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Playing field far from level

From Dr Angus Ross

Kirkby Stephen, Cumbria

This may already be common knowledge, but I was shocked in a practice-based commissioning locality meeting this week when our PCT senior commissioning manager told us that all services agreed by the PCT must go out to tender.

I am hopefully setting up a rapid-access breathlessness clinic in the Upper Eden

Valley, Cumbria, and am making progress with the business plan. From what we were told, however, after identifying the need for a service and doing all the work on the business plan, private providers would then have the opportunity to swoop in and win the contract.

Apparently the invitations to tender would be placed in 'European journals', presumably at the PCT's expense.

I was reassured and told not to worry as 'as long as someone is providing the service, it shouldn't matter who it is'. So much for being innovative and undertaking extra training for accreditation when it all may be a waste of time.

If this is true it will surely have huge implications for the NHS as all the new services to provide community, as opposed to hospital care, would be available to private providers with all the legwork done by GPs as individual practices or consortia.

Does anyone know if this is true?

· From Dr UA Pathak

Cobridge, Stoke-on-Trent

During the last two years a lot has been said and written about practice-based commissioning, not least that, if the profession is not careful, private providers may take over.

But it is not clear on what basis an alternative provider would take over a practice.

If a practice let an alternative provider take the role of commissioner, instead of the practice, would it affect either PMS or GMS income?

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