4.55pm Healthcare sector regulator Monitor has ruled out the suggestion that it will recommend a corporation tax exemption for private providers of NHS funded care. The move comes in response to a Guardian story, published yesterday, which suggested that the regulator’s “fair playing field” review of NHS competition might propose such an exemption, and that the “final draft” of the review was “sympathetic” to private sector demands. In a statement issued this afternoon, Monitor said: “There is no draft report of the Fair Playing Field Review and Monitor does not intend to provide a running commentary on the review. Monitor has yet to decide what recommendations it will make to the Secretary of State. However in the light of recent media speculation, Monitor has decided to clarify the position on one specific issue. While it is the case that corporation tax is one of many distortions that the review is looking at, Monitor will not be recommending that private sector providers should be exempt from paying corporation tax.”
4.50pm From yesterday’s Public Accounts Committee hearing: NHS medical director Sir Bruce Keogh has admitted that around half of all primary care trusts have restricted access to cataract surgery, with the majority of commissioners basing this rationing on inferior evidence.
1.21pm: The review looking at how the Liverpool Care Pathway is being used in practice is to be chaired by crossbench peer Baroness Julia Neuberger, care and support minister Norman Lamb has announced. The senior rabbi at the West London Synagogue and former chief executive of the King’s Fund, will look at:
- the experience and opinions of patients and families;
- the experience and opinions of health professionals;
- hospital complaints;
- local payments made to hospitals in respect of theLCP; and
- the literature about benefits and limitations of the Liverpool Care Pathway.
1.05pm Jeremy Hunt, Norman Lamb and Dan Poulter have just finished answering health questions in the House of Commons. HSJ reporter David Williams was live tweeting the session. Here are the key lines:
Labour’s main line of attack today was on accident and emergency performance. The opposition appears keen to establish an argument that the government has failed to prepare the service for winter pressures, resulting in ambulances stacked up outside emergency units, patients on trolleys in corridors and declining performance against the four-hour wait target.
Dan Poulter (who was flanked on the front bench by Leader of the House and former health secretary Andrew Lansley) re-stated the “four tests” for reconfiguration. These were first set out by Mr Lansley, and dictate that all service reconfigurations should be: clinically justified; backed by clinical commissioning groups; good for patient choice; subject to local consultation. The planned reconfiguration in south London, which has been contested by some local CCGs, was also discussed in the debate.
Mr Poulter acknowledged that there was a problem in recruiting middle-grade doctors to work in emergency departments. After repeated boasts from ministers that the number of doctors in the NHS in England overall was going up, shadow minister Liz Kendall pointedly asked when those new doctors began their training - implying that the previous government could take some of the credit for this.
Conservative backbencher Douglas Carswell asked ministers whether local commissioners should have more “flexibility” over GP pay, in order to stop good doctors leaving the service. Jeremy Hunt said the NHS Commissioning Board’s medical director Sir Bruce Keogh was looking into this as part of a wider review around 24-hour care.
Debate on health policy in the Commons is as fierce as ever, despite the NHS Commissioning Board taking over operational responsibility for the running of the NHS. David tweets that there is “no real evidence that the House understands that Jeremy Hunt isn’t in charge of very much any more”.
7.51am: Good morning, today on HSJ Chris Naylor and Nigel Edwards from the King’s Fund write on the known and significant unknowns about CCG-led commissioning. With the first wave of CCGs having been authorised one important unknown is how CCGs will deal with primary care. “In many CCGs there was no evidence of a plan B even for high risk situations”, they say.
“The challenge will be to develop new approaches that reflect both the new culture and structures. The strong presence of GPs on the board and the added dynamic created by health and wellbeing boards may support these relationship changes by giving the CCG more ability to challenge the commissioning board.”
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