Competition rules block transfer of work out of hospitals

Hospital trusts have warned that competition rules are preventing the NHS shifting services from secondary to primary care.

Hospital services: transfer to community held up by competition rules
Hospital services: transfer to community held up by competition rules

The ‘unthinking and rigid’ application of a market ethos in the NHS meant that trusts would be unable to evolve quickly enough, according to the Foundation Trust Network (FTN).

Network chief executive Chris Hopson told a debate at The King's Fund think tank in London that reconfiguration of services was essential but mergers were being stalled by overzealous regulators trying to ensure competition.

‘It’s very clear that the way we are providing healthcare currently, simply does not work. We are trying to meet 21st century needs with a 20th century system.

‘People with long-term conditions and the frail elderly need a very different pattern of care. So there is a real clinical need to move a whole bunch of services out of acute hospitals and much closer to the community.

‘We also have too many hospitals trying to do too many things and we absolutely need a degree of specialisation and centralisation.’

The FTN represents more than 200 NHS public provider trusts, including foundation trusts and NHS trusts, mental health and ambulance trusts.

Mr Hopson said the proposed merger of Bournemouth and Poole hospitals had come about because the trusts believed they would be clinically and financially unsustainable within three to five years, but had been held up for over two years in a competition and mergers control process.

He said the idea that the move could be deemed anti-competitive in an area like rural Dorset was ‘somewhat fanciful’.

But Catherine Davies, executive director of co-operation and competition at Monitor, the regulatory body for foundation trusts, told the meeting that competition was only one tool for addressing issues in the NHS, not a ‘silver bullet’ for every situation.

She added: ‘Providers will make decisions that are in their interests, and many times those interests will coincide with the interests of the people who use their services but not always, and not necessarily.

‘So if the trusts are trying to ensure they retain a degree of financial sustainability, the answer to that question is not necessarily the same as the answer to the question about what’s in the best interests of patients.’

* Tough competition rules are giving NHS trusts that sinking feeling

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