The election choice on the NHS is becoming pretty stark

At next year’s election, the NHS will be on the ballot paper. Such is the scale of the challenges looming for the health service in the next Parliament that the decisions taken will determine its future.

One thing has become clear in the last four and a half years: you cannot trust the Tories with the NHS. In 2010, David Cameron promised “no top-down reorganisation” but, within weeks of taking office, he broke his promise and brought forward the biggest reorganisation ever.  It did not need reorganising. Cameron inherited a health service with the lowest-ever waiting lists and highest-ever public satisfaction. But he ignored doctors, nurses and patients and proceeded with a reorganisation that wasted £3bn of frontline money and dragged the NHS down.

There is no clearer evidence of the damage done by David Cameron’s NHS reorganisation than in A&E – the classic barometer of the system. Over the last 12 months, a million people have waited over four hours to be seen in A&E. Hospital A&Es in England have now gone 72 weeks since they last met this Government’s A&E target.

The pressure in A&E is having a knock-on effect on ambulance services, now taking on average over a minute longer to reach patients in a life-threatening condition, compared to three years ago.

NHS waiting lists are now running at their highest levels for six years, with almost three million people waiting. Cancer patients are waiting longer for treatment to start, with the NHS missing the national cancer treatment target for the first time, and mental health services are in crisis. One in three hospital trusts is in the red and the financial position of the NHS is getting worse.

Since Cameron scrapped Labour’s guarantee of a GP appointment within 48 hours and cut the scheme for GP evening and weekend opening we have seen people waiting longer and longer for an appointment – one in four now waits a week or more.

It is an appalling state of affairs and no way to run the country’s most valued service. And it highlights the very real threat that another five years of Tory Government would pose.

It is no exaggeration to say that the 2015 to 2020 Parliament will determine the future of the NHS. If the looming funding pressures combine with Cameron’s ideological prescription or privatisation and marketisation, it could create a toxic medicine that may well finish the patient off.

That is why it falls to Labour, the Party which created the NHS, to secure it for the 21st century as a public service which puts people before profits.

We will start by repealing the Health & Social Care Act 2012 to put the right values back at the heart of the NHS. If the NHS is to reshape services forthe 21st Century – and make them financially sustainable – it must have full permission to collaborate and integrate without being trapped in the red tape of compulsory tendering.

Next we will bring together physical health, mental health and social care into a single service to meet all of a person’s care needs – ‘whole-person care’ – with services organised around the needs of patients rather than patients organised around the needs of services. It will be a service that starts in people’s home and builds from there – keeping them supported where they want to be, surrounded by the people they love. It will allow us to give people and their carers a single point of contact and the right to a personalised care plan. Family carers, for too long invisible to the system, will finally be at the heart of things. And it will also be a service that finally gives mental health the priority it deserves, including a new right to talking therapies enshrined in the NHS Constitution.

To support this shift to an integrated service, and to ensure the NHS has enough doctors and nurse with the time care for patients, Labour will raise £2.5bn for a Time to Care Fund through a mansion tax on properties valued at at least £2 million, a new levy on tobacco companies, and clamping down on tax avoidance schemes. This will enable us to pay for 20,000 more nurses and 8,000 more GPs by 2020, along with 3,000 more midwives and 5,000 new homecare workers in the NHS to support people to stay in their home.

To tackle the problems with GP access faced by millions of families, we will guarantee a GP appointment within 48 hours, or on the same day if you need it, and also give people the right to book further ahead with the GP of their choice.

As part of our plan to be the best in Europe for cancer survival, we will also guarantee that patients will wait no longer than one week for a cancer test and result by 2020, and we will create a new £330m Cancer Treatments Fund to improve access not just to the latest drugs but also to the latest forms of radiotherapy and surgery that are too often not available for thousands of people with cancer.

So the election choice on the NHS is becoming pretty stark: a part-privatised, two-tier health market under David Cameron, with services going backwards and patients waiting longer and longer for treatment; or a public, integrated national health and care service under Labour that can truly rise to the health challenges of the 21st Century.

Andy Burnham is the Shadow Health Secretary