The government has rowed back from a promise to prioritise the NHS as the ‘preferred provider’ of health services, opening the way for increased privatisation.
The preferred provider pledge, made by health secretary Andy Burnham in September, has been “essentially neutered” by new guidance on procurement and commercial practice, claim independent sector and charity organisations.
Three new guidance documents make it clear that PCT commissioners should engage with a range of potential providers before deciding whether to issue an open tender.
The new rules state that the commissioning process, including any form of procurement, should be “non-discriminatory and transparent at all times” and should not give an advantage to any sector (public, private, third sector/social enterprise). PCTs are now required to “give all providers fair and equal opportunity to bid”.
“The guidance provides the clarity to ensure we get the best provider offering the best quality care for patients at the best price for taxpayers,” explained Burnham.
“Independent and third sector organisations will continue to make a valued contribution to providing treatment and care, helping to add capacity, improve quality, increase patient choice and drive innovative practice,” he said.
But he also made it clear that where existing NHS services were delivering a good standard of care for patients, “there is no need to look to the market”.
The guidance also stresses that where existing NHS providers are failing they must be given two chances to improve before contracts are terminated.
David Worskett, director of the NHS Partners Network, the organisation representing independent providers, said the new guidance marked a move towards a more open and competitive market with lower barriers to entry.
“The guidelines stress the importance of non-discrimination between providers, make a fresh commitment to the use of the independent sector and are clear about the need to use robust procurement to tackle under-performance. They effectively concede that while mainstream NHS organisations and their staff will inevitably continue to be the principle providers of healthcare, the unwise and anti-competitive concept of preferred provider has essentially been neutered.”
Stephen Bubb, chief executive of ACEVO, which represents charities, said: “This guidance is the final nail in the coffin for the preferred provider policy, which has been well and truly neutered. The Department of Health has explicitly told NHS commissioners that they must not prefer providers from any one sector, and should instead be non-discriminatory and seek to remove barriers to third sector participation.”
The BMA, which has been running a campaign highlighting the threat of the market to the NHS in England, gave a muted response to the new guidance. A spokesman said: “While we would have welcomed a more explicit commitment to the NHS as preferred provider, this guidance does keep the principle intact. The BMA will continue to work to highlight the benefits of public provision of NHS care, and the problems and waste created by competition.”
The new guidance is called revised Principles and Rules for Cooperation and Competition; revised PCT Procurement Guide, and Commercial Skills for the NHS.
Meanwhile, three private sector bidders have been shortlisted to win the franchise to run a DGH in Cambridgeshire. The companies seeking to run Hinchingbrooke Health Care Trust include Circle, Ramsay Health Care UK, and a partnership between Serco Health and Peterborough and Stamford Hospitals Foundation Trust. They have been invited to discuss their proposals for the heavily indebted Hinchingbrooke Hospital with NHS East of England, commissioners, hospital staff and others.
Read a blog on the preferred provider issue.
Tags: Preferred provider, Privatisation
We all have an emotional attachment to the NHS; and rightly so, for it is based on the ethical principle with which few would disagree - that no one should be denied health care because they cannot afford to pay for it personally.
However, is it not time that we took a cool look at the provion of health care throughout the country? And maybe face some unpleasant facts? It is indisputable that some NHS services are badly managed and some are excellent. Similarly, some private sector services are bad and some are good. And not all charities provide the best service.
What we want is a good quality service at a sensible ‘price’ (all services have to paid for somehow). We do NOt want to see public money wasted; and we do NOT want to see private companies making large profits out of Govt. contracts.
Particularly in the present economic climate, it is important that any contract provides a good quality service; but the problem is that NHS managers (and indeed managers in other Govt. services) do not seem to understand the meaning of the word QUALITY - or they have a different definiton from that used by clinicians! Furthermore, they do not seem to be able to write a contract that can deliver a service that meets the standards we (and our patients) expect at an ‘affordable’ price that is ‘cost-effective’.