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Ministers tell trusts to offer firms bulk discounts on polyclinics

By Gareth Iacobucci

Ministers have advised PCTs to gain financial benefits by setting up bulk deals with private providers to run multiple GP-led health centres.

Guidance from the Department of Health instructs trusts to seek discounts from providers in return for the award of multiple contracts.

The move paves the way for private firms to undercut GP practices and is the clearest evidence yet that the tendering process has been slanted in favour of the private sector.

Private providers are far more likely than GPs to be able to run multiple centres, with some putting in more than 50 bids apiece.

The DH guidance, entitled ‘provider discounts for multiple contracts', says: ‘It's recommended that where more than one contract is being procured, PCTs should consider whether, in addition to pricing each contract on a standalone basis, bidders should also be required to offer discounts for award of multiple contracts.

‘Discounts should be considered on a case-by-case basis where PCTs believe that economies of scale and value for money can be enhanced.'

The guidance, issued at the start of the tendering process, permits PCTs that are combining bids with neighbouring trusts to award contracts to one bidder, in return for reductions in price.

But it has provoked outrage from GP leaders, who claim it is proof the tender process is biased towards the private sector.

Dr Martin Baldasera, a GP in Hetton-le-Hole, in County Durham, who dropped out of the running for a Darzi centre because of the cost and bureaucracy of the tender process, said the policy was unfair on smaller bidders.

‘It's undermining general practice. If I was bidding for several, how would I be a doctor? I'd be a businessman.'

The DH has removed the advice from an updated version of its commercial strategy, claiming it wants to avoid confusion in the late stages of the procurement process. A spokesperson said: ‘Where PCTs wish to make local variations, they are free to do so but asked to carefully consider the implications.'

PCTs should ‘give due consideration to allowing bidders to offer discounts, where they are bidding for several schemes being procured by a single authority or where several PCTs have aggregated procurements', the spokesperson added.

Dr Richard Vautrey, GPC deputy chair, said the policy would inevitably favour large commercial bidders. ‘These elements make it that bit more difficult for local practices to put in bids to run a practice within their own area.

‘But even with those that have possibly put in loss-leading bids, it will come back to bite you eventually. The provider will soon realise it's not financially viable to maintain the service within the contract price, and will be approaching the PCT for more money.'

Dr Martin Baldasera: 'If I was bidding for several centres I'd be a businessman.' Dr Martin Baldasera: 'If I was bidding for several centres I'd be a businessman.'

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