THE destructive effects of Health and Social Care Act 2012 are being felt all across the country as NHS hospitals and GP services are being closed and clinical services are put out to tender.

The legislation abolished the NHS by removing the Secretary of State for Health’s responsibility for, and duty to provide, crucial services including hospitals and community services throughout England. The NHS has been reduced to little more than a public funding stream and a logo under which corporate providers operate.

In place of the NHS are market bodies, known as NHS England, Monitor, Care Quality Commission, and Clinical Commissioning Groups.Health services in England are moving to the US model in which increasingly access will not be through automatic entitlement but through local eligibility criteria as commissioners decide what services will be funded by the NHS and what will be paid for.

For the first time since the NHS came into being, legislation requires healthcare providers to draw up eligibility criteria as part of their licence conditions.

Under this system patient choice does not mean patients having choice of providers but rather providers being able to pick and choose their patients and treatments on the basis of ability to pay. Patients are being turned away and denied care.The NHS had solid foundations.

Its system was based on fairness of funding through income taxes and designed to maximise redistribution of resources and services.

An efficient public bureaucracy ensured that administration costs were no more than 5 per cent of the total budget and health expenditure didn’t rise much above 4 per cent of gross domestic product.

However, since 1990, under Conservative and Labour administrations, market incrementalism has been a hallmark of NHS legislation with the introduction of the purchaser-provider split. The Labour government in 1997 accelerated market-driven measures giving trusts new powers to generate private income and enter into exorbitant private finance initiative (PFI) debt obligations and commercial contracts for clinical care.

PFI has been a major driver of service closures. The link between planning and the needs of the local population was eroded.

The 2012 Act prospectively abolishes all NHS trusts, which must become NHS foundation trusts. Legislation expects these, in turn, to be 51 per cent NHS and 49 per cent private in terms of the income and services provided. This means that over half the beds, services and staff currently used in the NHS will eventually be turned over for the use of those that can pay — private patients.

The Act has resulted in destructive disorganisation and enormous fragmentation and cost as general practice, hospital and mental health services are broken up in piecemeal fashion and put out to tender, with no regard to planning for need.

Commercial contracting is expensive and providers are risk averse and cherry-pick the best services and patients.

Many public health functions, including children’s services, sexual health services, health visiting and district nursing, are being transferred to cash-strapped local authorities which will in the future break them up and contract them out, further fragmenting services. Britain cannot afford a market in health services. The US tells us all what is in store with healthcare costs in excess of 17 per cent of GDP compared with 9.2 per cent.

The main political parties are wrangling over public expenditure but have said nothing about the high costs of marketised healthcare.We have little time left. By 2020 the NHS as we know it will have disappeared, not with a bang but with a whimper. It is in terminal decline.

Only legislation can reinstate the NHS. The general election could well see a hung parliament where minority parties such as the SNP determine the balance of power.

On March 11 an NHS Bill to reinstate the NHS in England was tabled with cross-party support.

This Bill will abolish market and NHS contracting and the expensive market bureaucracy, make the Treasury responsible for resolving the high cost of private finance and restore the duty of the Health Secretary to provide universal listed health services to meet the needs of people throughout England. It would protect the NHS from challenges from investors under the Transatlantic Trade and Investment Partnership and other trade treaties.

Voters should ask all parliamentary candidates to declare their support for this Bill before the election.

The Green Party and SNP support the Bill. Labour’s manifesto promises to restore the duty to provide care but hasn’t yet committed to abolishing the internal market and external market and centralising PFI.

Voters need to know before they go to the polls tomorrow which of their local candidates and which parties will reinstate the NHS. For details of how to do this, they should go to www.nhsbill2015.org and go to the “take action” tab.

• Allyson M Pollock is professor of public health research and policy at Queen Mary University of London.