Burstow 'concerned' over actions of competition authorities

Mr Burstow - the only Liberal Democrat health minister in post at the time the contentious legislation went through Parliament - said the system needed to be re-examined to ensure that Monitor, rather than the competition authorities, was “referee” in reconfigurations of NHS services.

In an interview with HSJ at the Liberal Democrats conference in Glasgow, Mr Burstow said: “The one area I have my concerns about is the way [the legislation] opened up the role of the OFT.” He described its position in the new system as being “quite disproportionate” and not what the legislation had been designed to facilitate.

The Health Act allowed for the OFT to refer foundation trust mergers to the Competition Commission.

However, in January this year HSJ reported that the OFT had decided that non-foundation trusts were also “enterprises” under the terms of the 2002 Enterprise Act and that mergers between them would fall under its jurisdiction.

The Competition Commission made a provisional ruling in July that a merger between Royal Bournemouth and Christchurch Hospitals and Poole Hospital foundation trusts would substantially lessen competition in 58 services areas.

Mr Burstow said: “The intention of having Monitor as a specialist regulator was so we didn’t need the competition authorities to come into the market and get proactively involved. [The Health Act] has helped the competition authorities to do the exact opposite.

“We need to look at that to ensure Monitor is the referee.”

Mr Burstow also looked ahead to the next general election and discussed Labour shadow health secretary Andy Burnham’s plan to integrate health and social care together in a single organisation, with councils controlling much of the NHS’s budget.

“The lesson from this Parliament is that there can’t be any more major upheavals [to the health service],” he said. “That means Labour has to think quite hard about their current position to scrap the Health and Social Care Act.”

However, Mr Burstow described Mr Burnham’s proposal as “an interesting idea”, which “wouldn’t be a red line” that would scupper any chances of a coalition between Labour and his party.

Mr Burstow, who was reshuffled from his post as care and support services minister in 2012, said “cultural change and changing behaviours” should be the priority for the new chief executive of NHS England.

“They have got to be someone who understands collaborative styles of leadership and co-production. They will need to be a good networker,” he said.

He welcomed moves to criminally prosecute healthcare providers who breached new fundamental standards of care, saying they would increase accountability. But he said the laws had to apply to providers both in the public and private sectors.