Despite catastrophic failures in the banking sector, the market is far from in retreat in the NHS. Reports in advance of a white paper suggest the coalition health secretary, Andrew Lansley, could be about to hand over the bulk of the NHS budget, around £80bn, to private corporations which will buy hospital and community health services on behalf of GPs.
The proposal will advance the changes implemented under New Labour, where the impetus was to dismantle the mainly integrated structures and system of NHS health authorities, hospitals, clinics and specialists and GPs providing care to the whole population, replacing it with a market system under which private companies such as Bupa and US company UnitedHealth are given NHS funding and commercial contracts to supply clinical services.
Lansley's reforms will dovetail seamlessly with those of Labour, which pioneered the commercialisation of GP practices and the contracting of services to private suppliers of clinical care.
Over the last decade Labour encouraged primary care trusts – NHS bodies that planned and purchased care for their local populations – to turn to private-sector management consultants and for-profit healthcare companies to help them develop "commissioning" skills.
According to the health select committee inquiry published earlier this year, it proved to be an expensive experiment. It is of grave concern that general practices of the traditional kind, with next to no commissioning or planning skills, will be told to follow the same route.
What are the implications of reducing the NHS to a payer for healthcare under a system increasingly dominated by for-profit multinational corporate-owned commissioners and providers?
One only need to look to the US for an answer.
The vision of the future is one in which corporate interests will be given incentives to select patients, time-limit care, sell top-up insurance, and introduce charges for some elements of care no longer provided by the NHS. We may even see the development of practices competing against one another for members (patients), just like US health insurers. That's a chilling prospect for the elderly, those with chronic illness and people with mental illness and long-term needs, who are often of no commercial interest to the corporates because of their high healthcare costs.
For all the talk of revolution, the new proposals are unlikely to overturn Labour's pro-market zeal in favour of efficient, integrated, fair and careful needs-based planning, thereby protecting the NHS's founding principles. We cannot tell from the advance reports who under the reforms will be left with the duty to provide a universal healthcare system free at the point of use.
This duty, imposed on government by the post-war parliament, was due for abolition in draft legislation set out by the Conservatives in November 2007.
It will be fascinating to see how Labour responds. The danger is that without careful and informed debate one of the best-loved and most successful public institutions of the last 60 years will go down undefended.
Allyson Pollock is professor of international public health and David Price is a senior research fellow at the centre for international public health policy, University of Edinburgh