Alliance concerned over NHS competition reforms
pharmafile | February 10, 2011 | News story | | Health and Social Care Bill, NHS, NHS Alliance, NHS reforms
The NHS Alliance has called on the Government to clarify major issues around the Health and Social Care Bill which it says could jeopardise the plans for clinically-led commissioning.
The organisation, which represents GPs and other primary care health professionals, says a poorly thought out and badly implemented reform could have significant consequences for the NHS and its patients.
Michael Sobanja, chief executive of the NHS Alliance, said: “Clinically-led commissioning, as proposed in the Bill, provides the best chance for the NHS to deliver a truly integrated care for its patients, where local needs are fully met. This is something we have long campaigned for, hence the full support we have shown the Government’s reforms over the past months.
“However, some key aspects of the Bill leave open the possibility that service may become less integrated, less accountable, less fair and less transparent. So we need to make sure these are fully addressed.”
Sobanja was one of several experts who gave evidence on Tuesday to the committee of MPs charged with scrutinising the Bill.
The NHS Alliance calls for clear, written commitments from the Government on three key issues:
Competition: Competition should be used to stimulate greater integration of services and not fragment them. Specifically, the “Any Willing Provider” should be a policy which ensures that commissioners are able to nurture effective collaboration between diverse, innovative, high-quality providers and not a general policy which can be used to flood the provider market and undermine commissioning based on local needs.
Public Accountability: Commissioning should remain both now and in the future publicly accountable, a function that should be undertaken by statutory bodies acting on behalf of and accountable to local communities.
Making a commissioning-led NHS a reality: The rhetoric about a commissioning-led NHS must be cemented in reality – one that requires commissioners to work with providers, but to hold ultimate responsibility and authority to meet local needs; for regulators to act in a manner supportive of commissioning requirements; and for the national commissioning board to adopt a style of management which is truly enabling and empowering.
The NHS Alliance raised several more detailed issues, which it says require urgent written clarification in relation to the Bill itself. First of all is the question of whether GP commissioning consortia will be subject to the Freedom of Information Act – as they should be, in line with the Coalition Government’s core principles of openness and transparency. The Alliance says this must not become the territory of ‘commercial in confidence’ withholding of information about the use of public money.
Secondly, it says the Government should remove any tensions between section 24D of the Bill (the clause that requires practices to act in a manner consistent with consortia policy) and the duties conferred on individual GPs by the GMC and the contractual elements of practice-held contracts (GMS, PMS and others).
Finally it wants to see the adoption of maximum tariff pricing – i.e. allowing providers to compete on price – to be used only when the quality of a service can be guaranteed.
Mr Sobanja said he believed the “direction of travel” was absolutely right, but that the reforms needed to ensure the interests of public and patients came first. Other issues of accountability; equity and transparency also needed to be enshrined in the legislation.
Click here to view a video of the House of Commons’ committee meeting
Andrew McConaghie
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