In this paper I argue that close attention should be paid to the changes that have been taking place in the National Health Service over the last 15 years as a result of governmental initiatives. The identification of the direction that the recent health reforms have been taking should allow us to draw significant conclusions regarding the possible fate that the NHS is facing in the not-too-distant future. The introduction of the internal market in health care, the Private Finance Initiative, private Diagnostic & Treatment Centres and Foundation Trusts may indicate that the privatization of the NHS has begun in earnest. The relevance of such considerations to all NHS workers and users needs to be appreciated, as it may go some way towards answering the important question of what kind of NHS we will be having and using in the future. The implications for the NHS in general, and for psychotherapy services in particular, of the insidious but invasive process of privatization inherent in the ongoing changes in the structure and funding of the NHS are discussed.