A copy of the party's health document seen by the Independent says: "Our first aim must be to take the money currently being wasted on the transaction costs of the internal market and put it into frontline patient care.
"Then we will make the decision as to whether additional resources are necessary."
The document cites figures from Parliamentary answers and the Audit Commission to claim that pounds 1 in pounds 10 now goes on management costs, against a figure that Labour says was pounds 1 in pounds 20 in 1989, before the NHS reforms.
Mrs Beckett yesterday acknowledged more money had gone into the NHS. But it was not clear, she said, how much has gone into direct patient care rather than the management costs of the new system. Labour would examine where the money was going "and see if we can put it to better use".
The party is to promise a Royal Commission on community- and long-term care, amid concern how that is to be funded. There are "inadequate" guidelines on what should be free NHS care and means-tested social care, the document says. A Royal Commission "will encourage the widest public debate on the community services people have a right to expect and how best they should be provided and funded". It will examine the extent to which families and individuals should be expected to fund such care themselves.
That opens up the possibility of a new social insurance for long-term care, a move Germany has just made. The Prime Minister's policy unit is already grappling with the issue. Ideas that it is examining include allowing people to put houses into trust, to preserve them for their children's inheritance, and tax breaks for long-term care insurance.
In an interview with the Independent, Mrs Beckett has made clear that Labour opposes the Government's private-finance initiative in the NHS - an area some in the service had believed was no longer controversial. Once the private sector had replaced old hospitals with buildings which it financed and ran, Mrs Beckett said, "they would have the service over a barrel". Equipment-leasing was one thing, she said. But allowing whole hospitals to be provided by the private sector was another. Private provision of clinical services was "particularly unacceptable".
Private finance was needed for rail and infrastructure projects, she said. If it was allowed for the NHS, "it will all go into the NHS because health is an easy market and you will get nothing for British Rail or infrastructure of anything else that is difficult".
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