Dr David Bennett told the Commissioning Show in east london last Thursday his body was focused on delivering the best interests of patients. A defence could be that the costs of going through the competitive process would outweight the benefits of doing so.
He stressed Monitor had no powers to prosecute or fine but could require contract change or re-tendering.
Asked which services were increasingly likely to be subjected to competition, he said: 'We're absolutely not trying to tell commissioners how to do their jobs. Some people want us to be more specific, others are very anxious we don't get into that. Legally, we're trying to stay out of that.'
* Watch the full question and answer session on our sister website Inside Commissioning.