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CCGs 'restricted' by competition rules

CCGs 'restricted' by competition rules


Rules and restrictions for commissioners and GPs must be reduced, a commissioning leaders has claimed. 

Dr Michael Dixon, chair of the NHS Alliance and president of NHS Clinical Commissioners believes clinicians are currently too restricted by an "over-prescriptive model" of how to bring continuity of care to patients. 

Speaking at an educational afternoon for GPs, Dr Dixon said that clinical commissioning should have "greater headroom" to do what is right. 

"We must free clinical commissioning from rules, regulations, competition restrictions and conflict of interest issues so commissioners and their constituent practices can plan and implement “general practice at scale”. This will then allow them to take on the ‘out of hospitals services’ agenda that we have all been talking about for so long," he said.  

He added: “For general practice, it is essential that we restore the element of professionalism and goodwill, which comes from treating GPs with respect, and enabling general practice to get on with the job.  This was very much the intention behind the drive for personal care and continuity of treatment for the vulnerable elderly and those with complex disease." 

Dr Dixon warned that "tick-box medicine" is not patient-centred and that the new direct enhanced service (DES) for avoiding hospital for vulnerable patients is more about "filling in forms" than relating to older people. 

He said: "When it comes to personal care and continuity it is often the un-measurables that are the most important things. And, having got rid of 40% of the QoF because it was over bureaucratic, we are in danger of replacing it with an even more bureaucratic process in the name of something that is entirely appropriate and laudable. 

“Consequently, in the same way as we must give clinical commissioners greater headroom to do what is right, we must also give frontline GPs and general practices greater headroom to make a real difference.  That means less rules and restrictions, not more. It also means handing more decision making powers to local clinical commissioners working with local offices, who know the realities of everyday general practice, and the detrimental and demoralising effect that stifling bureaucracy can have on GPs trying to do their best for patients.”



I find it somewhat surprising that individuals at this level are talking about removing/reducing competition in procuring services. At its most basic level competition is governed by EU Treaty obligations which require that ALL purchasing which uses public money must be undertaken in a manner which is "Fair, transparent and allows equal treatment" of all potential suppliers/providers. Indeed for the first time this Treaty requirement was written into the new EU Procurement Directive which was published at the end of March, and is currently being transposed into UK law. The transposition process does not allow for ”derogation" or opt out of this requirement. One possible solution might be for the UK to leave the EU and thus renege on the Treaty. Ho0wever, there are problems here as the GATT and the WTO arte busy transposing rules which are similar to those of the EU into their procedures. It is therefore very difficult to see how the government can respond positively to this ongoing request. Might it not be better and ultimately more productive for patients to find out exactly how the system works and prepare to engage effectively? As the government cannot remove the competition requirement, of at least reduce it of the UK leaves the EU, and then surely the best approach is to learn how to tender effectively. If providers do not do so, there are many providers who do and will secure contracts. How will that benefit patients?

This has all been predicted before, competition does not enhance health care provision but restricts it.

We must all call on the next government to dismantle this pernicious legislation that takes funding away from front line care, and serves no valid purpose other than to create profit for private providers, which again reduces efficient delivery of care.

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