The end of healthcare in the UK

I don't think the title is over the top. Certainly if we do not act soon the NHS will have been pulled out from under us like a table cloth.

Corporate interests have been trying to smash the NHS for years. They have no concern for us (this is purely pathological) and would love to see the institution of healthcare along US lines.

Unfortunately, whilst we like to moan about the NHS (we British have turned moaning into an art form) we also retain an extraordinary affection for it, which, for many years, the corporations have found difficult to undermine. Even Thatcher wouldn't touch it despite de-nationalising everything including the family silver.

They found their way in under (ironically, given the Labour party's socialist origin) Blair. Attacking as a wolf in sheep's clothing was a master-stroke, I suppose.

A quick re-cap for those unfamiliar with the N(ational) H(ealth) S(ervice). It was set up by the Labour government under Clement Attlee in the wake of WWII as state-financed healthcare for all. Any Briton could walk into a hospital, receive diagnosis and treatment (antibiotics for a chest-infection up to costly procedures such as heart transplants or chemotherapy) completely free of charge (barring a small charge of around $10 per script which is waived for those receiving state-benefit for unemployment, retirement etc.)

Blair was lobbied by corporations into instituting the Private Finance Initiative, which was an outrageous sleight-of-hand trick of front-loading nice, new and shiny hospitals onto us today at considerable future expense. Formerly the NHS owned and controlled its own hospitals. Now corporations lease the hospitals to the NHS. In many cases the buildings are only guaranteed structurally for 25 years, at which point they should be torn down, re-built and the cycle continues.

The con here is pretty simple. Make the here-and-now benefits (new facilities) obvious whilst hiding the massive future costs in a labyrinth of mathematical formulas, equations and projections.

Instead of making the NHS more effective the Blair government introduced a new piper to pay. It doesn't take a genius to work out that with less money the NHS will increasingly need to rationalise treatment.

Over the last few years we've begun to see the hideous reality. Patients being kicked off practices because they've become too expensive. Smokers being denied treatment because they've dared to require costly treatment (despite paying a lifetime's taxes). Now under Cameron the NHS is attempting to deny treatment to the morbidly obese.

It's totally outrageous and people should be rallying to activism and venting their fury. Alas, we are so hopelessly doped with X Factor and football and "Asylum Seekers" to care...

It's difficult to grasp the details of the Lib Dems' NHS strategy. If you look at their website there are the usual complaints about inefficiency and appeals to widespread belief. One suggestion which I agree with is bottom-up reform whereby greater power, flexibility and room for decision making is placed in the hands of the practitioner, surgery and primary care trust.

I do agree that under Labour there was an explosion of NHS middle management and a tendency toward top-down autocracy. That said, they were quite effective in uniting the various services (triage, practinioner,specialist, surgical, mental health, maternity etc.) under individual trusts - something I was never conscious of under the previous Conservative government. And the use of information technology (patient records, prescriptions etc.) has mushroomed exponentially.

Another campaign pledge which I wholeheartedly agree with is the scrapping of central targets. If anything symbolises the damaging interference of Labour during its tenure it is the imposition of targets (not just in the health service, but education also), which whilst ostensibly providing some kind of objective method of determining the efficacy and efficiency of services (thus, in theory, providing the motivation to improve) has instead served only to make them think of the figures and nothing else.

Of course, the days of campaign pledges actually meaning something are long gone. Labour demonstrated this in the most cynical fashion and it didn't take long in power before the Lib-Dems backflipped similarly with arguably their most respected minister (Vince Cable) stridently advocating university tuition fees after promising that he would scrap them entirely during the election campaign.

I'll wait and see. But given their contemptible alliance with the Conservatives (something I'll never forgive them for) I'm not hopeful.

Cameron has said there will no election until the full 5 year term is up (I believe it's part of the contract with the Lib Dems). The Tory economic plan is based around the Public Sector cuts bearing fruit in 4-5 years time and hoping this offsets the lingering resentment many will no doubt feel towards this Government.

So it would be a major political risk (or suicide) to go to the polls before then, thou as PM that is his right.