Why the NHS reforms really are the end of the National health service

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One of the most pernicious aspect of the Tories' NHS reforms is one of the least known.

At present we have a National Health Service because the Department for Health (and it's Welsh, Scottish and Northern Ireland equivalents) all have a statutory duty to ensure that there is a health care service for all in this country free at the point of supply.

That will not be the case after Cameron's reforms go through. The Department for Health will ot have such obligation in England, at all.

GP consortia will have a legal obligation to provide services to those registered with them. But note, you have to be registered t enjoy the service. It will not be a right: it will only be a right if you are registered.

And there will not be an obligation on consortia to provide universal health care free at the point of delivery, quite extraordinarily. If a consortia decides it cannot supply a service because it is too costly or it has run out of budget then it will be able to decline to do so. GP consortia will not be an NHS: they'll be a selective healthcare service because they'll have a statutory duty to supply a service for which there will be increasing demand at ever reducing cost and that will necessarily mean they'll ration - which will impose impossible conflicts of interest on GPs.

And what for those who do not or cannot register with a GP consortia or who need the services their GP consortia cannot or will not supply? For them their health care supplier will be their local authority. Yes, it is local authorities that will have the duty to supply universal health care after the reforms come into effect.

Of course, local authorities have no mechanism to make those health care supplies. And nor are they being given any budget to deliver them. But you can already hear Cameron saying it's not his fault that they won't be able to deliver - it's their legal responsibility and if they fail it won't have anything to do with him.

Except of course it will. He, Lansley and Clegg are responsible for this reform. The reform will end the right to universal healthcare. And it signals the end of national healthcare - and brings in an era of supposedly local healthcare when there is no mechanism to supply it.

That's not chance: that's further evidence of designed in failure in the scheme the ConDems are proposing. And there's only one reason for that designed in failure: it is complete contempt for democratically controlled supply of services for the benefit of all the people of this country when what Cameron and his friends wan is the opportunity to capture control of those services so they can rake billions off them to enhance their personal wealth.

We don't have long to stop this deliberate act of destruction. And if the Lib Dems toe the party line we have no hope of doing so.

Will dogma destroy the NHS? I hope not - bit only vociferous action can prevent it. That I do know.