NHS England chief executive Simon Stevens has told MPs he does not share his predecessor’s concerns that competition law is standing in the way of health service reform.
Sir David Nicholson repeatedly raised concerns in the run-up to his retirement last month about the impact of competition law and regulation since the introduction of the Health Act 2012, and indicated legislation needed to be changed.
During his first major public appearance, before the Commons health committee this afternoon, Mr Stevens was asked whether it was correct that he was more “sympathetic” to the role of competition than his predecessor, something which has been asserted publicly by Monitor chief executive David Bennett.
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Mr Stevens declined to comment directly on Mr Bennett’s views, made in an interview with HSJ earlier this month, but said his approach to competition was “pragmatic”.
“Under some circumstances as patients we may want a choice as to where we are treated,” he said. He said “under particular circumstances where care is problematic and we need to do something different [with services]” then it is sensible to use competition.
“Do you I think it’s the answer to what needs to happen [in the NHS]? No I do not.”
Mr Stevens was also asked about the impact of the Health Act 2012 on competition and procurement in the NHS.
He was questioned about HSJ’s Barometer survey of CCG leaders earlier this month, in which many said they had received informal challenge or questioning of commissioning decision under procurement, choice and competition laws, and some had invited competition purely because of the rules.
Mr Stevens said he did not believe there had been a “significant difference” in the way services were being commissioned under the Health Act 2012.
Asked whether he was concerned CCGs were spending excessive sums on legal advice, something raised in the HSJ survey and by Sir David.
Mr Stevens said he believed that “over time people will see what they were most concerned about [at present] is not something they have to be spending that kind of money on”.
Mr Stevens said his view differed from Sir David’s on the proposed merger between Royal Bournemouth and Christchurch Hospitals and Poole Hospitals foundation trusts, which was blocked by the Competition Commission last year.
Sir David had highlighted it as an example of competition regulations getting in the way of necessary service change.
However, Mr Stevens said the commission’s decision had “sent a clear signal to hospital managers that the need to be very clear about what the supposed benefits are going to be before they embark on that process and that’s no bad signal to send”.
Stevens sets out alternative approach to small hospitals
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NHS chief will take 'pragmatic' approach to competition