A new beast is unleashed onto the healthcare world tomorrow which could change the landscape on everything from pensions to private practice.

The Co-operation and Competition Panel starts work, adjudicating on complaints from companies and NHS bodies that believe they are getting unfair treatment in the NHS market.

It is a measure of the panel's importance that NHS chief executive David Nicholson has written to NHS managers highlighting the work it will undertake.

Political minefield

Top of its to-do list is likely to be the political minefield of consultants' private work, with independent providers wanting access to the best staff and trusts fretting over whether their medics are compromised by working for competitors.

Such test cases are likely to provide early indications of the extent to which the panel will take a robust stance on opening up the NHS to more private competition.

The recession can only increase focus on its deliberations. With the health service now one of the most recession-proof markets in the economy, organisations such as the CBI can be expected to lobby hard for companies to be given the maximum freedom to compete. Similarly, business secretary Lord Mandelson has been making enquiries about the NHS. As the squeeze on public sector funding tightens and companies fight for survival, it is easy to imagine Lord Mandelson arguing that opening up the NHS market would provide a virtuous circle of driving efficiency and helping companies through the recession.