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There's a conspiracy to turn NHS into net tax generator

I have a very bad feeling about the next five years for the NHS after reading your coverage of secret talks with private firms ('A conspiracy theorist's dream').

It has always struck me how much the NHS budget has soared over the term of the current Government, from £49bn to £106bn, and the fact Her Majesty's Treasury has allowed it, despite its normal frugality. Given Gordon Brown had to retain the mandarins' goodwill if he was to follow the tradition of chancellors usurping prime ministers, it could easily have been stopped.

But it all makes more sense when you look at how much of that budget has been diverted into taxable activities - not just independent sector treatment centres, but PFI and IT contractors, the huge numbers of functionless supernumerary staff in trusts and the generous salary increases. Unlike patient care, which burns money once and for all, these activities raise national insurance, income tax, VAT and corporation tax. They keep unemployment figures down and taxable retail spending up, creating a shadow economy based on funds circulating between the NHS and the Exchequer in ever-decreasing circles until they vanish up Treasury backsides.

At a conservative estimate, some 55-60% of the NHS budget returns to the Treasury within the financial year, compared with 45% of GDP for the whole economy. Even the annual QOF payment is made in June, just in time to give roughly the same amount back as income tax in July. Taking into account marginal tax rates, GPs making a windfall of £10,000 on swine flu vaccines will pay 84% back next January - a sprat to catch a mackerel, from the Exchequer's viewpoint.

NHS superannuation also goes into the tax pool - the pension fund is really a virtual line of credit at the Treasury.

My own conspiracy theory is that during the tenure of Prime Minister Margaret Thatcher and health secretary Ken Clarke, a decision was made to convert the NHS from a tax-consuming to a tax-paying organisation. The Treasury has been stealthily implementing the Thatcher-Clarke agenda ever since 1987, across five general elections and four prime ministers.

My expectation is that once the next administration has its mandate legitimised by a general election, there will be a judiciously contrived sterling crisis, as in 1976, requiring the help of the IMF.

Throughout the Third World, IMF loans have caused misery by being conditional on denationalisation of health services, and as our economy now verges on Third-World standards anyway, such an insistence in the UK could be very useful to the next Government, supplying both the means and the scapegoat for privatising the NHS.

From Dr Julian Randall, Woodsetton, West Midlands

So NHS top management was secretly briefing large companies about the way to bid for polyclinics and GP-led centres ('NHS wooed private firms over polyclinics', pulsetoday.co.uk/news).

If it was not offering the same facilities to other bidders, does this qualify as anticompetitive behaviour in the legal meaning of the term, and should it be reported to the Competition Commission with a view to prosecution?

Would unsuccessful bidders who did not have this advantage be able to challenge the award of the contracts?

Just asking...

From Dr Mary Hawking, Dunstable, Bedfordshire

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