Lansley stands by his NHS competition plans_2

18 Apr 11
Health Secretary Andrew Lansley has defended his controversial plans for increased competition in the National Health Service following attacks by Deputy Prime Minister Nick Clegg.

By Richard Johnstone | 08 April 2010

Health Secretary Andrew Lansley has defended his controversial plans for increased competition in the National Health Service following attacks by Deputy Prime Minister Nick Clegg.

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Councils will now face a maximum reduction in spending power of 8.8% in 2011/12, although the average cut remains the same as set out in November’s provisional settlement at 4.4%.

Shire districts will also receive an extra £10m to compensate for the loss of concessionary bus travel funding, ministers said.

The government said it had consulted widely and listened to the concerns of the Local Government Association, London Councils and many individual authorities since December 13.

Today’s settlement allocates a total revenue grant of £72.7bn to councils for 2011/12. It also distributes £29.4bn in formula grant for 2011/12 and £27.1bn for 2012/13.

Ministers claimed the final arrangements were ‘fair and progressive’ since they directed money to where it was most needed while also protecting taxpayers. The government used the same words to describe the provisional statement, which was widely disputed.

Local Government Secretary Eric Pickles said today’s settlement ‘goes hand in hand with the new localism powers and spending freedoms we are handing councils so they can be as efficient and effective as possible with public funds, rooting out waste and focusing on frontline public services’.

Local government minister Bob Neill added that councils had a ‘big part to play’ in reducing the country’s public spending.

The Local Government Association said the settlement remained the ‘toughest in living memory’ and

Speaking at a conference organised by the King’s Fund health think-tank this morning, Lansley said that competition was ‘a means to an end’ which would see increased choice and improved outcomes for patients.

He insisted that the reforms in the Health and Social Care Bill proposed no competition on price, as these would be set by tariffs, but instead for ‘competition on quality’. The controversial Bill has been put on hold so the government can consult with the public and NHS staff.

Lansley said that the NHS internal market reforms introduced the 1990s – which did allow competition on price – had led to a diminution in quality, and this would not be repeated. ‘That’s why we are moving to competition based on tariffs and driving up quality,’ Lansley said.

His defence of the plans comes after Clegg said he would oppose the new wider economic regulatory role to be given to Monitor, which oversees foundation trusts. Clegg said that Monitor should be given a duty to ensure collaboration not police competition.

Under the changes in the Bill, the new GP consortiums would be able to commission  ‘any willing provider’ to provide health care, including private and voluntary sector companies, to increase choice for patients.

Lansley said this meant ‘that providers will be, in effect, in competition’, and this could be used as a catalyst to greater collaboration, and integration, of health services. ‘We should demand the integration and then competition will drive that,’ he said.

GPs would seek this integration as part of the commissioning system that will replace primary care trusts in buying health care for patients.

Lansley said: ‘They will demand nothing less. They will be rewarded for outcomes and these will be better if there is further integration in health care.’

The health secretary was speaking at a conference where the King’s Fund launched a report into NHS leadership and management.

The future of leadership and management in the NHS: No more heroes found that the organisation was in ‘urgent need’ of a new style of leadership to adapt to future challenges, such as the proposed reforms.

It concluded that high-quality, stable management was essential for high-performing health services, but found that across the NHS chief executives spent an average of just 700 days in the job after they were ‘parachuted in’ to turn around troubled services.

The report recommended the creation of an NHS Leadership Centre. Lansley said he was ‘actively considering’ backing the proposals.

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