The government has introduced revised regulations to parliament to clarify that clinical commissioners will not be forced to create competitive markets for National Health services against their will.
The move was spurred by a barrage of protest last week over controversial revisions to the Health and Social Care Act, which some feared would in effect force clinical commissioning groups (CCGs) to put out to tender all services rather than just those they feel would benefit from the process.
According to the NHS Alliance, the proposed changes appeared to be "contrary to previous reassurances from the government that CCGs will have the freedom to choose when and whether to use competition", and in a letter to health minister Lord Howe, leaked to The Observer, the Academy of Medical Royal Colleges accused the government of attempting to expand the private provision of services by stealth.
But Lord Howe was quick to dismiss the fears, stressing that it was "neither the intention nor the practical effect of the regulations".
According to the Department of Health, the new regulations now make clear that there is no requirement to put all services out to competitive tender, and that Monitor will not be able to force competition either, leaving healthcare professionals completely in charge of local services.
In addition, CCGs can commission an integrated service where it is in the interest of patients, it said.
Anti-competitive behaviour prohibited
It will still fall under Monitor's remit to prevent anti-competitive behaviour in the provision of healthcare services "for the purposes of the NHS that is against the interests of people who use such services", according to the NHS Commissioning Board.
But “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," Howe stressed, adding: “I believe we now have a set of regulations which puts this beyond doubt.”
Mark Porter, Chair of British Medical Council, said if the redrafted regulations are supported by clear guidance - they should provide "greater clarity" on the commissioning process.
However, "it is vital that competition is not allowed to undermine integration, innovation, or clinical autonomy," he said, and called for a "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.”