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Johnson signals major private sector expansion

By Steve Nowottny

The Government has signalled a dramatic increase in the role of the private sector in NHS spending decisions, after decided to nationally rollout its so called Framework for External Support for Commissioners (FESC), much sooner than expected.

The influence of FESC will be dramatically increased as Health Secretary Alan Johnson announced that all PCTs needing advice on commissioning services would now be allowed to seek support from a list of 14 approved companies.

Pulse revealed last week that half a dozen PCTs involved in the pilot were in talks with a string private providers, including the likes of controversial US giant UnitedHealth, Axa and McKinsey, about tapping into private sector resources.

They plan to follow Hillingdon which signed a deal in January with BUPA to become the first FESC partner.

But the surprise move by the health secretary sees the accelerator put firmly down on private sector influence in the NHS.

Mr Johnson praised the early success of FESC, which he claimed ‘can help PCTs to develop their capacity and skills to commission.'

‘We have been piloting FESC in a small number of trusts,' he said. ‘Many PCTs involved in FESC are discovering there are real benefits to bringing in FESC. In particular they can improve the skills of those involved in commissioning who work in the trust.'

But leading GPs expressed doubts over the real reasons for expansion plans. Dr James Kingsland, chair of the National Association Primary Care, said it pointed to major holes in PCTs' commissioning expertise.

‘We're going to be spending a lot of taxpayer's money on independent organisations helping PCT management to aspire to things they were appointed to in the first place,' he said.

Dr Michael Dixon, chair of the NHS Alliance, said: ‘If our PCTs aren't providing us with the right information or input, then I would hope they would allow us to access it directly from a FESC provider or give us the resources to do so.'

But he warned that major concerns over potential conflicts of interest remain.

‘I think that has to be looked into extremely carefully,' he said. ‘I would hope PCTs are engaging local GPs to ensure this is not in any way providing an advantageous market entry to say a FESC provider acting as a provider of primary care services.'

The move comes as thousands of GPs expressed strong opposition to the increasing role of private providers in primary care, as part of the BMA's contract poll.

The BMA's found widespread concern over the increasing expansion of private providers. Out of more than 27,000 GPs who responded, 92%said they believed an expansion of private commercial provision would be ‘detrimental to patients and the service as a whole'. Just 1% described the trend as ‘beneficial'.

GPC chair Dr Laurence Buckman warned GPs were seriously concerned that an increase in private provision would hit standards of patient care.

‘The Government must take heed of the strength of feeling shown in this poll,' he said.

But Dr Neil Bentley, CBI director of public services, defended the plans.

‘It is plain wrong to suggest that bringing in private providers will be bad for the NHS,' he said. ‘In other areas of the health service they have delivered high quality care and led to very satisfied patients.'

Alan Johnson: opening door wider for private sector Alan Johnson: opening door wider for private sector

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