A massive extension of Monitor´s powers will see the organisation – which currently only oversees Foundation Trusts – in charge of a new and highly competitive NHS marketplace.
The Health and Social Care Bill extends Monitor´s powers to protect service users by promoting competition and regulating all providers. Its remit is also being extended to adult social care services.
Among its key functions Monitor will:
* license healthcare providers and set the criteria these must abide by
* have the power to impose a levy on providers to provide financial support
* establish the national tariff and setting a price or maximum price for services
* consult with commissioning consortia and providers before publishing the tariff
* potentially investigate the NHS Commissioning Board and consortia to ensure they comply with best practice procurement guidelines
* specify designated services which would have a significant impact on users’ health if discontinued
* review unilateral applications from commissioning consortia for variations to the tariff
Dr Johnny Marshall said it remained to be seen whether Monitor would use its ‘huge powers” constructively: ‘We´ll have to see in practice what they do. And hope they don´t want to over-regulate.’
At a recent conference, Andrea Longhi, partner at Ernst and Young and former director of commercial policy at the DH, said the challenges for market regulators had changed in recent years.
‘A lot of competition regulators focus on dominance, market shares and things like that.
‘But I have a hypothesis, that over the last few years and also in the future quite a lot of the potential detrimental competition is less about size and more about behaviour and conduct. And the behaviour among organisations and their professionals which isn’t in the consumers’ interest – that’s very difficult information to capture.’
Janice Barber, managing partner for Hempsons solicitors questioned whether the regulators could take on all the responsibilities.
‘CQC is taking over the roles of three regulatory bodies and doing it for about a third of the combined budget. Now that’s a bit different isn’t it?’