Let GPs decide when to enforce competition

Monitor should not be allowed to dictate how consortia commission services, says NHS Alliance.

Dr Dixon: 'Don't let Monitor start pushing in and telling consortia they are not fulfilling some ghastly market philosophy that doesn't have anything to do with patient care.'
Dr Dixon: 'Don't let Monitor start pushing in and telling consortia they are not fulfilling some ghastly market philosophy that doesn't have anything to do with patient care.'

GP consortia must be free to decide when to use competition to help them commission services and not be dictated to by Monitor, the NHS Alliance chairman has said.

Under current NHS reform plans, foundation trust regulator Monitor could be handed a duty to enforce competition between NHS providers.

But Dr Michael Dixon told a joint NHS Alliance and King's Fund commissioning conference in London last week that GPs 'must be king' in deciding when competition was appropriate. Other speakers warned that the government's 'any willing provider' policy - often referred to as 'any qualified provider' - was not appropriate for all NHS services.

Dr Dixon said: 'Put the cards in the commissioners' hands so they can decide how much competition and integration they need, and trust them.

'Don't let Monitor start pushing in and telling them they are not fulfilling some ghastly market philosophy or false ideology that doesn't have anything to do with patient care.'

GP consortia should be able to decide where to use the any willing provider policy, when to put services out to tender, and when to collaborate with providers, he said.

Dr Sarah Baker, a GP and accountable officer for Warrington Health Consortium, told the conference that any willing provider should not be introduced for all NHS services.

'It is super for those little, acute, one-off interventions,' she said. 'It just doesn't apply to the biggest part of long-term conditions where you want integration between providers.'

King's Fund director of policy Anna Dixon agreed the policy was most appropriate for 'rather small items of care', such as a chiropody service.

'We need to be very clear about where it is and isn't appropriate,' she said. 'The big question is will the NHS Commissioning Board decide and make it mandatory where any willing provider services have to be, or will GP consortia have discretion themselves.'

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