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"Competition is not about ideology..."

Cobblers!

I have just retired after 12 years as an NHS CEO, and in the last few years the drive for competition and open market procurement has been absolutely about ideology.

My arm has been twisted so far up my back on several occasions, by SHAs, by CCP, even directly by Treasury, that there is no question that this about ideology.

As a pragmatist, I have wanted the ability to procure services through the market as an absolute last resort, and have used it in that way. I have also had no problem about working with the private and third sectors to provide services, they have always been visible in the spectrum of provision for the NHS.

But the idea of mandatory procurement (whatever the reassurances, this will look mandatory in 12 months time) is crazy - unless the government wants to massively add to the management and transaction costs of the NHS, and promote dis-integration of services, which is very bad for patients. This is ideology.