Jeremy Laurance: This will fuel fears of creeping privatisation

The Coalition's plan to open up the health care market to "any qualified provider" and to remove the cap on private earnings for foundation trusts are lightning rods for the opposition. As budget pressures force NHS trusts to look to other sources of income, wealthy paying patients, at home and overseas, is an obvious market to exploit. The NHS will not be privatised overnight but, it is feared, stealthily, bed by bed and ward by ward.

The Royal Marsden is a cancer hospital able to draw patients from around the world. Its private earnings are already higher as a proportion of its total income than any other trust. But its plans for further expansion of its private work will be seen as a harbinger of what is to come. Other trusts with private ambitions include the Christie Hospital, Manchester, Britain's second specialist cancer hospital.

John Healey, Labour' shadow Health Secretary, argues that removing the private patients' cap is a "vital feature of the Govern- ment's plans to turn the health service into a full-scale market".