Consultation response
11 Oct 2010
Project:
The NHS White Paper and Health and Social Care Bill
Area of work:
Commissioning, Competition, Efficiency & productivity, NHS & social care reform

The Government intends to develop market based mechanisms in the NHS to improve efficiency and quality. This entails a much larger and more influential role for the Foundation Trust regulator Monitor, which under plans in ‘Regulating healthcare providers’ will oversee competition in the NHS.  Our response examines the conditions necessary to make a success of this innovation.

Summary

Key elements of market-based incentives in the NHS to date have included competition among providers, choice for patients, and national prices (tariffs). On the basis of the available international evidence the Nuffield Trust considers that all these areas need further development in synergy with one another.

Key challenges facing the new economic regulator include the establishment of a correct tariff rate, making a decision about what forms of competition should be encouraged, and tackling the barriers to entry, exit and expansion faced by providers. We also believe it is important to recognise that an effective economic regulator will be a very powerful force influencing the pattern and cost of health care across England. Our response urges the Government to consider how accountability and public engagement are to be managed.

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