WHETHER IT'S the Tories or New Labour who form the next government, one thing is clear, the National Health Service (NHS) faces its biggest crisis since it was founded in 1948.

Roger Davey - Chair, Swindon and Wiltshire Unison Health Care branch, (personal capacity)

All the establishment parties agree that in order to bail out the bankers and this rotten capitalist system, spending on the NHS is going to have to be ruthlessly cut by at least £15 billion. The only difference between the Conservatives and Labour is when services are to be slashed, not if.

You only have to look at the predicted spending figures to realise the disaster that awaits the NHS. The indications are that there will be no spending increases between 2011 and 2014, in contrast to the increases of approximately 5% during the last few years (much of which, of course, was creamed off by private companies).

If you also factor-in the already proposed 'efficiency savings' and add the escalating costs of the disastrous Private Finance Initiative (PFI) schemes, then it's obvious that the NHS faces financial meltdown.

Under the circumstances it is inevitable that the government and local managements will launch a full frontal attack on health workers' pay and conditions, since labour accounts for 70% of the NHS budget. It's likely that pay will be frozen, mass redundancies implemented and many of the rights currently enjoyed by NHS workers abolished.

The government's drive to slash spending and the push for a cheaper NHS workforce will mean that the pace of privatisation is likely to accelerate. Indeed, at the moment the government's latest reform - 'transforming community services' - is being implemented, which could potentially privatise all NHS services outside main acute hospitals.

The twin altars of financial cuts and privatisation will have a devastating impact on patient care. Increasingly, care once provided free by the NHS will be means tested, as hospitals and Primary Care Trusts desperately try to save money.

We will also see, on a much larger scale than ever before, the closure of hospitals, wards and other vital services.

In fact, the future of the health service more and more is one where the commercial market determines care, where treatment is provided by profit-hungry multinational companies, and where a two-tier system will operate, with the rich enjoying a superior service to the rest of us.

Yet ironically, the cost of privatisation is huge, not just for PFI, but also because the cost of administration has risen from 12% of the entire NHS budget to 20%, which partially reflects the cost of running the 'health market'.

Unison, the main health workers' union, must demand that all private contractors are kicked out of the health service and all pharmaceutical companies are nationalised, measures that would save the NHS billions.

Unison must also build a campaign of resistance which should say, 'no to hospital closures, no to service cuts, and no cuts in health workers' living standards - we won't pay for the capitalist crisis'.

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