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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.

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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.