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Tories pledge to ramp up private companies’ role in NHS

By Lilian Anekwe

Exclusive: The Conservatives would scrap the Department of Health's recent guidance making the NHS the ‘preferred provider' and open up the health service to further competition from the private sector.

Shadow health minister Mark Simmonds pledged an end to the imposition of sweeping changes to the NHS from the centre, reiterating the Tories' recent promise to consult with GP leaders on key decisions over the restructuring of primary care.

The declarations mark the latest clear dividing line between the parties on primary care policy, following Conservative pledges to rip up plans to shift hospital workload en masse into GP polysystems and hand GPs commissioning responsibility for out-of-hours care.

Last month health secretary Andy Burnham delivered guidance to help NHS managers deliver on his pledge that the NHS would be the preferred provider of healthcare services.

But with the general election date called today, the Conservatives have made clear their intention to invite private providers, independent and voluntary sector organisations to bid for contracts to run primary care services.

Pulse revealed in January that the Tories had already been in talks with a string of alternative providers as they prepared to create a more competitive NHS market should they win the election.

‘Our policy is very clear: any willing provider – as long as they meet the safety standards. What's important is making patients better,' Mr Simmonds told Pulse.

He rebuffed any suggestion private providers would be more interested in profits than patient care.

‘I don't buy the argument private providers are a threat or only interested in profits. I'm slightly perplexed by some GPs saying these things, because they're independent providers.'

Mr Simmonds said increasing the role of private providers would ‘drive efficiencies' and force GPs to compete with alternative providers to attract patients, particularly when practice boundaries are scrapped later this year.

‘You've got to have an element of competition in the system, as it drives efficiencies, as long as you have benchmarkable information. That way, patients can see which provider is providing the best patient outcomes and make a choice – but at the moment people can't make that choice.'

Mr Simmonds said GPs themselves would have a key role in directing the involvement of alternative providers, through their beefed up commissioning role.

He provided the greatest detail yet of how GP commissioning would work, pledging GPs would get ‘real budgets and real cash', but also insisting they would not be able to simply pocket any savings.

‘The vast bulk of that will have to be reinvested back into frontline care,' he said.

GPs could commission services from practices, pharmacists, voluntary organisations or the private sector, but could expect PCTs to act as referees, and so could not simply expect to commission services from themselves: ‘There will be an ongoing role for the PCT to ensure the most efficient and effective provider is actually providing the service.'

Mark Simmonds on…..

Real budgets
‘We will offer real budgets and real cash. That's the big difference between practice-based commissioning and our proposal of GP-led commissioning.'

OOH commissioning
‘The biggest and most significant mistake of the 2004 contract was the Government allowing GPs to completely opt out of any involvement with OOH care. GPs will have the ability to be involved in structuring the service, and where they choose, to provide it. But we are not proposing a return to the pre-2004 status and GPs will not have a legal responsibility.'

The GP contract
‘We're going to have to renegotiate the contract to give GPs a more clinically focused QOF and make sure it takes into consideration the fact GPs are going to be leading on commissioning. We're in regular contact with the BMA.'

NHS efficiency savings
‘We will ringfence the NHS budget, it won't be subject to the cuts of other departments. We're going to increase in real terms the investment in the NHS in the lifetime of the next Parliament. We want to cut a third of administration in the NHS and put that into patient care. We want to streamline or merge quangos, and where they are not providing patient outcomes, got rid of them altogether.'

Watch the interview here

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