Hospital chief executives still feel the competition and merger control rules introduced under the government’s NHS reforms are making it difficult to carry out important reconfigurations.

Asked to rate out of 10 how obstructive the current regulations were to service change, with one being no impediment and 10 indicating impossibility, the average across chief executives was 6.8.

Eighty-eight per cent of respondents to the latest HSJ/Capsticks survey of hospital chiefs said securing change to competition and choice rules should be a priority for incoming NHS England chief executive Simon Stephens (see graphs below).

The results comes in the wake of the Competition Commission’s decision to block a proposed merger between foundation trusts in Bournemouth and Poole, which it said would have damaged patients interests by eliminating competition for a range of elective services.

Earlier this month HSJ reported that a £2.3bn merger between King’s College Hospital, Guy’s and St Thomas’ and South London and Maudsley foundation trusts had been indefinitely put on hold, with competition rules a major factor.

In October, healthcare sector regulator Monitor signed a joint statement with the Competition Commission and the Office of Fair Trading, which will effectively see merger proposals vetted by Monitor before being handed over to the other authorities.

A formal memorandum of understanding between the organisations has been delayed and the regulators were unable to confirm when it would appear.

HSJ understands Monitor chief executive David Bennett will shortly write to foundation trusts setting out more detailed arrangements for considering proposed mergers.

When the memorandum was signed Dr Bennett said: “Monitor will now ensure any merger proposal makes sense from both good governance and competition perspectives. 

“The OFT will give significant weight to our advice in its own considerations. This should mean that in future, hospital mergers will only be proposed when it is clear that they are likely to have a positive overall effect for patients, and therefore comply with the competition rules.”  

Pies: Do you agree with these priorities for incoming NHS England chief executive Simon Stevens?


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