By Caroline Ryan BBC News Online health staff in Harrogate

Members of the Royal College of Nursing debated the issue at their annual meeting in Harrogate.

Several government initiatives sparked nurses' concerns.

Speakers attacked the number of new hospitals built with private money under the private finance initiative, public private partnerships, and the introduction of foundation hospitals, where trusts will be given control over their own budgets.

Nicola Cottington, of the RCN's Lewisham branch, said: "We should be very concerned about the current government's tendency to privatise the NHS by stealth."

She said PFI was costing the NHS dear. "It's unprecidented. It's escalating out of control."

"The University College Hospital in London was initially supposed to cost �130m - but that had risen to �439m by the time the agreement was signed."

Mixed reaction

Many nurses working in larger PFI schemes, such as the Cumberland Infirmary, have complained they were not directly involved in the design of the building, such as ensuring rooms are big enough.

However, those working in smaller PFI projects, support the initiative because they have been closely involved in the design of the new hospital.

The RCN has also attacked foundation hospitals, saying they look to be more about profit than improving patient care.

It has also warned that they could draw staff away from other local hospitals because they would be able to offer better pay and conditions.

But some nurses defended the involvement of the private sector in the NHS.

Wendy Richly, chair of an RCN forum said the NHS bought in around 150,000 elective operations from the private sector, giving the health service added capacity.

She added had always used the resources of the private sector: "The NHS has never been entirely publicly provided."

Around 25% of RCN members work in the private sector. �