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Commissioners will be forced into ‘unfair competition’

BMA slams plan which ‘favours large business’

Jo Carlowe

Wednesday, 23 November 2011

Leading GPs fear new government proposals will give the commercial sector an in-built advantage in the commissioning support process.

Draft guidance from the Department of Health - Developing commissioning support: Towards service excellence – makes a number of recommendations about how clinical commissioning groups (CCGs) should function from 2013, including how the technical and “back-office” functions should be provided. Current primary care trust (PCT) clusters are forming commissioning support units and from 2016 would be encouraged to form social enterprises and partner with the private sector.

The British Medical Association says the proposal will position commissioning support in a full-scale market and introduce commercially-focused criteria to determine who is eligible to provide this support.

These criteria would make it very difficult for CCGs to employ their own commissioning support staff and for NHS commissioning support bodies evolving from existing PCT clusters to compete against large, established commercial organisations, the BMA warns.

Dr Laurence Buckman, Chairman of the BMA’s GP committee said: “The government promised a greater role for clinicians in its plans to reform the NHS and created CCGs, placing local GPs and other healthcare professionals in a leading position in the commissioning process. Yet now it seems barriers are being put in place that would undermine the ability of clinicians to take local decisions.  

“This latest guidance gives the commercial sector an in-built advantage and appears to be yet another worrying step towards an NHS focused on commercial priorities.”

The BMA says CCGs would be left with little choice, but to use large, commercial organisations to provide a huge range of commissioning support services, from transactional services such as payroll and IT services, to equipping CCGs with the complex and sensitive population data that inform commissioning decisions. This, they say would lead to an imbalance of power between clinical commissioners and large, commercial providers of support, undermining the government’s proposals for genuine clinician-led and locally-focused commissioning.

“CCGs need proper professional support, but they must have the flexibility to decide who is best able to provide these services,” said Dr Buckman.

“The skills and experience of staff in current PCT clusters will be invaluable as they support the development of CCGs. To provide continuity at a time of huge financial pressure and structural overhaul, current PCT clusters should be supported to become viable commissioning support organisations and should not be forced into an unfair competitive process with large, commercial organisations.

“We are seeking an urgent meeting with government to urge them to reconsider these proposals.”

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