NHS competition rules prompt Lords concern

Doctor's equipment, a sphygmomanometer and stethoscope
Image caption Concerns have been voiced about the impact of the new rules

A House of Lords committee has voiced concerns about rules on contracting out services in the NHS in England.

The peers say draft regulations would have led to compulsory competitive tendering of most health services.

Ministers say this is not the intention and had already said the regulations would be rewritten after concerns were raised by many health organisations.

But the new report warns the government will have a "major task" in explaining the new system to health staff.

'Widespread concern'

BBC health correspondent Branwen Jeffreys said: "This is a further embarrassment for the government in a row which has escalated since it published draft regulations three weeks ago.

"They're intended to give a legal framework to the decisions of GP-led groups when they take over budgets in a few weeks time. The committee says the rules are a significant change from the current position, and appear to require competitive tendering for most health services."

The House of Lords Secondary Legislation Scrutiny Committee says the changes will have to meet the concerns raised by 2,000 submissions to the committee.

It states: "Rather than the more generalised duty not to be anti-competitive that the health sector evidently expected, these regulations require the wider use of competitive tendering in the procurement of most services.

"The contention is over the degree to which, from 1 April 2013, NHS services will have to be commissioned through competitive markets, whether contracts will have to be advertised and how the procurement legislation will be enforced by Monitor, a sector regulator."

It adds that it is "clear that from the widespread concern" that the Department of Health will have "a major task in explaining these provisions to health staff and persuading them to accept the department's interpretation of them".

The Department of Health said it recognised that there were "concerns about the precise wording of the regulations", adding that it took such fears "very seriously".

It said: "We want there to be no doubt about what these regulations do. That is why we are acting quickly to make them clearer - we intend to lay revised regulations in the next few days.

"It has never been, and is absolutely not the government's intention, to make all NHS services subject to competitive tendering."

'Humiliating retreat'

The regulations were intended to provide guidance on how the NHS reforms should be implemented.

Previous guidance on the issue was set to be rendered obsolete because it applied to organisations that were being scrapped on 1 April.

But, after they were laid before Parliament, concerns were voiced that they broke previous assurances from ministers about the extent to which competition was going to be used.

Last week more than 1,000 doctors wrote to the Daily Telegraph claiming the legislation makes "virtually every part" of the NHS open to private firms.

And, over the weekend, the Academy of Royal Medical Colleges said it could cause "dangerous" fragmentation of health services.

On Tuesday, health minister Norman Lamb told MPs the wording of the regulations had "inadvertently created confusion".

The government said it would be withdrawing the first draft of the regulations to rewrite them following concerns from many medical organisations.

Shadow health secretary Andy Burnham described this as a "humiliating retreat", adding: "Coalition policy on competition in the NHS is in utter chaos."

Labour has also secured a Lords debate about the regulations later this month.

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