Hospital Dr News

“Competition regulations should be replaced”

Doctors leaders have called for controversial competition rules to be withdrawn and replaced ahead of a crucial House of Lords debate next week.

In a briefing paper sent to peers ahead of the debate, the BMA calls for the withdrawal of the regulations that detail how aspects of patient choice and competition operate under the Health and Social Care Act in England.

They should be replaced with new regulations that unambiguously reflect previous government assurances that commissioners will not be forced to use competition when making their commissioning decisions. The BMA is pressing for this principle to be explicitly stated in the regulations.

The BMA argued that mandatory competition for all services risks fragmentation of services and creates unnecessary transaction costs, making it harder for the NHS in England to deliver high quality, cost-effective and integrated care to patients.

Regulations, which were first laid before Parliament in February, set out how competition and patient choice would work under the Health and Social Care Act.

At the time, health minister Norman Lamb told MPs the wording of the regulations had “inadvertently created confusion”. He said there would be no privatisation of the NHS and that competition was only a means to improving services not an end in itself.

The re-drafted regulations were intended to ensure good procurement practice, but have continued to prompt widespread concern and uncertainty about the apparent requirement for competitive tendering for most health services.

Dr Mark Porter, chair of BMA council, said: “The absence of expected guidance on how the competition regulations would operate in practice, and the lack of satisfactory guarantees in these regulations, has created great uncertainty and anxiety for clinicians and patients.

“Only explicit wording in the regulations would allow patients, doctors and commissioners to be absolutely certain that clinicians will have the freedom to act in the way they consider to be in the best interests of patients.”

Meanwhile, a letter signed by over 700 doctors has been sent to the Academy of Medical Royal Colleges, as part of the Call on Your College initiative, calling for it to lobby for withdrawal of the competition regulations. “The role of the Royal Colleges and Academy are vital to swaying the Lords debate,” a spokesperson said.

On Wednesday 24 April, the House of Lords will debate the following ‘fatal’ motion secured by Lord Hunt of King’s Heath: ‘National Health Service (Procurement, Patient Choice and Competition) (No. 2) Regulations 2013 – Motion to Annul’.

Read the BMA briefing.

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