SOME people may be startled that Labour leader Keir Starmer is using Tory rhetoric to talk about the NHS. The key word is “reform” and phrases are used like “get real about reform.” These are euphemisms for opening up the NHS to the private sector.

For instance, it could mean insurance or co-payments — and the US model has meant that healthcare is the biggest cause of bankruptcy in that country. Pro-Starmer commentators have been anxious to reassure us all by claiming that what Starmer means by “reform” has no resemblance to Tory “reform.” But in reality, it means the same thing.

Starmer is using Tory rhetoric for a reason. And for the avoidance of doubt, he has placed his latest article calling for “reform” in the leading Tory newspaper, the Daily Telegraph.

He intends to intimate to the public that in fundamental ways his plans for the NHS are not much different from those of the Conservative Party. And if some voters do not realise this now, they will grasp the significance of the word “reform” soon enough when Starmer becomes Prime Minister.

But it is not only about the use of one word. Starmer talks about how the NHS should not be treated as a “shrine” and complains about “bureaucratic nonsense.” In passing, he seems to be arguing that he knows all about reforming the NHS because he once was the director of public prosecutions (DPP). This seems plausible until you remember that the NHS has over 1.5 million staff and the DPP has just 7,000.

Meanwhile, shadow health secretary Wes Streeting uses the same language as his boss. He says: “We cannot afford to be romantic and misty-eyed about the NHS. It is a service, not a shrine.”

Like Starmer, he uses all the standard Tory Party language about a service owned by the people, “vested interests,” or “producer interests.” It is worth noting in passing that although Streeting talks about “vested interests” in the NHS, he has never been heard to use the word about the City of London and manufacturing monopolies.

Streeting boasts that “we are not going to have something-for-nothing culture in the NHS.” He insists “the NHS exists to serve patients — not itself,” and, “I am not prepared to pour income into a black hole.” He often sounds almost hostile to GPs and seems to think they are to blame for the difficulty everyone has in getting a GP appointment. Worse he seems to hint that GPs are opposed to higher standards for patients.

More generally, Streeting complains a lot about the NHS. But he dodges the fact that if you complain about the NHS, ultimately what you mean is the doctors and nurses that make it up.

Instead, he insists that Labour will “take on those holding back the service,” including “some of the most powerful unions.” And echoing his boss Starmer, he says “reform or die.” He seems not to have noticed that after a decade of Tory reform, people are dying.

Streeting and Starmer do have some random schemes which make up their “reform” project.

One idea is to make people get their vaccinations from their local chemists. Making people do this initially seems fine, but women from marginalised communities are not going to go into Boots the chemist and get themselves and their children vaccinated by a man they have never seen before in their life. Inevitably levels of vaccination in the most marginalised communities will go down and the levels of infection will go up.

The shadow health secretary does not seem to understand the serious nature of the diseases that a universal vaccination protects people from. One example is smallpox, a horrific disease with a mortality rate of 30 per cent. Survivors have extensive scarring. Many are left blind.

Thanks to vaccination, smallpox has been eradicated. But if levels of vaccination go down, we could see it again.

Another example is polio. Victims of it were often incarcerated in “iron lungs,” their lungs paralysed and unable to breathe unaided. Again this was eliminated in the 1980s. Last year the World Health Association said vaccines saved the lives of up to three million people. But Streeting appears to know nothing about all this. Instead, he says “vaccination is money for old rope.”

Another “reform” idea is that people should be able to skip going to a GP and refer themselves to a consultant or specialist. But how do you know which consultant you should refer yourself to?

Starmer says: “Why can’t people with persistent back problems refer themselves to a physio?” The reason is that persistent back pain could be caused by any of several conditions, from metastatic cancer; to multiple myeloma; bacteria discitis; osteoporosis; tuberculosis; spinal cord compression and multiple sclerosis. You need a GP to look at it initially.

But the fundamental “reform” of the NHS that is being suggested, and is endorsed by Tory commentators, is greater use of the private sector.

Streeting says that Labour would vastly increase the use of the private sector for NHS patients. Streeting also says “Labour would have gone further than the Tories have in using private hospital beds for NHS patients, taking hundreds and thousands off the waiting list.”

But the private sector does none of its work for free. Spending money on private hospital beds always means that some of the money disappears into the profits of private businesses. It will always be a better use of taxpayers’ money to invest in the NHS itself.

So, what is the reasoning behind all this talk of “reform” and the random so-called “reform” suggestions? The first thing to note, if you examine the “reform” proposals carefully, is that they do not necessarily improve the service or even save the taxpayer money.

They are designed to create a smokescreen of activity shielding the fact that Labour is just not prepared to put in the level of investment that the NHS needs.

But more important is that the Tory rhetoric about the NHS, which Starmer and Streeting have taken to echoing, is less about improving the NHS and more about persuading a certain group of voters and commentators that they are not going to throw money about. As one member of the Labour front bench put it recently, “We need to show that we can be trusted with taxpayers’ money.”

Trust in our fiscal stewardship will not be bolstered by throwing money at the private sector, or by further privatisation or outsourcing. That is a waste of resources.

The first necessary reform of the NHS is to raise our spending on health to the equivalent of our European counterparts, about an extra £20-25 billion.

This in part would allow increased capital spending to address the dilapidation of the NHS estate as well as to improve technology, which is woeful in some areas (MRI and CT scans, for example).

Crucially, it would also allow a decent level of pay for NHS staff at all levels, which is only fair and is needed to address the crisis of recruitment and retention. The crisis in social care also needs to be addressed with substantial additional funding.

Finally, privatisation and outsourcing need to be stopped and reversed. There is no point in providing the NHS with its much-needed flow of funds if there is a great big hole in the bucket known as the private sector.

Diane Abbott is MP for Hackney North and Stoke Newington. Follow her on Twitter @HackneyAbbott.