Responding to NHS England and NHS Improvement’s announcement on proposals for legislative change in the NHS, David Hare, Chief Executive of the Independent Healthcare Providers Network, said:
“The current legislative arrangements for the NHS are by no means perfect, and we welcome the opportunity to put forward ideas to government on how legislative change could enable an NHS that works better for patients. And today’s document does contain some positive proposals, particularly around strengthening patient choice rights, which for too long have existed in theory but not been fully promoted in practice.
“However we have serious concerns about the proposed reforms to commissioning and procurement which risk undermining accountability to taxpayers for how NHS resources are spent. NHS England and NHS Improvement are right to say that there should be a continued place for the use of competitive procurement, either by NHS commissioners or by integrated care providers, to bring in new capacity or innovative service models into the NHS. However the proposals risk opening the door to decisions being made between commissioners and providers in airless rooms rather than out in the open, with incumbency trumping quality. The impact of this would be to risk recreating the huge NHS monopolies of old, accountable to managers and politicians rather than patients and the public.
“The proposals also risk creating substantial new conflicts of interest in NHS decision making, with a blurring of the lines between commissioners and providers. This means that a ‘best value’ test in procurement might simply be meaningless – with NHS organisations directly incentivised to award contracts to each other without due process and no transparency over quality.
“It should also be acknowledged that these proposals potentially reflect a major new top-down reorganisation of the NHS at a time of significant workforce pressures and deteriorating performance against key NHS cancer, A&E and planned care waiting time standards.
“Having embarked on this engagement exercise, it is important that any final proposals for legislative change do not turn the clock back a generation and reintroduce outdated NHS planning and delivery structures. Instead, the NHS must build on two decades of work to create a more patient centred, responsive and plural NHS.”