With the NHS struggling to cope with growing demand and increasing budget pressures, the future of this sacred British institution has been called into question ahead of Thursday’s General Election.

Many have warned of the threat from private companies, claiming an American-style insurance based system could be on the cards.

Labour activists claim that is the Conservative plan, and only they would ensure the NHS stays free for all. The Tories, however, deny this, stressing that they are fully committed to securing the NHS for the future.

Locally the issue has risen to the surface in recent days.

Readers told us the health service is their biggest concern in our comprehensive General Election Survey 2017.

A high-profile rally in Carlisle at the weekend then saw almost 200 people gather to campaign against cuts to the NHS, locally and nationally.

Sunday’s demo was toned down in respect for those killed in the London terror attack, and Labour Party leader Jeremy Corbyn, who was due to speak at the event, had to cancel his appearance.

However the message that shone through from patients, NHS staff and local campaigners was one of fear for their health service’s future.

Several speakers raised the threat of privatisation.

Among them was Mai Harrison, of Askam in Furness, who travelled to Carlisle to share her experiences of a private health system in America.

Born in the USA, she married a Brit and now has dual nationality.

She told the crowds: “I have a Cumbrian husband and Cumbrian son. A lot of people ask me why I came here. There are lots of reasons, but the greatest part of Great Britain is the idea that a country is only as strong as its most vulnerable citizens. This founded the NHS. The view that every person has the right to robust and comprehensive care.

“Where I grew up it is very different. I grew up in a private medical system, where the quality of healthcare depends on how much money is on your profile.

“Imagine choosing between your health and your home, between your children’s health and your home. Imagine choosing death because you can’t afford your medical bill.

“These were my choices as a young adult. To pay hundreds of pounds in insurance or not having any insurance, and hoping for good luck. My experience has convinced me that the NHS is the most noble and most moral institution of our lifetime.”

There was also criticism of Prime Minister Theresa May’s recent reference to the Naylor Review, which proposes selling off ‘surplus’ NHS property and old buildings to private developers.

Campaigners in Carlisle claimed this was a step towards privitisation, and Henry Goodwin, who compered the rally, went as far as claiming voters had just one week to save the NHS.

Conspiracy theories have also been circulating on social media, with a link showing US provider Kaiser Permanente International (KP) revealing it has links to Cumbrian health trusts being widely shared.

Both NHS Cumbria and Cumbria Partnership NHS Foundation Trust were listed on its website, among a ream of other UK health trusts, as organisations that have participated in its programmes or had KP speakers at their events since 2004.

However both Cumbrian trusts have denied this, and have since had their names removed from the site on request.

A spokesman for NHS North Cumbria Clinical Commissioning Group said there is no recent link.

“Neither NHS North Cumbria CCG, nor its predecessor NHS Cumbria CCG, have worked with Kaiser Permanente and we have requested they take our name off the list of participants on their website. Some staff from Cumbria Primary Care Trust worked with Kaiser Permanente before the reorganisation in 2013,” she explained.

A Cumbria Partnership spokeswoman added: “We can confirm that CPFT has had no involvement with Kaiser Permanente and as such we have requested that our name is removed from their website.”

When asked whether they had worked with these trusts, a KP spokesman said: “Since 2004, thousands of health care leaders from more than 50 countries have participated in Kaiser Permanente International’s two to three day educational programs.

“Participation does not constitute a partnership.”

But Gareth Ellis, deputy leader of the Conservative group on Carlisle City Council, labelled the talk of NHS privatisation as Labour Party scaremongering and insisted it would never happen.

He said: “Claims of privatising the NHS come along about as regularly as a DFS sale. We always hear that a Conservative Government will privatise the NHS. They say it every election, but it’s not true.”

Mr Ellis admitted the health service is under pressure, but said making people pay for healthcare was not his party’s plan.

“I think the funding that’s required to sustain what people want is not enough. The NHS is in huge demand, but we as citizens keep asking more and more of it,” he said.

“I do not know what the solution is, and the problem is it’s very difficult to have a rational debate.

“As soon as someone says there could be a better way of organising it, people jump up and say you want to privatise it.

“There are countries across Europe and the developed world that don’t have a system like America – for example, France, Germany and Norway. There are different schemes.”

He added that using private providers to run a specific service could be beneficial, saying this happened previously under Labour.

Asked whether it would harm the NHS to see money going to profit-driven companies, he said: “The purpose isn’t to put money back in the system, it’s to treat people who need it.”

He also questioned the definition of privatisation. “Is that privatisation, or is it privatisation when you ask people to pay for it?

“That’s never going to happen. The NHS is as much of a sacred cow to the Tories as it is to Labour.”