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Friday 25 February 2011

The NHS and competition - top people speak up

In today's Times newspaper Public sector section (no link - payment issues) Dr David Bennett the new chair of Monitor outlines his thoughts for the future of competition in the NHS. If you're wondering, Monitor is the economic regulator for the NHS see http://www.monitor-nhsft.gov.uk/.
In addition the BBC reports comments from Sir David Nicholson NHS chief, (note to self - what is it with David's and top jobs just now?) see http://www.bbc.co.uk/news/health-12566716.
Dr Bennett makes a number of points. He begins with the 'inertia' of the market caused by what is in essence the buyer's (GP's) inexperience as buyers - so they will need support (empowering in his language). To me that means experts and experts mean money; so there is a cost to empowerment. Competition may not thought be universal in the NHS - Dr Bennett reportedly says it will exist 'where appropriate'; what does that mean? In specialist areas competition will be slower coming but I sense no discomfort in Dr Bennett at all areas eventually having some element of competition. What that would mean for hospices?  We'll have to have clear business models to use when negotiating; a clear model and measure of quality making explicit the benefit of our style of service. We'll need to be 'robust, rigorous and transparent' he says.
Another important point he raises is a belief that competition based on quality will transform the health care sector. He thinks individuals will look something 'varied [where] an individual can find something that better suits them'. This helps me understand the need for personalisation in our services and well as give a push to the need for explicit quality markers.
Meanwhile Sir David Nicholson has issued a warning that some hospitals may find the future difficult; the landscape of management of hospitals is already changing with Circle coming to run Hinchinbrooke later this year. Competition rules; those who will survive in 10 years time will have become adept at changing and maybe more efficient but there will scars and casualties along the way. How ready are we for this?

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