madness New Labour's reconstruction of the "internal market" in the National Health Service has already gone even further than Thatcher ever dreamed: indeed it is increasingly clear that the ambition is to create › vate hospital. not an internal but a free market in care in which the NHS is only one among many varying providers of services.
The National Service is set to become little more than a "brand name", a centralised fund that commissions and pays for patient care, while NHS hospitals compete - On ever less favourable terms - with private sector companies for a share of the budget and for the staff they need to sustain basic services.
Ministers have made it clear that they want at least 10 per cent of elective (le. nonurgent, waiting list) operations to be carried out by the private sector next year, rising to 15 percent by 2008.
By the end of 2005 Primary Care Trusts will be obliged to offer almost all patients a "choice" of providers from the time they are first referred - including at least one priGP Fundholding has also returned, under the guise of "practice based commissioning", with GPs encouraged to shop around their patients, with the promise that they can retain half of any unspent funds within their practice.
As the new GP contract allows family doctors to optout of on-call work and 24hour responsibility for patient care, private companies are striking deals to fill the gap, some working in liaison with ambulance Trusts.
But ministers have also encouraged the private sector to develop chains of primary care outlets, which could begin to squeeze NHS prilary call
Already much continuing