Don't be a 'slave to competition', NHS told

Image caption NHS reforms will open the health service up to more competition

The government must not become a "slave to competition" over the NHS, the ex-head of the health regulator says.

Anna Walker said competition had an important role to play in making the health service more efficient.

But Ms Walker, now head of the Office of Rail Regulation, said ministers had to learn from other sectors - and limit the scope of private involvement.

It came as private health firms hit out at what they said was scaremongering about the changes in England.

Under plans put forward by the coalition government, the NHS is to be opened up further to competition from private sector firms.

This has prompted unions to suggest the health service is at risk of being privatised.

'Complex beast'

Ms Walker, who was chief executive of the Healthcare Commission for five years until stepping down in 2009, said competition had an essential part to play in modernising the NHS.

But she added it had to be carefully managed.

She said having competition, in markets like the NHS where there was a lot of public money at stake, was complex and not as simple as having full-blown competition.

Instead, she said simply comparing performance between different NHS trusts or setting up strictly regulated mini-markets, like the rail franchises, needed to be explored.

"In my experience, competition is a complex beast. What we have developed [in the rail industry] is a much more sophisticated understanding of when it helps and when it doesn't. My message: don't be a slave to competition."

And she added that if the reforms did not lead to the NHS becoming more productive it could undermine the whole ethos of the NHS.

She said: "There is going to come a point that if the NHS is not delivering efficiently for people then gradually there will be a debate about whether everybody wants to contribute. If that happens society is going to be a huge loser."

Matt James, chief executive of H5, an alliance of five leading private health firms, agreed competition had a role to play.

But he added: "Unions have whipped up accusations of privatisation, but that is not going to happen. I cannot see the amount of NHS work the private sector does increasing by that much.

"It is just not as lucrative as it is often suggested. It can only be used when there is spare capacity."

A Department of Health spokeswoman said: "Competition is not an end in itself - it's a means to getting better outcomes for patients and taxpayers. There is no one-size-fits-all approach when it comes to competition in health care - commissioners need to take decisions on how best to improve services for patients."

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