IT is as stark as this — this election will mark either the rebirth of our NHS or its end.

While we have licence to debate how we have reached an NHS more fragmented, privatised and cut than we have seen in its history, this election focuses on the future of the health service.

With the morale of health service staff at a low point, many are asking if politicians really do value the NHS, their work or even their patients.

David Cameron promised that there would be “no top-down reorganisation of the NHS,” claiming that he would “cut the deficit and not the NHS.”

Yet just six weeks after entering No 10 he announced the blueprint of a reorganisation so large “that it could be seen from outer space,” as described by the recent chair of the health select committee.

This reorganisation forced all services out into competitive tendering processes, up against the giants of the private sector like Serco, Virgin and Care UK.

The 2012 Health and Social Care Act has now driven every part of the NHS to be floated on the market, awaiting the vultures to consume the best pickings from the system.

Over £13.5 billion worth of contracts have now been tendered as we lurch ever nearer to a US-style health system.

As private companies pare back services for profit, a new postcode lottery has resulted in some having to pay “top-ups” for basic services.

It is this culture that has advanced the prevalence of zero-hours, low-paid jobs in the health and care sector.

At the same time, investment in disease prevention, social care and the services which kept people safe at home have collapsed.

Services are now forced to funnel patients through the crowded doors of local A&E departments.

There were queues of ambulances at hospitals this winter, caused by patients struggling to return home due to the disconnect of social care.

In parallel, service users struggle to get the social care they so desperately need and in turn families struggle to find money to pay for these most essential of life services.

Eight per cent cuts to mental health services have resulted in clients being transported across the country to find the right level of support and a growing number of us are waiting more than a week to see our GPs.

This is the result of the Tory Party’s NHS, helped every step of the way by the Lib Dems — politicians who thought that they knew best and refused to talk to staff delivering healthcare every day.

At this point it is worth reminding ourselves that the most professional, caring, innovative, creative, loving, supportive workforce, performing over a million miracles every 36 hours, have been repaid for their dedication with a 16 per cent real-terms pay cut.

They’ve had their pensions cut.

The government is insisting that they perform their back-breaking work until they are almost 70.

They continue to donate on average eight hours unpaid overtime to the NHS each week.

And, of course, for those that have migrated to our country to address our skills shortages, they are stigmatised as the unpalatable immigration debate moves centre stage.

Yet it is health professionals, patients and the public who know what is best for our NHS.

As Labour sought to learn and listen, Unite has connected these rooted health experts with the party and enabled a fresh dialogue about the shape of a future health service that needs to be delivered.

From this dialogue, we have now seen the Labour Party commit to a preventative health service, to connect mental and physical health services with social care and to ensure that there is a new deal for the 1.4 million staff who make the NHS succeed on a daily basis.

Most important of all, we have been heard by Labour over the biggest threat yet to the NHS — TTIP.

Labour will not allow TTIP to irreversibly marketise our NHS and will ensure that public services and the secret investor-state dispute settlement tribunals are excluded from it.

While many of us call for the end of TTIP, we know that removing the market and its accompanying estimated £10bn bureaucracy from the NHS is also needed to safeguard the NHS’s future. If this requires a refocusing of relationships between services, then so be it.

Labour’s health and social care agenda, created by those who provide and use the service, doesn’t only give us a reason to vote Labour to save the NHS, but a really positive reason to put Labour in power to recreate the NHS, coupling it with social care.

While there is much talk of what other parties will offer at this election, the NHS is too serious to lose with a protest vote against Labour or to place an X by a party that may aspire to do good by the NHS, but has little chance of winning a seat.

Staying away from the ballot box is exactly what this government wants, so that Labour will not get enough votes to stop the big NHS sell-off.

When it comes down to it, the electorate has one straight choice on May 7. Seventy years on, we must return to the aspiration of that inspiring 1945 Labour government which said that for the NHS to survive we must have the faith to fight for it.

People, having marched 300 miles down the country, organised lobbies, demonstrations, protests and all-night vigils for the NHS, are not urging you to vote Labour on May 7 for nothing.

Labour is the last hope our NHS has — we have to kick out the Tories and Lib Dems who have put our NHS up for sale. And as Labour has learnt from the errors it made in the past while on its journey in opposition, we must give Labour one last chance to rebuild our NHS again.

• Rachael Maskell is Unite head of health and York Central’s Labour Party candidate.