Payment by Results 'ill thought out' says former Blair adviser

A strategy for coping with institutions that fail under Payment by Results was never really thought through, a former health policy advisor to Tony Blair has admitted.

Professor Julian le Grand, speaking at a seminar in Oxford this month entitled 'Healthcare re-imagined - what is the role of private provision in the NHS?', said there were other problems in the shake-up to promote choice and competition. These included private companies being able to select the least costly patients.

Mr James Johnson, chairman of the BMA Council, asked: 'Who is going to protect all the services the private sector don't want to provide?'

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