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Designing the "new" NHS

5th June 2006

05062006_healthreport1Q.jpgA new report 'Designing the ‘new’ NHS: Ideas to make a supplier market in health care work' says that if the government’s current health reforms are to work, it must state unequivocally that it wants to create a health care market involving a range of different providers and that it believes this model represents the long-term future for the health service in England.

The report, from an independent working group made up of health service leaders from the NHS, the voluntary and the independent sectors, and commissioned by the King’s Fund, examines the changing landscape of NHS funded services and look at what needs to be done to make the new market work effectively for patients.

The report calls for greater clarity over the long-term objectives of the new market and says that the first challenge must be for the government to refrain from setting an upper limit to independent sector provision in the market. According to the report the amount of care coming from the NHS, private and voluntary sectors should emerge as the market develops rather than being artificially defined.

A series of ideas for making the new market work are outlined in the report, they include:

The need for less central control from the government - a market with a range of providers should operate as part of a system which is independent of day-to-day ministerial control

Providers should operate on a level playing field - there should be no unfair advantage or disadvantage between providers from the NHS, independent and voluntary sectors

Regulation should be explored in more detail - including the possibility of introducing a separate competition regulator

Commissioning should be strengthened - deciding what the NHS should buy and how commissioners work together should be a top priority in the new market

The infrastructure of the health service should be enhanced - prioritising the success of the IT programme ‘Connecting for Health’ will play a big part in this, the report says.

Greg Parston, Working group chair, said that a supply-side market is being created in health care out of a powerful mix of tariffs, incentives and new providers, adding 'this offers tremendous opportunities but it also carries great risks'.

Mr Parsons concluded “With the greater clarity of direction, the improvements to central structure and regulation, the strengthening of commissioning and the better infrastructure that this report recommends, it will be possible to create a future in which the health care market produces a service that is more innovative and responsive to patients’ needs and wishes while also operating more efficiently and delivering better value for money.?

Niall Dickson, chief executive of the King’s Fund said that the move towards the introduction of a supplier market has been achieved with surprisingly little serious discussion and there is still some uncertainty about where it is all heading. "We very much hope this stimulating report will generate debate over what needs to be done to ensure high quality care within a market system" he said.  Mr Dickson added that all the changes and new incentives in the system are but means to an end, saying "The current changes will need to be judged on what they achieve for patients and the public who fund the NHS.?

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