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CCGs’ independence threatened by choice regulations

BMA warns law could force CCGs to open all services to competition

Adrian O'Dowd

Wednesday, 27 February 2013

Doctors’ leaders have called for an urgent parliamentary debate on Health and Social Care Act regulations covering patient choice and competition in the NHS.

The BMA is worried that GP-led clinical commissioning groups (CCGs) could be forced to open up provision of almost all services to a market of providers, creating a compulsory competitive market in which the private sector would bid for NHS contracts.

New Section 75 regulations, which would implement aspects of the legislation, were laid in Parliament earlier this month and are designed to ensure good procurement practice.

However, the BMA has concerns that they will open up the NHS in England to widespread competition, despite government assurances to the contrary, and allow a growing role for the private sector in the NHS.

The regulations say commissioners can only award a contract without competition if they are “satisfied that the services to which the contract relates are capable of being provided only by that provider”.

The BMA has already warned of the dangers of increased competition and wants the regulations to be debated in Parliament as well as the government to provide additional clarity on its intentions.

BMA council chair Dr Mark Porter has written to the House of Lords secondary legislation scrutiny committee, drawing its attention to the regulations, and urging it to add its voice to the calls for a debate.

Dr Porter’s letter says: “This is an extremely important matter that highlights very serious concerns about the role of choice and competition in the health service, which are at the heart of the government’s reform agenda.”

Dr Porter points out that the BMA had raised concerns that good practice in relation to procurement – which presumes a need for competition – would prevent cooperation between commissioners and existing providers that is in the interests of improved patient care.

“We have repeatedly argued that CCGs should be able to place contracts with the most suitable providers without fear of being accused of anti-competitive behaviour,” he said.

“We feel it is imperative for CCGs to be free to design new clinical pathways in the best interests of patients, built around integration of services, inclusivity and partnership.

“As there is such a wide range of views on the implications of the legislation, we believe that there is a pressing need for a debate, which would afford the government the opportunity to clarify the intended scope of these regulations.”

Dr Porter has also written to health minister Earl Howe and Labour shadow health secretary Andy Burnham on the subject.

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