'do not depend on private role'

The Commons health select committee's eagerly anticipated inquiry into the role of the private sector in the NHS has warned the health service not to get too dependent on the private sector. And it calls for transparency about how the independent sector is used.

In its first report, published on Wednesday, the committee stressed it has no objection to the NHS combating shortages in capacity by making 'short-term use' of the independent sector, but said it is 'imperative' that the NHS develops 'sufficient acute capacity' to keep waiting times down.

It expressed concern that the independent sector could sell activity to the NHS with a view to establishing a dependence on their services which would put them in a position to increase prices to the NHS in future - a point which the establishment of regional tariff systems may now address. Among the main themes of the report was the private sector concordat. The committee warned against earmarking specific sums for private and voluntary provision, as was done this year, and said resources to cut waiting 'should be available for use in whatever way is best suited to local circumstances'.

It urged the Department of Health and trusts to provide greater incentives to staff to work for the NHS - particularly to ensure that the NHS has the consultant time and resources to carry out higher levels of activity.

Appraisals and revalidation for consultants should also be used to ensure that those working in the NHS do not cultivate longer waiting lists to boost demand for their own private work.

On the private finance initiative, the committee called for greater 'transparency, openness and accountability'.

'PFI is still being blamed for numerous ills not directly related to it, whereas the many benefits ascribed to PFI have yet to be proved. The time has come for a more rational and objective debate and it is the responsibility of the government to take the lead on this.' It called for 'immediate urgent' studies of several major health schemes to establish the economic aspects of value-formoney in the PFI process.

The report also raised concerns about the possible abuse of the calculations underpinning the public sector comparator, which the report described as so 'complex' that it can be used as an excuse to produce whatever result is needed.