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NHS commissioning competition regulations should be withdrawn and replaced, says BMA

Doctors leaders have today (Thursday, 18 April) called for controversial competition rules to be withdrawn and replaced ahead of a crucial House of Lords debate next week.

In a new briefing paper sent to peers ahead of the debate, the BMA calls for the withdrawal of the regulations that detail how aspects of patient choice and competition operate under the Health and Social Care Act in England.

They should be replaced with new regulations that unambiguously reflect previous Government assurances that commissioners will not be forced to use competition when making their commissioning decisions. The BMA is pressing for this principle to be explicitly stated in the regulations.

The BMA has long argued that mandatory competition for all services risks fragmentation of services and creates unnecessary transaction costs, making it harder for the NHS in England to deliver high quality, cost-effective and integrated care to patients.

Regulations, which were first laid before Parliament in February 2013, set out how competition and patient choice would work under the Health and Social Care Act. They were intended to ensure good procurement practice, but have continued to prompt widespread concern and uncertainty about the apparent requirement for competitive tendering for most health services.

Dr Mark Porter, Chair of BMA Council, said:

“The absence of expected guidance on how the competition regulations would operate in practice, and the lack of satisfactory guarantees in these regulations, has created great uncertainty and anxiety for clinicians and patients.

“Only explicit wording in the regulations would allow patients, doctors and commissioners to be absolutely certain that clinicians will have the freedom to act in the way they consider to be in the best interests of patients.”

Dr Laurence Buckman Chair of the BMA’s GP Committee said:

“GP commissioners now have responsibility for making critical decisions about how best to provide services to patients in their locality.

“Commissioners could be put in the position of facing costly tendering processes and possible legal challenges from unsuccessful bidders because of ambiguous rules. That is why GPs want the regulations withdrawn.”

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