The Government pledged that the private sector would play a permanent and increasing role at the centre of the National Health Service.

Tony Blair made clear that the Government would go much further than a scheme announced yesterday to allow 180,000 patients to be treated at a private or other NHS hospital if they have been on a waiting list for six months. People waiting for heart operations will be the first to benefit. "Reform does not stop there," Mr Blair told a Downing Street press conference. "I will not let ideology or dogma prevent this Government from doing what it knows to be right for patients."

The British Medical Association and trade union leaders hoped the "patients' choice" plan would be only an interim measure. But in an interview with The Independent, the Health Secretary, Alan Milburn, declared: "It is a relationship not just for the short term but the long term."

Mr Milburn said he hoped private health firms based on the Continent would come to Britain "lock, stock and barrel", bringing doctors and nurses with them. "Where we need to get to is a position where the NHS is no longer a monopoly provider of care but it does become a monopoly funder of care," he said. "We will use much more of the spare capacity that exists in the private sector. No doubt there will be more private-sector operators coming in."