A health minister has attempted to allay concerns around the number of services commissioners have to put out to competition, as the RCGP wrote to him to ask for ‘significant changes’ to the regulations surrounding the use of competition by CCGs.
Earl Howe wrote to peers attempting to diffuse the row over the section 75 regulations, which says that commissioners would have to open up services to competitive tender unless they have a good reason not to.
The letter comes as the chair of the RCGP, Professor Clare Gerada, became the latest high profile GP to call for the withdrawal of the regulations.
In a letter to Earl Howe, Professor Gerada wrote: ‘It is clear to us that, as they currently stand, the regulations will be interpreted by CCGs as requiring services to be put out to competition.
‘This will have significant implications for local determination, stability of services and transaction costs (given that tendering is a very expensive undertaking).
‘As such, significant changes are required to the face of the regulations. I would accordingly urge you to withdraw the regulations in order to allow this to happen. I would also welcome the opportunity to meet with you to explore the concerns articulated in this letter and to discuss the Government’s intended response.’
Earlier this week, Pulse reported that the chair of the NHS Alliance, Dr Michael Dixon, reported that onerous competition requirements will lead to GPs abandoning CCGs. The GPC also warned that the regulations were a ‘betrayal’ of the Government’s commitment to give clinical commissioners autonomy.
However, his letter to peers, Earl Howe wrote that the exemptions will be ‘broad in their application’. He wrote: ‘Contrary to arguments from some commentators, I am absolutely clear that the regulations do not force commissioners to open new markets.’
Commissioners would not be obliged to advertise, or competitively tender, where no market exists and there is only one provider capable of delivering their requirements, he added.
This will fall under the ‘technical reasons’ exemption, he said: ‘In practice, this criterion will be broad in its application,’ he wrote. ‘For example, this may be the case where the requirement is for provision of acute hospital services accessible on single sites; a range of integrated services to be delivered in the community; or when clinical volumes need to be maintained to protect patient services.
‘It is also likely to be the case for the provision of services in more rural or remote areas of the country.’