Once our NHS is smashed it will not be healed

ANEURIN BEVAN once said of the NHS: "It will last for as long as there are folk left with the faith to fight for it."

But, today, the NHS is being "marketised" and, in the process, dismantled at such speed that those within the system feel that they are being swept along in a swift current with nothing but sheer banks to right and left.

New Labour stated that the NHS would be "safe in our hands" in 1997. Its last election slogan was the empty, fork-tongued "forward not back."

Along with weasel words like "reform of the public services," ie selling off, and "patient choice" - for the time being - we might assume that "forward" means abandoning public projects founded on solid principles of collectivism.

Out of the deep hunger and deprivation of the Depression and the war to end wars came a wide consensus that we should build a health service that cared for everyone who needed it, with the cost shared by all.

Surely, the government of the Rt Honourable Anthony Blair would be, well, honourable in this, wouldn't it? Just as pigs fly, we should be happy to trust in his administration and the truthfulness of its words.

After all, new Labour has doubled the billions spent on "health care" in the eight years that it has been in power.

There have been steady increases in the numbers of senior doctors in the hospitals and in the nurses and other staff out in the community. There have been very creditable innovations like the midwifery teams pioneered in my local area of south Devon. However, we shouldn't necessarily give credit to the government - the professions often know best how to improve things.

The marketisation of the NHS started back in 1988 with the Thatcher government's "internal market." This was a creature born of a secret Cabinet committee, with central input from monetarist US Professor Alain Einthoven.

It makes sense. If you want to dismantle a health service, you choose a monetarist from a country that has never embraced fairness for the suffering.

This process destabilised the service and increased the cost of administration from 5-6 per cent to at least 12 per cent.

It enabled its successor to accelerate the process. New Labour trod quietly in the first few years. The message was that there had been so many changes under the Tories that a period of stability was required. But that which drove the Tories also drove the Blairites. They are of the same ilk - free marketeers.

Driven by the World Trade Organisation's privatisation doctrine enshrined in the General Agreement on Trade in Services, their mantra is public bad, private good.

What Britain has seen on its railways, with contracts let to over 3,000 firms, including Hatfield's Balfour-Beatty and Potters Bar's Jarvis, is now well advanced on the blood lines of the NHS.

Foundation trust status for hospitals and primary health-care trusts mean independence of ownership. It will be possible for assets which are state-owned to be sold off.

If trusts become insolvent, as well they might in a recession, there is nothing to stop private companies from purchasing them. Yet a large amount of taxpayers' money lies embedded in the buildings and technical facilities.

The private finance initiative is a big tool in the hands of the public bad, private good automaton. Under PFI, the hospital ends up paying rent or a mortgage to the privateers that built it over a period of 30 to 60 years. What no-one seems to know is who owns the buildings and land at the end of this term.

PFI is much more costly than direct construction and public spending, but it suits new Labour well. Brown likes off-balance-sheet spending. It means that the public-sector borrowing requirement has been kept within its target - for a while. The major contractors, corporate lawyers, bankers etc are fattened by the process and some of the largesse will feed back to new Labour coffers.

Waiting lists have come down for surgery and for some investigations. This partly reflects the use of existing private facilities, as well as the formation of surgical treatment centres.

Health Secretary Patricia Hewitt was formerly a consultant with Arthur Andersen - former accountants until Enron's implosion with which they were associated.

She announced recently that the "spend" on buying surgery privately would be increased from £5 billion to £9 billion.

When asked whether this proportion would be increased further, she refused to answer. That was left to her chief Mr Blair.

"There is no limit to the amount of 'outsourcing' we will undertake," he said in as many words. One cannot be plainer than that. The NHS is being broken up.

This is plain to see in the plans for primary care trusts. These have been responsible for disbursing about 70 per cent of the total NHS budget. They pay the hospitals, GPs and community hospitals, among others. Now, they are to be purely commissioners in primary care, not employers.

The backbone of care in the home is the district nurse, to use their old-fashioned title. They are waiting in understandable anxiety to learn what private firms emerge after a "tendering" process.

Some GPs are forming private limited companies, as are surgeons. The latter will tender for the provision of surgery within the district general hospital in the same way that the coffee shop owner does for a place in the crowded foyer.

There are several good reasons why the NHS might not be "safe in Mr Blair's hands," especially given his zeal for establishing a legacy.

One thing is sure. Once the National Health Service is asunder, it will never be repaired. A repairer of bones and joints is telling you that.

An ignorant and arrogant cabal is throwing the bones of a large skeleton high in the air without the least idea how they might ever fit together again.

• David Halpin MB BS FRCS is a former senior orthopaedic and trauma surgeon at Torbay Hospital and the Princess Elizabeth Orthopaedic Hospital, Exeter.