The  Tory NHS plan, to be unveiled on Monday in a White Paper, is essentially the next corporatist stage in the dismantling of the founding NHS principles of efficiency, integration, universality, and careful need-based planning.   The original commercialisation of the NHS was initiated by New Labour under Blair with the establishment of independent foundation trusts, the continuation of the Tory split between the commissioning and provision of health care, the marketising of specific NHS services, and the encouragement of the private sector through independent treatment centres and other subsidised schemes.

The issue now is whether any political party is sufficiently committed to the genuine principles of the NHS to rally a massive campaign to fight vigorously for them, given that Labour has been so deeply compromised by the Blair years.   For nothing less is at issue than whether a universal health care system free at the point of use is going to survive.

The key point in the Lansley Tory proposals is that power will be transferred in the NHS from primary care trusts to some 500 GP consortia who will be given £80bn of public money each year to commission the health provision they want.   But because the vast majority of GPs have neither the expertise, the skills or the inclination to undertake this enormous administrative task, they will hand it over to private providers such as BUPA, Virgin or US multinational corporations such as UnitedHealth to parcel out health care to the private sector on a vast scale.

It’s dragging down the NHS towards a US-type health care system, and it’s not as though there is any evidence-based case to support this.   The US health system is the most inefficient in the Western world, costing a staggering 16% of US GDP (twice the proportionate share of the UK), it is riddled with conflicts of interest, it denies health care to millions of excluded patients even after the Obama reforms, and it gives inordinate power and colossal profits to the insurance and hospital industries.   It does however provide instant state-of-the-art health care for the extremely wealthy.   That is the path for health care now being opened up in Britain.

It isn’t enough simply to resist this US-style disaster.   New Labour had already encouraged PCTs to use private sector management consultants and for-profit healthcare companies to help them develop ‘commissioning’ skills.   Lansley will certainly portray his “reforms” as merely an extension of these practices.   The real question now is: is Labour going to present a new radical vision of an integrated, efficient NHS driven by a public ethos of altruism and professionalism or simply mumble objections that the Lansley proposals are a step too far?

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