Lords win tweaks to Health Bill on competition

Ministers accepted an amendment in the Lords on Monday requiring clinical commissioning groups to follow NHS Commissioning Board guidance on conflicts of interest and to register members’ interests. A separate Labour proposal on the latter issue was defeated.

Liberal Democrat peers who pressed the change also tabled another set of amendments, due to be heard next week. Most are believed to have the support of the government and are expected to be accepted.

They would scrap planned reviews by the Competition Commission of competition in the NHS and create duties on providers to “cooperate” with others.

Another would write into the bill that the NHS is “a service of general economic interest”, a change designed to exclude it from European competition law.

Perhaps the most significant proposal would mean Monitor’s foundation trust compliance regime continues until the health secretary passes a further parliamentary order removing it. As things stands the regime would automatically disappear in the next four years.

The change would exacerbate the conflict of interest for Monitor between operating its compliance regime and economic regulation.

Lord Clement-Jones, the Lib Dem who is leading the changes, said the conflict was not a problem. Referring to Monitor’s current proposals for managing the short-term conflict, Lord Clement-Jones told HSJ: “[Monitor chair and chief executive] David Bennett has already made it clear he is going to have to have two teams [one for each function].”

Baroness Murphy, a crossbench peer and former Monitor non-executive director, said the change could potentially lead to calls for the introduction of economic regulation to be delayed or dropped, although she said that was not sensible.

The government has also indicated it will outline in more detail how it will oversee service reconfigurations, following calls from Baroness Murphy and former health minister Lord Warner.