There seems to be a tendency that the State is slowly stopping to have control over the health services the public is receiving. And private companies are providing more and more services on behalf of the NHS.

Servies within the hospitals, like cleaning of catering, are being allocated to a company that wins the right to provide them. In the case of catering, multinational giant Sodexho has a large portion of hospitals (and other public buildings') canteens. Food in these canteens are usually charged at high street prices. In the case of cleaning services, public money is paid to the private company, with little power by the NHS to stop a contract when standards fall bellow acceptability. The government aim to pay for the outsourced service the same amount that was needed to provide internally, so the profit will need to be made from the difference of cost - and quality at which the service is now achieved.

Ron Finger, president of the Medical Practitioners' Union, maintains that hospitals where the cleaning is outsourced are dirtier and therefore suffer the spread of viruses, with the fatal consequences that this can have in a hospital. As an example, "the outburst of the virus MRSA was partly due to the poor higyenic conditions" of hospitals.

George Monbiot writes in an article that in hospitals where the telephone services are provided by a private company, users are charged similar rates as callers to sex hotlines.

There is then the issue of conditions of employment. John Saxby, Chief executive of the county of Durham and Darlington hospital trust, committed to PFI, explained to me what the consequences were for workers doing services that were outsourced in north Durham:

When the services were transferred to the private sector, then staff had contractual right to transfer to the private provider, and the terms of the transfer were, that the terms and conditions that they enjoyed when they were directly employed by the nhs would be no worse than those applied by the private sector. Now, that applies only to staff who transfered from the nhs to the private sector provider. If staff leave the private sector provider and new people come in and join directly then the private sector can offer them their new terms and conditions they are not bound to offer NHS terms and conditions. He said that it is not his job to know what the private sector offers... he expects the laws of the country to be observed, but in fact it is not our responsibility, to make sure that they are, that is down to the private company.

Even medical services are currently outsourced privately. And, according to an independent investigation carried out by "The Observer" newspaper, this is done at several times more than it costs the NHS. One reason for this may be the differences of wages between private and public surgeons: up to £500,000 a year a private surgeon, £60,000 a year a public one.

And, with Foundation Hospitals, these differences will be legitimate even within NHS hospitals.