Local campaigners are warning a major healthcare shake-up affecting Enfield is part of the creeping privatisation of the NHS.

Members of a group called Defend Enfield NHS say a decision to merge the borough’s clinical commissioning group (CCG) with four neighbouring CCGs will lead to patient care being increasingly based on cost rather than need.

They claim it will lead to more private firms being used for NHS contracts – and more people feeling the need to take out private medical insurance.

CCGs were set up in 2012 and can buy in services from private health companies as well as NHS providers.

Enfield CCG is now merging with Barnet, Islington, Camden and Haringey CCGs to form the giant North Central London CCG.

This is part of a move to create an integrated care system (ICS) – a type of organisation the campaigners say mirrors a system found in the US.

These systems involve the NHS working closely with councils and other organisations to “help people to live healthier lives for longer and to stay out of hospital when they do not need to be there”, according to the NHS England website.

But Defend Enfield NHS member Martin Blanchard, a retired medical academic and NHS consultant, claimed the new system would be designed to “keep people away from expensive care” such as GPs and accident and emergency departments.

He said: “The idea is to reduce spend – as the population grows, to keep spend the same and keep people away from expensive care.”

Fellow campaigner Marion Judd, a former NHS physiotherapist, added: “Access to GPs is going to become more difficult.

“It will lead to patients needing operations such as hip replacements waiting much longer for treatment, placing pressure on them to consider taking out private health insurance to access earlier treatment.”

The campaigners said gradual privatisation of the NHS had been taking place since Margaret Thatcher’s government, and the CCG merger was one more step in this process.

Mr Blanchard added: “NHS England has a list of registered organisations allowed to provide support to set up and run the ICSs.

“Out of the 83 listed, only seven are NHS organisations, the rest are private companies and 23 of them are from the USA.

“The public have not been consulted about this. It is so important that they know – they are doing it behind their backs.”

Defend Enfield NHS aims to raise awareness of what is happening to local NHS services.

Its campaigners are leafleting, speaking at NHS and council meetings, lobbying MPs and giving public talks.

An NHS spokesperson said: “The single CCG will continue to work closely with local authorities, NHS providers, GPs, voluntary and community organisations at a borough level – including through the development of borough-based integrated care partnerships – to deliver high quality, accessible health and care services for residents, improve outcomes and reduce health inequalities across North Central London (NCL).

“Patients, services users, carers and residents will continue to be central to the development of plans at both the NCL ICS level and borough-based Integrated Care Partnership level.

“Patients and residents will continue to be represented on appropriate committees that are directly linked to the development and delivery of these models and the CCG’s key commissioning activity.

“There will continue to be an important interface with borough democratic structures to ensure public scrutiny is maintained via Health and Wellbeing Boards and Overview and Scrutiny Committees.

“At NCL-level, we will continue to work closely with the Joint Health Overview and Scrutiny Committee.”

The Conservative Party was also approached for comment.