The DH has published a consultation on which organisations should be required to hold a licence from Monitor. Licences would be required after next April, when Monitor will have the power to regulate prices, promote integration and protect against anti-competitive behaviour.
The consultation proposes that Monitor would have powers to take action if a provider breaches a licence condition, fails to hold a licence or fails to provide Monitor with information it has requested.
Under the plans, Monitor will be able to take three enforcement actions. It could impose a ‘compliance requirement’ on the provider to take action to stop the breach in question. It could impose a ‘restoration requirement’ on the provider to take action to restore a position to what it was before the breach. Or it could impose a variable monetary penalty’ on the provider.
The consultation states that this penalty could be ‘a fine of such amount as Monitor may determine, up to 10% of its turnover in England’. This would represent over £90,000 for an average GP practice in England.
The 39-page consultation explains that, although the DH is recommending that primary medical and dental services should initially be exempt from the requirement to hold a licence, the government could overturn this.
‘We are recommending that providers of primary medical and dental services should initially be exempt from the requirement to hold a licence,' the consultation said.
'However, when the government carries out its proposed review, during the next parliament, of how the licensing regime is operating, it will consider this aspect specifically. It may be that, in the light of that review, it would be appropriate to license providers of primary medical and dental services in future.’
The consultation said that the DH would not have a role in determining how Monitor will calculate fines, adding that it would be for Monitor to decide.
GPC negotiator Dr Chaand Nagpaul said there is no justification for English practices to be forced to hold a licence from Monitor.
He said: ‘English practices are already subject to greater regulation than the ones in the devolved nations. To add to that with a wholly unnecessary bureaucratic tier would serve no purpose. The GPC has not had to argue the case against it as we thought it had been dismissed a long time ago.
‘It does not make sense and has no rationale.’
The consultation said that the DH is proposing that all NHS foundation trusts should be required to hold a licence from Monitor, ‘without exception’.
The consultation is due to close on 22 October.