The Health and Social Care Select Committee has welcomed the NHS Long Term Plan proposals to replace existing competition rules but said independent providers and other stakeholders must continue to play a role in healthcare delivery.
In its report, NHS Long-term Plan: legislative proposals, the committee said it supported NHS England and NHS Improvement’s proposals to encourage greater integration by repealing Section 75 of the Health and Social Care Act 2012 and removing the NHS from public procurement rules with the introduction of a ‘best value’ test.
However, MPs on the committee warned the proposals were ‘too NHS-centric’ and gave ‘too little consideration for the wider system with which the NHS seeks to integrate’. Although they agreed collaboration was essential to manage the rising demands on health services and improve joined-up care, they added that the NHS should not be allowed to become a monopoly.
‘The Department of Health and Social Care, NHS England and NHS Improvement should be clearer about the input and roles local government, the voluntary and wider community sector, as well as independent providers, are expected to have in the future of the NHS,’ said the report.
The committee called on the government to set out how it intends to ensure patients and taxpayers are protected from any adverse unintended consequences of the proposed legislation. It also recommended that the National Implementation Plan should include proposals to increase the uptake of existing contractual options and/ or further extend the ways organisations can work collaboratively. However, it supported proposed legislation to rule out the option of non-statutory providers holding an Integrated Care Provider (ICP) contracts. Doing so would allay fears that ICP contracts provide a vehicle for extending the scope of privatisation in the English NHS, the report said.
However, MPs agreed that ICPs should have the ability to subcontract with a range of other partners. ‘This proposal would achieve a sensible balance by enabling ICP contract holders to draw on the diverse mix of health and care provision that exists across the country, while ensuring the responsibility entailed in these long-term contracts rests with public statutory bodies,’ they added.
Independent Healthcare Providers Network (IHPN) CEO David Hare said the report was ‘a helpful and pragmatic review of the complex issues that are raised by potential changes to the NHS’s legal framework.’
‘Of particular importance is that the Committee once again makes clear that a diverse provider market including the independent sector can contribute to more integrated services for patients, and warns against the potential for ‘monopolistic, NHS-centric airless rooms,’ he said.
Hare went onto say that IHPN was pleased to see that the Committee had endorsed many of the points made by the Network in its written and oral evidence, including the need for much greater detail and scrutiny of the proposed ‘Best Value’ test for NHS procurement, proper protection of patient rights to choose put on a statutory basis; and safeguards against price competition resulting from changes to the national tariff.
‘Throughout the report the Committee is clear that without further development the legislative proposals risk introducing unintended consequences and could even lead to the NHS becoming a ‘protectionist monopoly provider’. We look forward to working with the Department of Health and Social Care, NHS England, and other stakeholders, to ensure that the eventual proposals deliver the best possible outcomes for patients and taxpayers,’ he concluded.