Mrs Bottomley will make it clear next month that NHS patients will still be treated free, but the service should 'buy' more care from private hospitals and health care companies such as Bupa.
The private sector's NHS involvement has been held back by Treasury rules, now relaxed, and hostility from within the health service. Some NHS patients have been treated on private sector machines, and private hospitals have been treating NHS patients to reduce waiting lists.
But the change to be signalled by Mrs Bottomley could mean barriers being brought down, with private companies running NHS wards or entire hospitals and more NHS patients being treated in private hospitals.
She is seeking to match public and private investment, as already planned by John MacGregor, Secretary of State for Transport, with private toll bridges and roads.
The plan is certain to be attacked by Labour and is likely to be resisted by the unions. Supporting the move, David Willetts, a Tory MP and former member of the Downing Street policy unit, warns today in a conference paper that private companies will want to change NHS labour practices, and not want to negotiate with NHS unions. The conference is being held next week with Bupa by the Social Market Foundation, a centre-right think tank.
The NHS could now save money and improve services by leasing entire hospitals, built and run by private health companies, Mr Willetts says.
Cabinet sources suggest Mr Willetts is pushing at an open door. Mrs Bottomley is being pressed by the Treasury to attract more private investment. The NHS would have to pay running costs, but supporters of the idea say leasing hospitals and large items of equipment could save millions of pounds.
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