A NORTH-EAST academic has said he believes the NHS "will never be the same again" after new reforms come into force next week.

David Hunter, professor of health policy and management at the School of Medicine, Pharmacy and Health at Durham University said the controversial changes, which are like nothing seen before, "should not be underestimated".

Prof Hunter writes - on BMJ.com - that once the Section 75 regulations in the Health and Social Care Act 2012 are passed they will allow competition to "freewheel" as more and more services will be put out to competitive tender, consequently "embedding market competition as the driving force in the NHS".

As such, he believes the NHS will begin to run under a different set of values which will "not be in the public interest".  

Following a "marketisation" programme in Sweden, he said profit-driven health services increased inequities with big cities and high income earners being favoured over rural areas and low income earners.

Prof Hunter concludes that if we are to save the NHS, a public debate is urgently required on "where markets should operate" and "where they should not".

But Julian Le Grand, Professor of Social Policy at the London School of Economics, argues that the reforms will not end the NHS.

Instead he says that that there is no need to fear the competition that will provide the challenge needed to improve NHS hospitals.

Drawing in part on his experience as senior policy adviser to Prime Minister Tony Blair from 2003 to 2005, Prof Le Grand says that competition has had a positive impact on the quality of management with "knock-on effects on hospital quality".

He bases these conclusions on research which found that when more patient choice was introduced in England, hospital quality improved faster.