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01.03.13

Competition rules ‘nail in the coffin’ of public NHS

The controversial regulations that seem to open up the NHS to far more competition must be changed, doctors have warned.

Over 1,000 doctors and nurses are demanding that the Government withdraw regulations that would force NHS trusts to open up competition with private providers.

The call comes after it emerged that Monitor would be given powers to “force” trusts to introduce competition, although the DH has briefed reporters that it is to review the regulations following the outcry.

The NHS (Procurement, Patient Choice and Competition) Regulations 2013 made under section 75 of the Act are being considered by the House of Lords Legislation Scrutiny Committee on March 5.

The doctors wrote in the Daily Telegraph: “We are concerned about the Government's proposed secondary legislation (under Section 75 of the Health and Social Care Act) to force virtually every part of the English NHS to be opened up to the private sector to bid for its contracts.

“These regulations were proposed on 13 February and will become law on 1 April unless MPs first insist on a debate and then vote them down.

“Parliament does not normally debate or vote on this type of regulation, but it is possible. We urge parliamentarians to force a debate and vote on this issue to prevent another nail in the coffin of a publicly provided NHS free from the motive of corporate profit.”

Signatories include Dr Clare Gerada, chairman of the Royal College of GPs, and Professor John Ashton, incoming president of the Faculty of Public Health.

Labour MP Andy Burnham, shadow health secretary, said: “The Government needs to start listening and they should start by withdrawing these regulations without delay.

“What is now clear is that the medical professions and Parliament have been treated with contempt – the Government is now forcing competition through the back door. People have never given them the permission to put the NHS up for the sale and they need to be forced to remember that.”

Dr Michael Dixon, head of the NHS Alliance and a member of NHE’s editorial board, told Pulse magazine that the move could lead to GPs leaving the NHS in protest.

He told the BBC that competition should only be introduced when in the interests of patients: “I don't want tenders, which cost a lot of money and time, when a local provider is doing a good job. Sadly, I think this is what one or two of the clauses might lead to.”

A Department of Health spokesman said: “The Government is absolutely committed to the principle that doctors and nurses – in clinical commissioning groups – will be able to decide how services should be provided, because they know what patients need best of all.

“The regulations will make sure that doctors and nurses can decide when and where to use competition so they can improve services for patients.

“However, we do recognise that concerns have been raised about the way in which the regulations could be understood and we want to do everything we can to address these issues and provide clarity for all concerned.”

David Worskett, chief executive of the NHS Partners Network, said: “The draft S.75 regulations provide a vital framework for ensuring that commissioners use the best available processes for securing the best quality and best value care. The regulations essentially place onto a statutory basis the guidance and rules that have been in place since early 2010, when they were introduced by the last Government.

“The Regulations will also ensure that the health sector, which has some unique conditions, has the benefit of a specialist sector regulator that understands the sector properly and can act accordingly.

“There is widespread agreement that patients must be at the centre of the reformed NHS. The Mid Staffordshire Inquiry has made absolutely clear the need for constant vigilance and challenge to ensure proper standards of care for all patients. It has also made clear that the NHS urgently needs to embrace a new culture and new approaches to delivering care. One of the most important means of achieving this is to ensure that commissioners have obligations to open the way for the potential contributions that can be made by new, innovative, providers. But commissioners also need a legally secure framework for doing so, and these regulations are a key part of that.

“The regulations as drafted are consistent with overall governing procurement and competition law. Watering them down can only create ambiguity and leave patients, taxpayers, commissioners and providers in a worse position. The Government must stand firm and we will be urging Ministers to do so.”

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Comments

John Moon   06/03/2013 at 13:55

1. Competition laws often have the oipposite effect. A health facility was built in our locality a couple of years ago. Because the budget was over a certain amount it had to go out to European tender, which meant that only bidders with "Procure 21" status could tender. Obtaining this status is all about red tape and cost so only larger companies qualified. They then effectively became a cartel and no one from outside was allowed to bid. They therefore effectively excluded genuine competitive bidding. All the quotes from the cartel members were above £3000 per square metre. When we added 3 rooms to the back of our premises the tenders were in the region of £1600 per square metre - half that of the Procure 21 tenders. The so called competition meant the public were paying double for their health facility, and Procure 21 is actually anti-competition. The public would be outraged if they knew the truth. 2. We saw what happened with the west coast rail tender. Virgin appealed and the contract was withdrawn. This could potentially happen with all the CCG contracts if private providers can contest every decision as being anti competitive, and this proposed change to the Act could mean the CCG are spending more time fighting legal battles with private providers than delivering care. 3. Private providers will cherry pick the profitable stuff and leave the rest for a run down NHS to deal with - 2 levels of care will result. Elderly will probably suffer most. It is also in their nature offer loss leaders and special deal to corner the market then when they have starved out the opposition their prices will mulitply. Every private company aims at a monopoly and the closer they get the more they can charge. PFIs are only now being seen for what they are - a low start mortgage with horrific costs when the honeymoon period is over. Private health tendering will lead to the same outcome. By the time the proverbial hits the fan the politicians and Directors of the private providers will have taken a fat pension and be sitting on a beach somehwere laughing at the stupidity of the people which allowed them to get away scot free from shafting the nation.

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