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NHS Privatisation And Competition Remains Fully Intact

“References to unfettered markets might be missing in the revised health and social care bill, but competition will still play a significant role in the reformed NHS”

That is the sub heading in a major article written by Dr Richard Lewis, published in the website version of the influencial publication, Public Finance. A partner at Ernst & Young, Dr Lewis spent a decade working within the NHS, most recently as an executive director of a large health authority in London.

In article which appears to be at first read neutral, Dr Lewis provides a good analysis of the current situation with regard to the privatisation of the NHS, or NHS reforms as it is erroneously called amongst Tories and Lib Dems alike.

He comments:

“At first blush, it seemed as though there had been a spectacular climb-down……. “ and “The ‘pause’ in the progress of the health and social care bill appeared to be a rewind: the secretary of state was back in charge of the NHS, Monitor’s wings appeared severely clipped and GP commissioning consortia morphed into multi-specialty clinical groups with lay members and newly accountable to health and wellbeing boards.”

However, in reality little has changed, and this seems the main point of his critique of the current situation in Parliament. He indeed confirms what most of the public realise, and something that seems to have gone over the heads of both the Labour and Liberal MPs in opposition to Landsley’s plans.

click to read original article in fullDr Lewis continues:

“However, a closer look reveals a rather more subtle set of changes that alter the tone rather more than they do the substance of the reforms. This is nowhere more evident than with regard to competition policy, the lightning rod for much of the most vocal opposition.”

Acknowledging that there has been some withdrawal of attack by the Government he says:

“Price competition is dead for the foreseeable future. Monitor will no longer promote competition so much as police specific abuses of competition. Monitor will also have fewer powers to challenge commissioners who might be soft-pedalling on competition and will no longer be able to require providers to open up their facilities for use by competitors.”

But, he argues, it would be total folly to think the Government had stepped back from it’s competition dogma:

“The Principles and Rules of Cooperation and Competition (the code of practice that kick started the march to competition under the previous government) will not only remain, but will gain a statutory footing. The Cooperation and Competition Panel will survive, being lodged within the new Monitor.”

He confirms many people fears that the only thing that has changed is the rhetoric, but nothing has changed as far as the Tory plans for the NHS privatisation is concerned:

“Moreover, the ‘any qualified provider regime’, the subject of so much debate and – in some quarters – concern,  will be implemented from April next year (although it will initially focus on community services in addition to current hospital services already subject to choice).  As recommended by the Future Forum, the secretary of state will enshrine the duty of the NHS to deliver choice through a new ‘choice mandate’, presenting further opportunities for competition, if appropriate.”

His final words should echo in the minds of those who wish to protect the NHS from privatisation and competition:

“The move away from placing too much faith in unfettered markets – overestimating the real value of competition – is welcomed.

However, while the political war over the NHS looks set to continue in Parliament, it is hard not to conclude that competition has survived this particular battle relatively unscathed.”

Source: Public Finance magazine

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