David Cameron faces fresh questions about his election strategist Lynton Crosby after it emerged his lobbying firm advised private health companies at the time of NHS reforms.
Mr Crosby's company told a group of private healthcare providers how to exploit perceived "failings" in the NHS, the Guardian reported.
Labour frontbencher Andy Burnham called it a "shocking conflict of interest".
A Conservative spokesman said Mr Crosby had never lobbied the prime minister.
The Guardian said a slideshow presentation was produced for the H5 Private Healthcare Alliance by Mr Crosby's firm Crosby Textor towards the end of 2010, just months before the government's Health and Social Care Bill was given its second reading in the House of Commons in January 2011.
The presentation stated that people believed the NHS provided good health care, but that it was "too bureaucratic with long waiting lists".
Cigarette pack furoreCrosby Textor advised its client that 63% of those questioned in a poll conducted for the presentation agreed that "going private frees up the NHS waiting list".
Mr Crosby, who masterminded the Tories' 2005 election campaign, was brought back into Conservative HQ by the Prime Minister in November last year.
The health presentation pre-dates the Australian's hiring by Mr Cameron.
This latest discovery follows Labour leader Ed Miliband's call for an inquiry into whether Mr Crosby was behind the prime minister's decision to shelve plans for plain cigarette packs.
Shadow health secretary Mr Burnham said: "It is more evidence of a shocking conflict of interest that David Cameron has created at the heart of his government.
"Shortly after Lynton Crosby started work for the Conservative Party, the government shifted its position in favour of private health companies by trying to sneak NHS regulations through the House forcing services out to the market.
"At the time, experts expressed surprise at the sudden shift in position. Now we can guess why."
But a Conservative spokesman denied that Mr Crosby had any influence on Mr Cameron's policy decisions.
"The prime minister has been clear that Lynton Crosby has never lobbied him on anything. Lynton Crosby is an adviser to the Conservative party. He does not advise on government policy."
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