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DH revises competition rules to include opt-out to preserve integration



CCGs will be able to exempt themselves from putting services out to competition if they can demonstrate that it will undermine integration, under the Government’s redraft of its controversial competition rules.

But they will still have to demonstrate that services can only be provided by a ‘single provider’ or be forced put that service out to competition, under the revised legislation.

The rewrite, prompted after a backlash from GP leaders and campaigners, has been cautiously welcomed by the BMA, although it warned that it was still concerned about the overall ‘direction of travel’ of the NHS towards the greater use of competition.

The Government removed a provision that stated that ‘technical reasons’ and matters of ‘extreme urgency’ were the only exemptions to putting a service out to competitive tender.

However, it retained the provision that CCGs can only award a contract without competition when it is ‘satisfied that the services to which the contract relates are capable of being provided only by that provider’.

The new rules also include a provision that a CCG can engage in anti-competitive behaviour if it can prove that ‘to do so is in the interests of people who use health care services for the purposes of the NHS’, including integration of services or co-operation between providers.

Dr Mark Porter, BMA chair, said they were ‘pleased’ the Government has listened to the concerns over the rules, but called for a parliamentary debate to clarify how they should be used.

He said: ‘The redrafted regulations, if supported by clear guidance, should provide greater clarity on the commissioning process. However, we remain concerned about the overall direction of travel for the NHS.

‘It is vital that competition is not allowed to undermine integration, innovation, or clinical autonomy. There still needs to be a full parliamentary debate, to provide absolute clarity that CCGs will have the freedom to decide how best to secure high quality services for local populations.’

RCGP chair Professor Clare Gerada told Pulse the rules would still cause problems for CCGs: ‘The problem is you can never ever say that only one provider can provide the services,’ she said.

Health minister Earl Howe said they had taken the concerns about the regulations ‘very seriously’ and that they want to put ‘beyond doubt’ their intended purpose. We have acted quickly to address the issues and lay revised regulations.

He said: ‘It has never been and is absolutely not the Government’s intention to make all NHS services subject to competitive tendering or to force competition for services. That would compromise the power and freedom we are giving to local doctors and nurses.I believe we now have a set of regulations which puts this beyond doubt.’

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