Competition Could Benefit the NHS, Declares the Office of Health Economics
Competition can help the integration of care in the NHS, and there is no proof that it would hinder it, according to a new report from the Office of Health Economics.
The report analyses the conclusions of the Commission on Competition in the NHS, which was assembled by the OHE (Office of Health Economics) in early 2010, and recommends the cautious growth of competition amongst providers of NHS-funded health care in England, and notes that, on the top existing evidence, rivalry at controlled prices has enriched the quality of certain NHS services.
Competition in the National Health Service is controversial, but in the correct situations it can be used to encourage the delivery of better health care than is attained without competition, says the Commission. However, it stresses that this does not mean that competition is desirable or practical for all NHS services in every location, and that the problem is not whether to have competition for all NHS services or for none; instead, the question is for which services and where rivalry would help patients.
While the evidence on rivalry in the NHS is restricted, current evidence suggests that, if used cautiously, it can benefit patients by assisting the incorporation of care.
The Commission’s recommendations include that:
– Where existing providers’ performance suggests health care could be improved, competition should be given serious contemplation;
– The expected effectiveness of competition can be evaluated prior to being tried, using an analytical device designed by the Commission;
– “any qualified provider” arrangements allowing patients, assisted by their GPs, to decide where to access their health care, are appropriate in certain circumstances:
– In other cases, competitive procurement by local NHS commissioning bodies on behalf of the populations they serve will be more suitable; and
– Routine assembly and publication of patient outcome measures should continue to be expanded to allow assessment of the effects of competition.
The Commission’s conclusions have been applauded by the NHS Confederation and its NHS Partners Network, which notes that competition and integration does not need to be mutually exclusive.
The NHS should encourage the use of well-managed and intelligent rivalry, but competition should never been an end in itself, NHS Confederation’s chief executive, Mike Farrar, commented.
“Competitive processes need to focus on the improvement of services across the system and ensure that poor providers of care are stamped out. Competition will be a key weapon to help clinical commissioning groups ensure that substandard care is never the only option for their patients,” he added.
While guidelines are vital to rivalry being successful, it is essential that Monitor’s new duties do not place additional burgeons on NHS organisations, Mr Farrar stressed. “The NHS needs an effective and intelligent regulator that allows space for innovation, new market entrants and service redesign, not unnecessary costs and bureaucracy,” he added.
David Worskett, the director of Confederation’s NHS Partners Network, welcomed the Commission’s report that competition does not equate to privatisation.
“Having a range of providers in healthcare is crucial for promoting innovative treatment and spreading best practice. If the NHS turns its back on competition now, it may hinder its response to the huge demographic and financial challenges it faces in the next 20 years,” he cautioned.
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