Flogging off our NHS

The NHS is not some Con-Dem plaything to be broken up and reassembled at a whim.

The government has no mandate for the actions that it plans. Its NHS reorganisation is another of the policies pulled together on the hoof by the coalition partners and then reworked by the Tory Health Secretary.

And even though it goes against everything that the Liberal Democrats have ever said about the NHS, Nick Clegg will be expected to whip his backbenchers through the lobbies in support of it.

It is no exaggeration to state that the very existence of the NHS is at stake.

The NHS is a huge enterprise. It could not be privatised by being offered as a job lot, as other public services have been.

But the Lansley white paper lays down the mechanisms by which the NHS can be privatised by stealth, becoming a victim of death by a thousand cuts.

First casualty will be primary care trust boards, to which elections had been expected, but, as Lansley himself commented, as a true democrat, "when you examine that structure, it seemed better to dismantle it."

Rather than a democratically accountable structure, the right-wing coalition foresees a number of private businesses in the shape of individual general practitioners or GP consortiums taking control of health finance.

The responsibility of these businesses would be to commission services on behalf of their patients - how long before they are referred to as customers? - from independent hospitals and other service providers.

The public-service ethos that holds together the NHS and those who depend on it would be eradicated.

Profitability would be the key factor, with competition between the various providers expected to hold down costs through a quest for greater efficiency, being expressed in the scale of profits achieved by the primary care businesses.

And the government is already ahead of the game, insisting at the onset on a target of £20 billion in efficiency savings within the NHS.

Despite the government's mantra-like recitation that front-line services will be maintained and that economies can be made by trimming backroom operations, there is little doubt that savings will translate into job losses for doctors, nurses and ancillary staff.

One of the first successes of the Labour government in 1997 was the decision, led by health secretary Frank Dobson, to abolish the NHS internal market in favour of an integrated care model.

And although Gordon Brown, as chancellor, bled the NHS of tens of billions of pounds through his disastrous private finance initiative schemes to build new facilities, Labour did indeed greatly increase the level of spending on health.

The Con-Dems are intent on reducing health spending, justified by spurious demands for further efficiencies.

In reality, the GP consortiums will, faced with reduced finance from central government, be forced to cut back on commissioning, forcing hospitals and other service providers to the wall.

And local people would have no-one to complain to over such closures since they would be due solely to the operation of market forces.

The more people find out about Lansley's plans, the more opposed they will be. That's why he wants speedy action to destroy our NHS. He must be stopped.