A defence of competition in health care

John Rentoul

Andrew+Lansley 300x198 A defence of competition in health careJust when you thought he was six feet under and all forgotten, Andrew Lansley comes bouncing back up to the surface in rude health. He has finally written an article that (a) I can understand, and (b) says some brave and right things about reforming the NHS.

In the Health Service Journal (registration required) today he says:

Creativity and innovation is best supported by competition. This word is used sparingly in healthcare because it is seen as a loaded term. But it has never been, nor should it be seen as, an alien concept in healthcare. It means simply that those who strive to innovate to provide the best possible care should find their efforts supported rather than stymied – supported through, for example, clear freedoms for any qualified provider to deliver NHS services to patients if they meet NHS standards and NHS costs, and through funding systems which are flexible enough to support the changes which health professionals want to lead. It also means giving patients more control over the care they receive, sharing in the decisions made about their treatment. These aims have been viewed as desirable characteristics of healthcare reforms for the past 20 years, and the next decade will see them further realised.

In healthcare, the term “competition” is often used pejoratively by vested interests with something to fear from change. But the vast majority of the NHS – including the many world-beating services we have which already compete with other health providers on a global scale – recognise that there is nothing to fear from competition. As the former Labour health minister Lord Darzi has commented, the NHS is up for competition. Competition between organisations facilitates the adoption of new treatments and technologies, and allows innovative individuals within those organisations to flourish. It is a critical element of healthcare system reform.

Perhaps Lansley feels his situation is so desperate that he might as well just say what he thinks. Or someone at No 10 has finally persuaded him that choice is the engine of efficiency and the only communications strategy is to argue for it. Either way, this defence of competition in health care from such an unlikely source is welcome, with a suggestion that he is only carrying on the best bits of Labour’s policy. If only we had had this sort of conviction from the start.

Hat tip: Benedict Brogan’s newsletter.

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  • William Harrison

    Competition means “innovation” (not the first thing on my mind when I have to go to the doctor’s or hospital, to be honest) but it also results in inconsistent delivery of services between regions. Look at what competition has done to state schools.

  • Pacificweather

    Referendums only occurr on a regular basis in democracies, like Swtzerland, so we won’t be getting one of those. Although, Mr. Langley could not get 50% of the vote in his own constituency, the coalition is the closest thing to a democratically elected government since 1931 which was the first and only democratically elected government in the history of Britain until 2010. The coalition did at least get a majority of the votes cast. The problem being that the LibDems chose the wrong party with which to form a coalition and then did not have the balls (they are men in the Cabinet) to stand up for their principles. What is worse, they have allowed the Conservatives to Gerrymander the constituencies to ensure they rule alone after the next election. Your wish for election will only make things worse. Until the English (it is only the English) decide they would like to live in a democracy as the Scots, Welsh and Northern Irish do then we are doomed to more of the same.

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