Revised rules still force commissioners to put competition first, says Dixon

Commissioning leaders have warned that the Government’s revisions to the competition laws will still place unnecessary obligations on CCGs that will hinder their ability to put patients’ needs first.

The revisions to Section 75, announced by health minister Earl Howe yesterday, contain a new opt-out clause for CCGs if using competition would harm integration of services.

But they retain a controversial clause that CCGs will have to prove that only a single provider can run a service or be faced with a labour-intensive tendering process.

Dr Michael Dixon, interim president of NHS Clinical Commissioners, warned that this will lead commissioners to be concerned about legal duties instead of focusing completely on improving patient care.

He said: ‘There is a danger that it still leaves open the possibility that a clinical commissioner who wants to contract with a good local provider with a strong track record, who is signed up to the aspirations of the commissioner, and is providing a good service close to people’s home, might still have to offer that service to someone else as part of a competitive tender or part of AQP.’

‘If CCGs are having to act in a way that makes them more cautious in respect to their local patients, that will be a bad thing… I would be very worried if doubts about Section 75 will change their behaviour.’

Dr Brian Fisher, a GP in South East London and patient and public involvement network lead at NHS Alliance, also said the ‘cosmetic changes’ remained ‘very dangerous’ for CCGs and the NHS.

He said on the Pulse website: ‘The provisions will be almost impossible to meet. CCGs will still need to do a huge amount of work whether being forced to compete or demonstrating why only a single provider can perform the tasks.

‘Monitor still rules and CCGs will still be open to challenge from corporations. No more freedom, more cost, a lot more fear - and almost certainly worse services for patients.’

But David Worskett, chief executive of the NHS Partners Network, a network for independent health providers, welcomed the new legislation.

He said: ‘We thought that the first version of the Section 75 Regulations simply confirmed the procurement position that was established under the last Government but if further clarification is needed then that can only be helpful.

‘However, while the regulations are necessary, in the real world of NHS care the reality is that when new commissioners see the need for innovation and integration they will often want to use procurement to obtain the best services for patients, including options offered by the independent sector.’