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This really is Extraordinary! – Secretary of State halts all health service improvement in the East of England in order to save face.

Filed Under (Primary Care Trusts, Secretary of State, World Class Commissioning) by Paul on 05-03-2010

The story so far…

Last September the Secretary of State for Health made a speech where he declared that his personal preference was for NHS providers to provide care for NHS patients. Since then he has been trying to impose this preference on all NHS Commissioners.

The problems of the last few days stem from the fact that he has been successful in bending some PCTs to his will. A letter from David Nicholson drawing their attention to his policy, resulted in some PCTs limiting their approach to tendering to those service providers that the Secretary of State prefers.

It is almost certain that by following the Secretary of State’s preference the PCTs have put themselves the wrong side of competition rules

But many PCTs, operating in the best interests of their patients, have refused to limit their opportunities and are still developing the full range of providers.

Part of the Secretary of State’s problem is that in the next 6 weeks most PCTs will undergo the “World Class Commissioning Assurance” process. Amongst other things this involves PCTs in demonstrating, as a commissioning organisation, that it is capable of developing and using the full range of market opportunities for its patients.

Simply saying that the Secretary of State doesn’t like them to exercise this competency will be not be considered a defence by the Panel. So the Secretary of State finds himself in charge of an assurance process for his PCTs wherein he has to hope that the all his NHS commissioners do badly in a key competence against which they are being judged.

An immediate problem for the Secretary of State this week is that Great Yarmouth and Waveney did as he wanted and, as a result, almost certainly acted in a way that was anticompetitive.

Following the Secretary of State’s personal preference Great Yarmouth and Waveney PCT decided to change the tendering process for its community services half way through the actual process. It wrote to a number of potential providers and told them that, actually, they could no longer be a part of the process.

The organisations excluded decided to take the PCT to the Cooperation and Competition Panel as they felt, with good reason, that the PCT was acting in an anti-competitive way.

The case was accepted by the Panel and we have been waiting their judgement.

An initial decision on March 1st decided to take the case further. It is understood that the Panel decided that there was a strong case for the complainants against the PCT.

But before it could publish this interim judgement it was told by the Department of Health that not just Great Yarmouth, but all 14 primary care trusts in the East of England had been told to suspend tendering altogether – leaving no case to answer.

So the case falls.

This is extraordinary! The Secretary of State is now prepared to stop the progress of the health service in an entire region of the country rather than face up to the fact that his personal policy is wrong.

Let’s look at how all this has come about,

  • Presumably at some time last summer all PCTs in the East of England decided that they wanted to improve community services for their public. Indeed the Department of Health had a name for it – Transforming Community Services  – and have been performance managing PCTs to move with speed.
  • Halfway through that tendering process the Secretary of State tries to start to impose his personal preference for NHS providers on PCTs. Some of them then change their tendering process to fall in line with the Secretary of State’s personal preference.
  • This tendering process is called into question and in order to stop the Secretary of State suffering the embarrassment of a judgement against him, the DH now halts the process across the entire region.
  • The only way the Secretary of State can be sure of avoiding the judgement of the panel – that his personal preference is anticompetitive – is by stopping all PCTs from doing anything.
  • The conclusion he has come to is that if he stalls NHS progress completely, then he might just get away with it.

To say the least this is a strange position for any Secretary of State to get themselves into would be an understatement.

It is difficult to see how this position can remain tenable for any period of time.

Comments:

One Response to “This really is Extraordinary! – Secretary of State halts all health service improvement in the East of England in order to save face.”


  1. Hi Paul. Well said. I too think this is extraordinary and am surprised that the Opposition and the media have not made more of this. I don’t see how patients will gain from this decision. This would not have happened under John Reid or Alan Milburn. I wrote a blog on this for my public affairs consultancy, Altitude, in which I speculated that there may also be some political positioning going on by the current Secretary of State in anticipation of a Labour leadership election after the general election. You can read it at: http://altiviews.wordpress.com/2010/03/04/nhs-first-patients-second/.

    Richard Olszewski
    Director
    The Altitude Consultancy

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