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Monitor should form greater understanding of primary care, say MPs

Monitor needs a greater understanding of primary care providers, a parliamentary report has concluded, amid fears from GPs around forming federations in case they fall foul of competition law.

The Commons Health Committee’s annual inquiry into the work of the health service regulator has also found that it needs to develop a ‘better understanding’ of primary care and third-sector providers, and review those relationships.

In evidence to the hearing, the BMA warned that GPs were ‘wary’ of forming federations due to ‘concerns that they may be in breach of competition law’.

The health committee report also recommended Monitor visit new commissioning organisations to ensure they understand the practical implications of guidance on competition rules.

Monitor released guidance on the Section 75 competition regulations – which compels commissioners to put services out to tender unless there is only one potential provider – in December, which stated that the new rules are similar to previous regulations.

But the BMA said that this did not allay fears around competition law, which threatens moves towards federations and greater integration.

In its evidence to the committee, the BMA said: ‘Within primary care there is a consensus emerging that larger groupings of GP practices, such as federations or alliances, are highly desirable if GPs are to cope with increased demand.’

‘This will allow them to pool resources and to provide innovative, integrated services.

‘However, GPs are wary of pursuing such groupings due to concerns that they may be in breach of competition law.’

The health committee report agreed with the analysis, saying: ‘The committee recognises that Monitor’s developing role as the health and care sector regulator requires it to develop a detailed understanding of a wide range of providers including primary care and third sector providers.

‘Concerns have been expressed to the Committee by representatives of both the third sector and primary care that Monitor has not yet developed this understanding in sufficient depth.’

It added that it will ‘seek specific evidence on this matter at the next accountability hearing’.

The report comes after Monitor told CCGs they can avoid putting services out to competitive tender if providers are already meeting the needs of patients.

Readers' comments (5)

  • Vinci Ho

    The health committee report agreed with the analysis, saying: ‘The committee recognises that Monitor’s developing role as the health and care sector regulator requires it to develop a detailed understanding of a wide range of providers including primary care and third sector providers.
    Seriously ?? Are we not expecting that this is the fundamental requirement from Day 1 ? What the hell has the Monitor been doing last 12 months ? How much are taxpayers paying to feed these guys everyday????

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  • What do monitor do?
    Is it really that different to the CQC and are both really needed?

    In fact I think the number of regulators is getting ridiculous.
    GMC, performers list, appraisers/ revalidation process, CQC, monitor, local area team/ nhs england, CCG, deanery for trainees, medical school for students and today we had someone in to inspect the plugs.

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  • the rise of the new quangos.. different names.. same old behaviour

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  • Competition in the NHS is a joke as is the existence of monitor. Contracts put out to tender at loss leading values by a monopoly employer attempting to get value for money is not going to encourage competition. Many private firms are unlikely to touch services put out at the current pricing guidance. The days of APMS contracts being awarded at prices well over basic GMS funding have long gone (However May return when a panicked government suddenly finds itself with no GP services and has to encourage all it's large multinational provider friends with sweeteners to take on contracts). I am aware of a few CCGs where there have been so few AQP providers for a service previously well run as a LES that the deadline has been extended! This then becomes a disadvantage to providers who have already been approved! Competition working at its best!

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  • If privatisation is so wonderful why are Circle losing money for the second year since taking over? Same patients, same management, same funding but we were told that they would make a profit. Privatisation will not fill the £30billion black hole over the next 5 years. The choice is pay for a health service or suffer the consequences of an ageing population.
    When will the government learn you can't get something for nothing unless you are a mate of Osbourne and set the price of Royal mail and buy the majority of the shares.

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