Hospital Dr News

Health Bill to create private sector advantage

Doctors representatives are continuing to seek amendments to the Health and Social Care Bill as more detail is revealed about clinical commissioning groups will function.

The BMA says new proposals from the government would give the commercial sector an in-built advantage in the commissioning support process.

Draft guidance from the Department of Health – Developing commissioning support: Towards service excellence – makes a number of recommendations about how CCGs should function from 2013, including how the technical and ‘back-office’ functions should be provided.

Current PCT clusters are forming commissioning support units and from 2016 would be encouraged to form social enterprises and partner with the private sector.

These proposals would position commissioning support in a full-scale market and introduce commercially-focused criteria to determine who is eligible to provide this support. These criteria would make it very difficult for CCGs to employ their own commissioning support staff and for NHS commissioning support bodies evolving from existing PCT clusters to compete against large, established commercial organisations.

CCGs, the BMA says, would be left with little choice, but to use these large, commercial organisations to provide a huge range of commissioning support services, from transactional services such as payroll and IT services, to equipping CCGs with the complex and sensitive population data that inform commissioning decisions.

This could lead to an imbalance of power between clinical commissioners and large, commercial providers of support, undermining the government’s proposals for genuine clinician-led and locally-focused commissioning.

Dr Laurence Buckman, chairman of the BMA’s GP committee, said: “The government promised a greater role for clinicians in its plans to reform the NHS and created CCGs, placing local GPs and other healthcare professionals in a leading position in the commissioning process. Yet now it seems barriers are being put in place that would undermine the ability of clinicians to take local decisions.”

Read about another BMA representative running in protest at the Bill.

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