IN THE countdown to polling day, many of us will be mighty tired of being lied to, as parties compete to show themselves even less trustworthy than we thought.

The biggest lie underpinning both the Tory-led coalition’s offensive against welfare and public services and Labour’s feeble and hesitant response has been that austerity policies have been and remain “necessary” to tackle a disastrous financial mess.

In fact, the main crisis had been resolved by 2010: the public sector had bailed out the banks. Then Tory cuts paralysed a growing economy.

Osborne is now borrowing £219 billion more than he said he would, having added more to the national debt than all of the Labour chancellors added together.

Nonetheless, working on the principle of never letting a good crisis go to waste, Cameron’s Tories have seized upon it as a pretext to wage the biggest-ever onslaught on public services, with Labour’s Ed Balls too compromised by his previous position to offer any alternative.

The neoliberal goal is to shrink the state, further reducing the tax burden on the rich. It’s worked. The latest figures show the wealthiest 10 per cent in Britain now own 44 per cent of national wealth, some £4.2 trillion, while the poorest are worse off.

What about the other lies that have been wheeled out? Cameron and coalition ministers tell us they have increased NHS spending by £12.5 bn over five years, failing to mention that this is only marginally above inflation and well behind increased pressure on NHS services, with an growing population, more elderly patients and new drugs and treatments coming on stream.

So even with their “extra” £12.5bn the NHS is still worse off in real terms (as of course are over 1 million health workers, many of whom have lost 16 per cent or more in purchasing power from their frozen salaries since 2010).

Now the Tories want us to believe they would come up with an extra £8bn for the NHS by 2020 without putting up any taxes for 5 years and without saying what other services would be cut to pay for it. The promise is as worthless as Cameron and Lansley’s pre-2010 promise to halt the closures of A&E and maternity units, or “no more top-down reorganisation.”

Cameron and co also insist that despite a rapid increase in contracts won by private companies consortiums since their 2012 Health and Social Care Act carved the NHS up into bite-sized chunks and compelled 211 commissioning groups each to put between 60 and 600 contracts out to tender, there has been “no privatisation” because NHS-funded care is still available “free at point of use.”

But payment for services is no yardstick to prove privatisation. Before they were sold off by previous Tory governments, railways, electricity, water, gas and British Telecom were all nationalised industries, although each levied charges for their use. The fact is that NHS services that were previously provided by the public sector are increasingly now being provided by profit-seeking private companies whose very existence has been sponsored by the coalition and Labour governments since 2000.

The spending squeeze and privatisation drive are increasingly reducing the publicly provided NHS back to the core services that the private sector does not want and health insurance will not cover — A&E, maternity, mental health and care of the frail elderly.

At the centre of the privatisation is the lie — still perpetuated by Labour and the Tories alike — that the private sector has something useful to offer a publicly funded NHS. Yet all of the evidence around the world, and displayed in a continuing series of private-sector contract failures, points to the opposite conclusion.

Private contractors proved 30 years ago that they could not keep NHS hospitals clean or deliver other non-clinical services as well as the displaced NHS staff had done. More recently the failures have been hitting clinical care too.

Serco, once a market leader, has proved they can’t make a go of community or primary care services, and pulled out of tendering. Other firms are hanging on to “loss leader” community health contracts waiting for the moment to crank up their prices, but struggling to recruit or retain the right staff. None of the promised improvements in services have materialised.

Carillion is just one of a number of companies and providers that have screwed up elective treatment and been forced to abandon their contract early. Circle at Hinchingbrooke has proved private companies can’t run busy general hospitals (indeed Circle can’t even make any money running its own extravagant, tiny private hospitals, which would have gone bust without a flow of NHS-funded patients).

But neither Labour nor the Tories seem willing to learn from these miserable experiences. Ideologically wedded to the private sector, they just keep hoping somehow things will turn out alright.

In practice, private provision can only deliver profits to shareholders either through hefty savings on staffing, by employing fewer qualified staff or simply working staff harder, or by charging more to the NHS for the same work. All of them so far seem to have gone for the first of these options, with predictably poor results.

As the disaster of the US system shows, in healthcare competition does not reduce prices or drive up quality, and private companies are less efficient than public-sector providers.

Meanwhile the privatisation drive is now being led by Clinical Commissioning Groups (CCGs), established by the Health and Social Care Act, which the Tories claimed would be “led by GPs.” In fact the few GPs initially attracted by hopes of improving services have largely departed in disgust. A recent poll by Pulse, a GP magazine, found just 11 per cent of GPs admitting any involvement with their local CCG.

Plans to put services covering huge populations out to tender in packages, some worth billions over the next five years or more, are being hatched by management consultants and decided upon by tiny handfuls of GPs enthusiastic for privatisation, many of them with vested interests.

Some of these contracts destabilise local trusts, A&E and mental health services, and hand services — even including cancer and end-of-life care — to untested privately-led consortiums. In only one controversial case have CCG policies been put to a ballot of the GPs they supposedly represent, only for the proposal to be heavily rejected.

The NHS is struggling. On Osborne’s original plans, the spending freeze would not end this year, but continue until 2020, meaning a whole lost decade in which all of the benefits of Labour’s decade of investment would be wiped out and the NHS would be reduced to a poor-quality safety net service, with more and more elective treatment hived off to the private sector.

To roll this back we need more than simply to kick the Tories out of office. We need to press a Labour-led government to go much further than the limp proposals of their Efford Bill in repealing parts of the Health and Social Care Act.

As Allyson Pollock and Peter Roderick have argued in their NHS Reinstatement Bill, we need not only to repeal the competition clauses of the Act, but also to stop the wasteful bureaucracy of the NHS market it created. The NHS needs more money, but some of this should be saved by scrapping competitive tendering and the division between commissioners and providers.

The NHS Bill also tackles PFI. Labour’s leaders must break out of their instinctive denial, closing their eyes to the costs of the many disastrous deals they signed off under the PFI, as well as the subsequent PFI deals rubber-stamped by the Tory-led coalition.

Action is needed to prevent these contracts not only lining the pockets of wealthy shareholders, often in tax havens, but also forcing cuts that wreck local services in PFI hospital trusts and in the surrounding area. PFI was largely forced on NHS trusts by government insistence it was the “only game in town.”

Government must halt any more PFI deals, publish the full details of each of the contracts, prosecute if any criminal fraud is revealed and take responsibility for sorting out the financial mess it has made.

If we value the NHS we need to vote out the Tories on May 7, but we must also prepare for a new round of campaigning to break Labour from itsBlairite policies on health and the economy, and press it to reinstate the NHS as a public service.

• John Lister is director of Health Emergency.