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Charities warn voluntary sector will be pushed out of NHS service delivery

Charities warn voluntary sector will be pushed out of NHS service delivery
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Charities warn voluntary sector will be pushed out of NHS service delivery1

Finance | Vibeka Mair | 19 Apr 2013

A coalition of charities has urged peers to vote to annul secondary procurement regulations attached to the Health and Social Care Act, that they say could push the voluntary sector out of delivering NHS services.

Next week, the House of Lords will debate a motion tabled by Labour peer Lord Hunt to annul regulations which set the rules for how clinical commissioning groups (CCGs) should commission NHS services.

According to the Financial Times, Lord Hunt says the regulations will open the NHS “to wholesale privatisation”.

“At its heart, this is what the government always intended with its legislation last year,” he adds.

Ministers have already been moved to reword the delayed Section 75 regulations after criticism from Labour politicians and others that it was “privatisation by stealth”. Sections amended included assurances that CCGs do not have to tender all services.

 

Even the largest charities could struggle to gain contracts

But charities and other campaigners have said the changes to the NHS procurement regulations do not go far enough.

In a briefing from a coalition of charities, including Marie Curie Cancer Care, Sue Ryder and Help the Hospices, it is warned that “the regulations as they are currently worded could lead to mandatory use of competitive tendering by CCGs in all but the most exceptional circumstances.”

It continues that given the administrative and financial burden of having to place each individual service out for tender, CCGs will tend to bundle services when contracting. “If contracts are bundled, then they are out of reach of voluntary sector providers and will force them out of the market," it says. “Even the largest charitable providers would struggle to justify the resource and the risk needed to bid for large, bundled contracts.”

The charities conclude by suggesting that peers vote to annul the regulations next week.

However, Sir Stephen Bubb, chief executive of Acevo, said it was important that the regulations be passed: “These regulations will enable charities to do more in partnership with the NHS, not less, and the result will be better services for NHS patients,” he said. “The regulations should be passed, without falling victim to another political slagging match, so that NHS commissioners and charities can get on with the job of improving the health services made available to the public.” 

He added that he did share concerns that a lot of people had right across the public sector about larger contracts being problematic for the charity sector. But he said it was a separate issue to the NHS procurement regulations. “The trend towards larger public service contracts is happening, and is likely to continue, irrespective of these regulations. They are about other issues like transparency and fair competition. We need to address the implications of larger contracts, but it’s a separate issue.

“There is a danger that the procurement regulations will descend into a political battle which will not be helpful.”

Last year, Sir Stephen Bubb was appointed to the NHS Future Forum to assess choice and competition when the government’s controversial Health and Social Care Act was going through Parliament.

Sir Stephen was appointed following mounting criticism of the Bill to take part in a “listening exercise” which would review the proposed reforms.

Titus Alexander
Coordinators
Democracy Matters
9 Jun 2013

This raises a much bigger question about democratisation of the NHS so that citizens (patients, public, voters, taxpayers) have an effective voice at all levels, with direct links to local councils and parliament. Coalitions of charities, the House of Lords and NHS Future are all very well, but none are directly elected or accountable to the public. NHS England is creating a Citizens Assembly, which could be an important forum for issues such as the rules for commissioning. But we also need to broaden, strengthen and improve our existing democratic mechanisms or they will continue to be bypassed by market mechanisms on the one hand and professional-official structures on the other. Both have a role, but they must be subject to democratic oversight and direction. A 'Parliament for Health' is one suggestion of how this might develop: see; http://democracymatters-practicalpolitics.blogspot.co.uk/2013/02/we-need-parliament-for-health.html and http://www.democracymatters.org.uk/how-would-a-parliament-for-health-work/

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