Hospital Dr News

Lansley opens up NHS services to competition

Patients will be offered greater choice following the opening up of more than £1bn of NHS services to competition in England, the government has claimed.

From April 2012, eight NHS areas, including musculoskeletal services for back pain, adult hearing services in the community, wheelchair services for children, and primary care psychological therapies for adults, will be open for “competition on quality not price”.

When patients are referred by their GP, they will be able to choose from a range of qualified providers – from the private, public or voluntary sector – who meet NHS quality, prices and contracts.

To date, choice has only been available in non-urgent hospital care, but the guidance sets out how it will be extended to community and mental health services, and has prompted claims that the NHS is being privatised.

The Future Forum recommended a phased approach to introducing competition, which the government has adopted. If successful, the “any qualified provider” policy would from 2013 see non-NHS bodies allowed to deliver more complicated clinical services in maternity and ‘home chemotherapy’.

The BMA, however, raised doubts over how much meaningful choice can be offered. Dr Hamish Meldrum, chairman of BMA council, said: “We support greater choice for patients, although in an NHS with finite resources it will always be limited. What we would question is the assumption that increasing competition necessarily means improved choice.

“When competition results in market failure in the NHS, the ultimate consequence is the closure of services, and the restriction of choice for the patients who would have wished to use them.”

Every area across England will be expected to offer more choice in a minimum of three services by September 2012 – either from the recommended list or for another community or mental health service that is a high local priority.

Health secretary Andrew Lansley said: “This is a big day for patients – real choice over how and where they are treated is becoming a reality. There is often confusion about these policies – a mistaken idea that competition is there for the sake of it, or to increase the independent sector’s role in the NHS.

“But let’s look at what this is really about: it’s about children getting wheelchairs more quickly. It’s about people with mental health conditions choosing to receive their care somewhere closer to home. It’s about older people being able to choose a service that will come to their home…It’s about real choices for people over their care, leading to better results.”

There eight services that have been recommended as the most suitable are:

Services for back and neck pain

Adult hearing services in the community

Continence services (adults and children)

Diagnostic tests closer to home

Wheelchair services (children)

Podiatry services

Leg ulcer and wound healing

Talking therapies (primary care psychological therapies, adults)

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