methods of healing are less researched?

Or consider diet. There is extensive research on diet and cancer in Harvard Medical School and other North American centres. But it is often ignored. Dr Sara Miller, who works at the Bristol Cancer Centre and strongly believes in combining "mainstream and complementary treatments", says: "We are not taught about diet. I don't think I had a single lecture on nutrition. Most mainstream medics have no idea of the amount of research going on, and immediately dismiss it."

Why? Because of intolerance, which has a sad role in the history of medicine? Or is the reason the almost unthinkable difficulty of "double-blind trials" on diet? Or is it the relentless pressure on doctors? There was a terrifying note in the British Journal of Cancer in April 2001: "There are too few doctors seeing too many patients in UK cancer clinics, with the added pressures of throughput and cost containment burdening them further. Furthermore, surveys in the UK and US have shown that psychiatric morbidity and emotional burnout are almost as common in oncologists as in the patients they treat."

Happily, this is not my experience. I have met tolerance and open-mindedness, notably from Professor Ray Powles of the Marsden hospital, who has monitored me, even if he would not recommend what I do. But let the British Journal of Cancer stand as a marker of what could be - and what an authoritative source says is. We need more doctors and if there are problems of training, as is rumoured, they must be addressed.

I meet advocates of the new NHS system (Professor Powles is one), who say it has a visionary structure in that it gives more power to local boards on which topics like those I have raised can be aired. This will be truly vitalising, they argue, and cut the Gordian knot of government control.

Paul Foot, commenting on Tony Benn's lifelong inspiration from the value of democracy, open debate and discussion, recently wrote that Benn "is constantly seeking to extend democracy even into publicly owned undertakings like the NHS". Even? Is this not a lethal even? Foot did not develop the point, but can democracy be so difficult in a publicly owned undertaking which you might think was the natural home of democracy?

David Rothman, the American medical sociologist, has argued that "great changes in the delivery and practice of healthcare do not come from within the profession but from outside". He was referring to the right-to-die movement but, as Sherwin Nuland noted in the New York Review of Books last month, he might equally have been talking about other changes, "the many by-products of the women's movement among them. As a result of advocacy groups the treatment of breast cancer has markedly changed, after approximately a decade of sometimes violent resistance by surgeons."

British medicine, of course, is not American medicine. Will our creativity make us more skilled at change from within? Will it meet wise open-mindedness? Or must we continue Tony Benn's fight? Will our changes also have to come from outside?

· Michael Gearin-Tosh teaches English literature at Oxford University and is a fellow of St Catherine's College. Living Proof is published in paperback next week
gearin@lineone.net