Deputy Prime Minister Nick Clegg is set to oppose a key element of the NHS reforms. In a leaked document, he says he is unconvinced by plans for an “economic regulator” as if the NHS were a “utility”.
In a policy document signed off by Nick Clegg and obtained by the BBC and The Guardian, the Deputy Prime Minister instead calls for a regulator which pushes NHS collaboration, not economic competition.
Under Health Secretary Andrew Lansley’s current plans for changes to the NHS, regulator Monitor will have much expanded powers. It already regulates NHS Foundation Trusts but this role will be expanded into a much broader economic regulatory position across the health service.
The Health Bill also says that, in exercising its role to “protect and promote the interests of people who use health care services”, Monitor should be “promoting competition where possible”.
But the Deputy Prime Minister, who has already threatened to veto elements of the NHS reforms, has signed off a policy document and told fellow Liberal Democrats and MPs that this is unacceptable.
At the meeting on Tuesday night, Mr Clegg said he would “never let the profit motive get in the way of the essential purposes of the NHS”.
The document, signed by the Deputy Prime Minister, reads: “We cannot treat the NHS as if it were a utility, and the decision to establish Monitor as an ‘economic regulator’ was clearly a misjudgement failing to recognise all the unique characteristics of a public health service, and opening us up to accusations that we are trying to subject the NHS to the full rigours of UK and EU competition law.
“I have come to the conclusion that we must not make this change.”
In a speech to the King’s Fund, Health Secretary Andrew Lansley responded to the criticisms. He said he saw competition as a route to integration, and took the comparison with “utility” providers more positively, saying that, for example, Vodafone and T-Mobile share phone masts, helping customers get coverage.
“Competition drives this integration…the service should be patient-centered not producer-centered,” he said.
The NHS reforms are currently “on pause” while the Government consults further about elements of the changes, which have angered health professionals. But Prime Minister David Cameron signalled his support for the principle of reform on Monday, saying: “It’s because I love the NHS so much that I want to change it.”
In his speech, Mr Lansley also signalled that he would accept change.
“I can entertain any amount of change in the bill if it is in the best interests of patients,” he told the King’s Fund delegates.
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