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Warning over NHS competition rules from reform doctor NHS reform 'complete waste' warning
(about 3 hours later)
A leading architect of the government's NHS changes in England has warned they may be undermined by new rules opening the health service to more competition. Opening most of the NHS in England to private firms could alienate doctors and render the reforms "a complete waste of time", a GP who helped draft the plans has warned.
Dr Michael Dixon told GPs' journal Pulse that regulations on tendering out services should be rephrased. Dr Michael Dixon told GPs' journal Pulse that he feared GPs "will walk".
Meanwhile, more than 1,000 doctors have written to the href="http://www.telegraph.co.uk/health/healthnews/9901194/Scrap-NHS-competition-rules-say-1000-in-letter-to-Telegraph.html" >Daily Telegraph claiming the legislation makes "virtually every part" of the NHS open to private firms. He says the legislation's wording on competition must be amended or doctors could get "bogged down" in the process and distracted from patient care.
The government insisted there was no policy to privatise NHS services.The government insisted there was no policy to privatise NHS services.
Budget responsibilityBudget responsibility
Dr Dixon said clinicians would feel the whole process had been "a complete waste of time" unless the rules were changed. The balance of power is about to shift dramatically within the NHS, with GPs and other clinicians given much more responsibility for spending most of the budget in England.
He said he feared GPs "will walk" from the entire clinical commissioning process if this was not done. There is already competition for services such as physiotherapy, hearing tests and dermatology - which could be expanded to many other areas of care. Essential services such as A&E would be protected.
The regulations are currently before Parliament, with the reforms taking effect in a month. But the issue of involving the private sector to introduce competition for services was vehemently opposed by some critics within the medical profession when the changes were drawn up.
New local clinician-led organisations will take over responsibility for much of the health budget. Ministers responded by agreeing to introduce competition in a more managed and balanced way. However, there is fresh concern that legislation about to go through the House of Lords will force nearly every service to be put out to tender. Critics have said this is a blueprint for privatisation and goes against government assurances.
The rules for buying services set out in the regulations ban unnecessary restrictions on competition and say all providers - NHS or otherwise - should be treated equally. Dr Dixon, who heads the NHS Alliance - an organisation which represents doctors, nurses and managers on the front line - said the danger with the current wording of the rules was "that it seems to put a duty upon the commissioner to go for competition with all contracts that are made".
'Eye off ball' He warned that doctors would "start getting bogged down" in dealing with competition and would end up taking their "eye off the ball".
Critics have said this is a blueprint for privatisation and goes against government assurances. He told the BBC that getting the right level of competition was vital: "It means not having to introduce competition willy nilly - but using it when it's in the interests of patients.
Dr Dixon has been a leading champion of the changes, but he is worried that the proposed rules will mean doctors could get bogged down in the procurement process rather than getting on with making services better for patients. "I don't want tenders, which cost a lot of money and time, when a local provider is doing a good job.
He said the danger with the current wording of the rules "is that it seems to put a duty upon the commissioner to go for competition with all contracts that are made". "Sadly, I think this is what one or two of the clauses might lead to."
Dr Dixon said: "The aim of clinical commissioning was to innovate to redesign, to try and ensure that we do more outside of hospital and in primary care.
"Now, if that is their aim and they start getting bogged down in matters of issues of whether or not they are being competitive, that is going to take their eye off the ball."
'Nail in coffin''Nail in coffin'
In their letter to the Telegraph, the doctors and health-care workers called on MPs to force a debate and vote down the proposal. Meanwhile, href="http://www.telegraph.co.uk/health/healthnews/9901194/Scrap-NHS-competition-rules-say-1000-in-letter-to-Telegraph.html" >more than 1,000 doctors have written to the Daily Telegraph claiming the legislation makes "virtually every part" of the NHS open to private firms.
They wrote: "We are concerned about the government's proposed secondary legislation (under Section 75 of the Health and Social Care Act) to force virtually every part of the English NHS to be opened up to the private sector to bid for its contracts.They wrote: "We are concerned about the government's proposed secondary legislation (under Section 75 of the Health and Social Care Act) to force virtually every part of the English NHS to be opened up to the private sector to bid for its contracts.
"These regulations were proposed on 13 February and will become law on 1 April unless MPs first insist on a debate and then vote them down."These regulations were proposed on 13 February and will become law on 1 April unless MPs first insist on a debate and then vote them down.
"Parliament does not normally debate or vote on this type of regulation, but it is possible. We urge parliamentarians to force a debate and vote on this issue to prevent another nail in the coffin of a publicly provided NHS free from the motive of corporate profit.""Parliament does not normally debate or vote on this type of regulation, but it is possible. We urge parliamentarians to force a debate and vote on this issue to prevent another nail in the coffin of a publicly provided NHS free from the motive of corporate profit."
The government said the rules were about ensuring the process was fair to all concerned.The government said the rules were about ensuring the process was fair to all concerned.
Labour said the regulations should be withdrawn without delay. Sources close to Jeremy Hunt said he was aware of the concerns but was "confident" the regulations were in keeping with the promises made.
It is understood that ministers will be writing to peers who will be addressing this issue next week to "allay fears". There is also consideration being given to rewording parts of the regulations.
Labour MP Andy Burnham, shadow health secretary, said: "The government needs to start listening and they should start by withdrawing these regulations without delay.
"What is now clear is that the medical professions and Parliament have been treated with contempt - the overnment is now forcing competition through the back door.
"People have never given them the permission to put the NHS up for the sale and they need to be forced to remember that."
Do you work in the NHS? Are you concerned about privatisation and the NHS? What do you think of Dr Dixon's warning? Send us your comments and experiences using the form below.Do you work in the NHS? Are you concerned about privatisation and the NHS? What do you think of Dr Dixon's warning? Send us your comments and experiences using the form below.