Letters NHS reforms

Issues MPs and the media have missed in Lansley’s bill

BMJ 2011; 342 doi: https://doi.org/10.1136/bmj.d3194 (Published 24 May 2011) Cite this as: BMJ 2011;342:d3194

"Any willing provider" vs "any qualified provider" in the NHS reform: different bottle, same contents


Dear BMJ Editorial Team,

Many have the impression that an important change was negotiated
through the alteration of "any willing provider" to "any qualified
provider" in the new version of the Health and Social Care Bill.
Comparison of the procurement guide issued by the DH a year ago with the
legal and operational advice from the NHS Confederation this month,
reveals that the underlying procedure will be identical. This is
explicitly acknowledged by the "Any qualified provider" Discussion Paper
from the NHS Confederation from which the details below are drawn.

The "any willing provider" (AWP) commissioning procedure is set by EU
procurement directive, and the term "any qualified provider" (AQP) does
not exist in EU law. Thus the AWP process has simply been renamed with no
change to its substance. The competitive commissioning process concerned
seems to be identical. The two are compared in this table through excerpts
from the source documents:

[i] http://www.dh.gov.uk/prod_consum_dh/groups



[ii] http://www.nhsconfed.org/Publications/Pages


This reform represents the completion of the roll-out of competition
throughout NHS-funded provision. All NHS commissioning is a market-based
process covered by EU law on procurement and competition.

If a future government wishes to bring a health or social care
service back into public sector provision (say if the consequences of this
reform turn out to be bad for patients) any existing or would-be provider
may sue under EU law on anticompetitive practices. Dr David Bennett, Chair
and Interim Chief Executive of Monitor, acknowledged this risk to the
Public Bill Committee on 28 June 2011 .

Competing interests: No competing interests

15 July 2011
Research Fellow
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