What should clinical commissioning groups do on 1 April 2013?

BMJ 2013; 346 doi: https://doi.org/10.1136/bmj.f1977 (Published 26 March 2013) Cite this as: BMJ 2013;346:f1977
  1. Clare Gerada, chair
  1. 1Royal College of General Practitioners, London NW1 2FB, UK
  1. clare.gerada{at}nhs.net

“First do no harm”

On 1 April 2013, in England, the NHS system of care and the secretary of state’s duty to secure and provide universal healthcare for all people throughout England will come under serious threat.

The Health and Social Care Act 2012, which comes into force on that date, allows for wholesale dismantling of the NHS and privatisation of the supply, organisation, planning, finance, and distribution of healthcare, drawing on structures and ideas borrowed from the US insurance industry. It is underpinned by several regulations that are currently under dispute, not least of which is regulation 5.1 2 3 This regulation requires that clinical commissioning groups put all services out to competitive tender unless the group is satisfied that only a “single provider” can deliver the service. But how can any group be sure that there is only one possible provider except by undertaking an expensive tender? The alternative is to risk the wrath of the competition regulator and a legal battle.

The government’s claims that general practitioners will lead commissioning are misleading. This is a front for privatisation plans that will leave trusted GPs bearing the brunt of the public’s wrath while much of the health budget is handed …

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