care of older people has been privatised, with the mass closure of NHS geriatric beds, and an increasing reliance upon privately-run nursing homes and private domiciliary services to deliver care to frail elderly patients.
The drive towards increased private provision of all forms of NHS-funded treatment has been reinforced by the introduction of a new "payment by results" system.
This will be phased in from next April, and will increasingly mean that hospitals will receive only a fixed price payment per item of treatment delivered, rather than the previous block contracts with local Primary Care Trusts.
This threatens the viability of hospitals which for whatever reason have costs above the NHS "reference cost", and also opens up fresh possi bilities of switching patient care - and the funding that goes with it - from NHS to private providers.
Ironically the payment by results system seems set to have its most serious consequences for new hospitals funded under the Private Finance Initiative (PFI) -which are saddled with high, fixed overhead costs while lacking spare beds and capacity to take on additional patients.
In 1997 Blair warned we had just "10 days to save the NHS: but as he prepares to do battle for a third term in office, who will protect this most popular public service from a further round of privatisation and wasteful market-style reforms? • This and other articles on the NHS on these pages are taken from issue 60 of Health Emergency newspaper, www.healthemergency.org.uk