Mark Steel: Soon hospitals will be charging rent for the beds

There's splendid news about the Health Service. It seems last year it made £95m profit from car park fees at hospitals. What an example of modern spirit and enterprise, and a contrast to the old "anti-business" ideology that allowed people to park at hospitals for free. These dinosaurs would never have had the imagination to say "Hmm, they HAVE to come by car as they're limping - we can charge them as much as we like."

And they don't just charge, they charge more than anyone. In Edinburgh for example, the car park at the hospital is more expensive than the one at the airport. Maybe the thinking is this is the way to cut waiting lists. Because eventually it will be cheaper to park at the airport, fly to Canada and get it done there than to pay to have it done free round the corner.

A spokesman from the Department of Health said the car park fees were reasonable because "they discourage people who are not using the hospital from using the car park spaces". Supermarkets have a similar dilemma with their car parks, so they pay a couple of bored guards to patrol them and check the people parking are customers. Which is one way of doing it, although another method is to make ninety-five million quid out of the sick and their visiting relatives.

Which means the Health Service has arrived at the magnificent point where it is more profiteering than Tesco. Soon they'll be building huge "Health Malls" and placing adverts in magazines that say "Visit the catheter experience". Or they'll copy that trick they do at theme parks, and as you're walking round the ward, everyone has their X-ray taken, which they can buy for seven quid from a kiosk near the exit.

Every corner of a hospital has been studied for its marketing potential. Bedside telephones are on offer at premium rates, and televisions can be hired for £16 a week. Surely with that combination on offer there ought to be an investigation into whether our hospitals are being run by ITV. Maybe the premium rates are in place because they discourage people who are not using the hospital from feigning a hernia in order to sneak a cheap phone call.

In any hospital, the one area you can guarantee is sparkling and clean is the bit where all the shops are. Still, maybe they've asked the patients and this reflects their priorities; they say "I'm not too bothered whether they find me a bed or not, but there's a wide selection of Supreme Brandy Delight Latte-flavoured Luxury Chocolates at Thorntons, so that's the main thing."

Supposedly the solution to the shortage of beds will be market reforms, so the beds will be rented like the televisions. Then instead of spending money training nurses, the hospital can be run by hotel staff, and as you check in they'll smile and ask "Will you be surviving for evening meal tonight, sir?"

A franchise can be offered to betting shops, who can set up in the corner of cardiac units offering odds on whether people make it or not. Cash would simply fly into the Health Trusts, as punters studied a patient's flickering torso as that big electric thing was about to be shoved on their chest, and waved wads of bank notes like in The Deer Hunter.

So far, they've only gone part way down this route, for example by placing a series of businessmen from companies such as Deloitte and Touche on NHS boards. This is why the police should be discouraged from pursuing the "cash-for-peerages" scandal. At least that way businessmen are only buying themselves a robe and the right to sit among some dribbling Lords, but in this case they're buying the opportunity to run a bloody hospital.

This is all a consequence of the Health Service being subordinated to the Private Finance Initiative, and you can study the details if you like but you ought to be able to tell from the title whether its purpose is to encourage a) health or b) private finance. One chap who is probably in favour is Adrian Montague, who back in 1997 was given the part-time job of setting up the rules for this system, for which he was paid £140,000 a year. And I bet the bastard got a free car parking space as well.

Maybe we'll see the benefits of co-operation between companies running old state-run institutions. The hospital trusts could sign a business agreement with the rail companies, in which they say "We'll keep sending them spiralling down banks, then you mend the survivors and we'll split the profit fifty-fifty." The genius of all this is it's created such cynicism the Tories are now able to position themselves as the true defenders of the NHS. So David Cameron spoke to a rally of junior doctors who were opposed to the current wave of cuts. He had to speak to junior doctors, as there was no point speaking to anyone old enough to remember it was the Tories who started all this in the first place.

But Cameron's line appears to be "Isn't it terrible having a government that copies the Conservatives? They haven't reversed a single thing the Tories did, have they? That's why it's essential you all vote Conservative."

Then we can get back to the true spirit of the Health Service that inspired the post-war generation, in which between the automatic doors of the A and E unit, struggling to be heard above Jeremy Kyle on the bafflingly loud TV, a figure screams "Has anyone got a pound coin? Mine got stuck in the machine, probably because after the accident with the chainsaw, it's got all covered in blood so it's a bit sticky, you see."

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