Guest Editorial: Listening exercise must deal with competition

The NHS Future Forum has met a great deal of cynicism from all sides, and accusations that it is little more than a PR exercise, while vehemently denied, cannot be rebutted until we see the panel's recommendations.

I cannot recall a time in recent years when College members and the profession have been as gripped and galvanised into action as we have been over the reforms. While we are a pragmatic lot who can always be relied on to do the very best for our patients, whatever the circumstances, the strong reaction demonstrates our unswerving passion and pride in what we do.

The College agrees with the principles of placing the patient at the centre of the health service and giving GPs responsibility for commissioning, but believes there are fundamental changes that must be made to these proposals to make them practicable, practical and fit for purpose. We welcome GP-led commissioning, but this is just one part of a much bigger picture. We would like to see the report address and make recommendations based on our concerns about any willing provider and competition.

We are not opposed to competition where it adds value to existing services, but we are mindful that competition-driven structures can be expensive and time-consuming, and that it is certainly not the only answer to improving care. We believe the ideal arrangement should involve continuity of patient care through partnership working and not driving competition as an end in itself. The NHS exists to provide the best possible quality of care to all patients, free at the point of need. This must not change but we also want the NHS of the future to innovate and deliver services patients want and need, and we believe this ideal can be achieved through collaborative working between generalists, specialists, the third sector and others to promote and deliver excellent care.

I remain confident that we will see real changes enacted on these reforms as a result of the recommendations put forward by the profession. We will remain actively engaged and continue to propose sensible, enforceable solutions that will preserve the principles of all that is good about the current NHS and lead to further improvements in the future.

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