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GPs still left unsure over competition rules

BMA calls for urgent clarification for commissioners

Adrian O'Dowd

Thursday, 04 April 2013

GPs and other healthcare professionals are lacking clarity over how commissioning should work in terms of competition rules, says the BMA.

Doctors’ leaders have renewed their call for the government to clarify how competition will be managed in the NHS following the full implementation of the Health and Social Care Act earlier this week.

In particular, the BMA is worried about the Section 75 regulations, which deal with competition when it comes to CCGs commissioning services.

Former Labour health minister Lord Hunt has secured a House of Lords debate on April 24 in which he will call for the Section 75 regulations to be annulled “on the grounds that they do not implement the assurances given by ministers to Parliament … that NHS commissioners would be free to commission services in the way they consider in the best interests of NHS patients”.

The BMA said it planned to brief peers on doctors’ ongoing concerns about the regulations.

Although the regulations have been withdrawn and amended already, the BMA said this had failed to answer concerns about the tendering of NHS services and the new role of Monitor under the Health and Social Care Act.

The BMA’s concerns were echoed by the Lords secondary legislation scrutiny committee, which examined the revised Section 75 regulations and also called for further parliamentary debate on the regulations.

The committee’s report published last month, said it was “very clear that there is no common understanding in the health sector of the requirement of the procurement rules contained in the substitute regulations”.

It also said the Department of Health has not allowed enough time to establish the system properly and enable thorough scrutiny. In addition, a lack of guidance from Monitor was a barrier to understanding.

BMA council chair Dr Mark Porter said: “We urge the government to give immediate and absolute assurances about the limits of competition, changing the wording of the regulations if this is what it takes, to ensure that its prior commitments match the reality on the ground.

“Although the revised regulations improved the original wording, we stressed the need for this to be supported by clear guidance to provide the assurance and clarity that is needed to ensure that competition does not undermine integration, innovation, or clinical autonomy.”

The guidance, being drawn up by Monitor, was due to be published for consultation last month but has not yet been finalised.

Meanwhile, independent political debate website OpenDemocracy, which runs a project called OurNHS, today published reactions from 15 experts on the regulations, saying there was much concern about their potential impact.

A range of health professionals, campaigners, academic experts, and politicians spoke out against the regulations, saying they would herald privatisation.

Lord Philip Hunt said: “The public will never forgive the governing parties for undermining one of the nation’s most popular services. Let’s hope that enough Tory and particularly Lib Dem peers understand their wider responsibility and support my motion to kill off the regulations.”

Dr Clare Gerada, chair of the RCGP, said: “The new reforms, of which these regulations are a key part, remove the legal framework for a universal, publically provided, publically managed, publically planned, democratically accountable health service.”

Dr Kambiz Boomla, Tower Hamlets GP and member of Tower Hamlets CCG, added: “These regulations are likely to be the death of clinically led commissioning, and the birth of lawyer led commissioning.”

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