THE NHS was a world-class, cost-effective and safe system three decades ago.

The entire country benefited from timely GP appointments, rapid emergency access to A&E, sufficient hospital beds and safe staffing levels.

Any upheaval in primary care should be opposed because years of “reform and modernisation” have already plunged a healthcare system that was the envy of the world into an unprecedented crisis.

Patients are now struggling to access the NHS. It is simply staggering that more upheaval — paving the way for further privatisation — is being proposed by the Labour Party for primary care.

Ripping up GP contracts and converting GPs into salaried employees inevitably raises the question of who will take over as the new custodians of access to the NHS.

When the NHS was founded, GPs wanted to operate as independent practitioners, but decades later they are deeply embedded into the healthcare framework.

Far from being “murky businesses,” GP surgeries are an access point into the NHS.

The referral system remains relatively straightforward because the public still know they can access medical help via a GP or the local A&E, despite confusing messages trying to dissuade them. Dismantling these systems will lead to neglect, significant harm or risk to life.

It is correct that skilled and experienced doctors should be the custodians of the NHS.

However, the NHS, including primary care, is facing a national emergency due to decades of the impact of marketisation.

Billions are extracted out of the healthcare budget in private profit, resulting in fewer beds, fewer staff and unsafe services.

GP surgeries are experiencing the impact of the NHS emergency, and therefore it is becoming harder than ever before for patients to get appointments.

Primary, secondary, and tertiary care are linked to decades of NHS reform which has adversely affected GPs who are stressed and demoralised.

Because of the intense pressures created by shortages of staffing and bed capacity within the NHS, there is pressure to keep patients in the home or discharge them quickly, sometimes before they are ready, and GPs are left with the burden of responsibility and risk.

GPs are also picking up the slack for a heavily privatised and failing social care system too.

All the pressure points across the healthcare system mean that far too many patients in need of medical attention are blocked from getting timely appointments and access to the NHS which is also under siege from the level of demand.

Due to political lobbying, the Health and Social Care Act 2012 was introduced to pave the way for private health companies like Centene to control commissioning bodies, and they are fast taking over GP surgeries.

Any plans to force GPs to become salaried employees, while sounding like part of a long-held dream to integrate them into the NHS, is designed to strengthen the grip of the private sector over primary care.

Control of GP budgets and services would be transferred from competent clinicians operating around a code of medical ethics to business-owners seeking to maximise profit from primary care.

Plans to restructure primary care also raise questions about patient safety.

GPs have had years of on-the-job training in multiple health specialities to enable them to accurately diagnose, treat or refer patients to specialist medical teams.

The notion that an ordinary member of the public could take over the role of their GP and “self-refer” to a medical specialist is dangerous because patients could refer themselves to the incorrect service.

It is careless and dangerous for the Labour Party leader to suggest that patients can self-diagnose internal bleeding or back pain.

Plans to roll out preventative healthcare would be severely hampered by rising levels of extreme poverty which are a causative factor in the development of poor mental and physical health.

Furthermore, not every patient can just pop to a pharmacy for analgesia or simple advice and the health service should be able to cater fully for patients with severe and enduring health conditions too.

These are the patients who will suffer significant harm if the GP surgeries are upended by dangerous and ill-thought-out plans.

The pandemic has accelerated the NHS emergency, but it is not the root cause.

NHS capacity has been eroded because a political consensus continues to prevail, which allows the private sector to extract profit from the NHS budget.

Mass outsourcing of ancillary services and PFI are well established, but now the core care functions of GPs and the NHS are being targeted for profit as well.

The NHS waiting list was more than four million before the pandemic but it is now being used by politicians as a convenient excuse to outsource elective surgery to private hospitals.

Bringing in the private sector on the pretence of tackling the backlog is a business opportunity for the profiteers that will prove costly for the rest of us.

The rising costs of elective surgery will ultimately be transferred onto patients and pressure to take out health insurance will increase.

An acceleration of the privatisation that has the NHS dying on its feet is not the solution to the NHS emergency, nor is it the answer to getting a timely GP appointment.

The real political alternative is to halt privatisation and the Labour Party should be articulating this. It could call to protect, strengthen, and stabilise primary care instead of turning it upside down.

It could make demands for emergency funding and resources to be allocated or requisitioned from the private sector to clear the backlogs.

The real concern and danger in ripping up doctors’ contracts is that this is not a solution to the NHS crisis, but a fresh invitation to the private sector to undermine free healthcare for good.

Helen O’Connor is a trade union organiser and former nurse. Follow her on Twitter @HelenOConnorNHS.