Intended for healthcare professionals

Observations Health and Social Care Act

Act now against new NHS competition regulations

BMJ 2013; 346 doi: (Published 20 March 2013) Cite this as: BMJ 2013;346:f1819
  1. Jacky Davis, co-chair, NHS Consultants’ Association, and consultant radiologist, Whittington Hospital, London,
  2. Ian Banks, president, Men’s Health Forum,
  3. David Wrigley, general practitioner, Lancashire,
  4. Clive Peedell, co-chairman, NHS Consultants’ Association, and consultant clinical oncologist, James Cook University Hospital, Middlesbrough,
  5. Alyson Pollock, professor of public health research and policy, Queen Mary, University of London,
  6. Klim McPherson, visiting professor of public health epidemiology, Nuffield Dept Obstetrics and Gynaecology and Emeritus fellow of New College, University of Oxford,
  7. Martin McKee, professor of European public health, London School of Hygiene and Tropical Medicine,
  8. William L Irving, professor and honorary consultant in virology, University of Nottingham and Nottingham University Hospitals NHS Trust,
  9. Peter Crome, professor, Institute for Social Sciences and Medical School, Keele University and department of primary care and population health, University College London,
  10. Trisha Greenhalgh, professor, Global Health, Policy and Innovation Unit, Centre for Primary Care and Public Health, Blizard Institute, Barts and The London School of Medicine and Dentistry,
  11. Walter Holland, Emeritus professor of public health medicine, London School of Economics and Political Science,
  12. David Evans, professor in health services research (public involvement), Centre for Health and Clinical Research and associate head of department (research and knowledge exchange), Department of Health and Applied Social Sciences, University of the West of England,
  13. Alan Maryon-Davis, honorary professor of public health, department of Primary Care & Public Health Sciences, Kings College London School of Medicine,
  14. Alan Smyth, professor of Child Health, University of Nottingham and co-ordinating editor, Cochrane Cystic Fibrosis and Genetic Disorders Group,
  15. Peter Fleming, professor and consultant paediatrician, University Hospitals Bristol,
  16. Michel Coleman, professor of epidemiology and vital statistics, Cancer Research UK Cancer Survival Group and department of non-communicable disease epidemiology, London School of Hygiene and Tropical Medicine,
  17. Deborah J Sharp, professor of primary health care, Centre for Academic Primary Care, School of Social and Community Medicine, University of Bristol,
  18. Peter Whincup, professor of epidemiology, University of London, Division of Population Health Sciences and Education,
  19. Stuart Logan, Cerebra professor of paediatric epidemiology, director, Institute of Health Service Research, and director, NIHR PenCLAHRC,
  20. Derek Cook, professor of epidemiology, Division of Population Health Sciences and Education, St George’s, University of London,
  21. Robert Moore, professor, School of Sociology and Social Policy, Eleanor Rathbone Building, University of Liverpool,
  22. Salman Rawaf, professor of public health, Imperial College London,
  23. J McEewen, Emeritus professor in public health, University of Glasgow,
  24. Robert West, professor, Cancer Research UK Health Behaviour Research Centre, Department of Epidemiology and Public Health, University College London,
  25. John S Yudkin, Emeritus professor of medicine, University College London,
  26. Aileen Clarke, professor of public health and health services research, Warwick Medical School, University of Warwick,
  27. Nick Finer, honorary professor, National Centre for Cardiovascular Prevention and Outcomes, UCL Institute of Cardiovascular Science,
  28. Paola Domizio, professor of pathology education, Barts and the London and honorary consultant histopathologist, Barts Health,
  29. Clare Bambra, director, Wolfson Research Insitute for Health and Wellbeing and professor of public health policy, Department of Geography, Durham University,
  30. Anna Jones, teaching fellow, Brighton and Sussex medical school.,
  31. Gene Feder, professor of primary health care, Centre For Academic Primary Care, School of Social and Community Medicine, University of Bristol,
  32. Alex Scott-Samuel, senior clinical lecturer in public health, University of Liverpool,
  33. Louise Irvine, GP, London,
  34. Ajay Sharma, consultant paediatrician, London,
  35. Mike Fitchett, partner, Island health, London,
  36. Kambiz Boomla, GP, Chrisp Street Health Centre, London,
  37. Jonathan Folb, consultant microbiologist, Liverpool,
  38. Ashish Paul, consultant in public health medicine, Cardiff,
  39. David McCoy, consultant, public health medicine and senior clinical lecturer,
  40. Ray Tallis, Emeritus professor, geriatric medicine, Manchester,
  41. Jilla Burgess-Allen, specialty registrar in public health, Matlock,
  42. Mark Edwards, GP, University Health Service, University of Southampton,
  43. Jonathon Tomlinson, GP, Lawson Practice, London,
  44. Deborah Colvin, GP, Lawson Practice, London,
  45. Jonathan Gore, GP, Lawson Practice, London,
  46. Kirsten Brown, GP, Lawson Practice, London,
  47. Sarah Mitchel, GP, Lawson Practice, London,
  48. Alice Lau, GP, Lawson Practice, London,
  49. Mel Sayer, GP, Statham Grove, London,
  50. Leon Clark, GP, Statham Grove, London,
  51. Ruth Silverman, GP, Statham Grove, London,
  52. Saul Marmot, GP, Bromley by Bow,
  53. Daniel Rainbow, GP, Stennack Surgery, St Ives ,
  54. Lucy Carter, GP, Well Street Surgery, London,
  55. Nick Mann, GP, Well Street Surgery, London,
  56. Richard Fielding, professor of medical psychology in public health, University of Hong Kong,
  57. Jane Logan, GP, London,
  58. Louise Tebboth, GP, Bermondsey, London,
  59. Natasha Arnold, consultant geriatrician, Homerton Hospital,
  60. Kate Stobbart, GP, Newcastle upon Tyne,
  61. Kate Cabot, GP, Acton, London,
  62. Sarah Finer, specialty registrar and clinical lecturer in diabetes and endocrinology, Barts Health,
  63. Martin Edwards, GP, Jenner Practice, London,
  64. David Davies, Amwell Group Practice, London,
  65. Helen Buttivant, public health specialty registrar, Wessex Deanery,
  66. Sebastian Kraemer, honorary consultant, Tavistock Clinic and consultant psychiatrist, Paediatric Department, Whittington Hospital,
  67. Jo Newell, GP, Leeds,
  68. Alun Griffiths, GP partner, Horton Park Practice, Bradford,
  69. Richard FitzGerald, consultant radiologist, Wolverhampton,
  70. Robert MacGibbon, retired GP, London,
  71. Alan Lee, Nottingham,
  72. A F Macklon, consultant physician, County Durham and Darlington Foundation Trust,
  73. Esther Hobson, neuromedicine registrar, Sheffield,
  74. David Jenner, GP, Cullompton,
  75. Bobbie Jacobson, public health consultant,
  76. Alison Timmis, consultant paediatrician, Countess of Chester Hospital NHS Foundation Trust,
  77. Asad Salim, consultant dermatologist, Countess of Chester NHS Foundation Trust,
  78. John Evans-Jones, consultant in genitourinary medicine and HIV, Integrated Contraception and Sexual Health Service, Countess of Chester Hospital NHS Foundation Trust,
  79. Woody Caan, professorial fellow of the Royal Society for Public Health, Cambridge,
  80. Ninaad Awsare, consultant urological surgeon, Countess of Chester Hospital NHS Foundation Trust, Wirral University Teaching Hospital NHS Foundation Trust,
  81. Neil Pride, Emeritus professor of respiratory medicine, Imperial College, London,
  82. Ruth Suckling, specialist registrar, emergency medicine,
  83. Catherine Bratty, GP, Surrey,
  84. Brian Rossiter, retired physician,
  85. David Hawkins, consultant physician, London,
  86. Jonny Currie, University Hospitals, Bristol,
  87. Corinne Camilleri-Ferrante, Nottingham ,
  88. Jonathan Fluxman, Harrow Road Health Centre,
  89. Osman Bhatti, GP principal, Chrisp Street Health Centre,
  90. James Anson, clinical director and consultant microbiologist, Directorate of Infection and Immunity, Royal Liverpool and Broadgreen University Hospitals NHS Trust,
  91. Robert Etherington, consultant radiologist, Countess of Chester Hospital,
  92. David Lawrence, consultant in public health medicine for IFRs, NHS SE London and honorary senior lecturer, Department of Health Services Research and Policy, London School of Hygiene and Tropical Medicine,
  93. Henry Fell, retired consultant microbiologist, Bury St Edmunds,
  94. Edward Clarke, GP, Liverpool,
  95. Julian Ormerod, Great Western Hospital, Swindon,
  96. Oliver Ormerod, cardiologist, John Radcliffe Hospital, Oxford,
  97. Maggie Ireland, public health doctor, North East,
  98. John A T Duncan, retired consultant anaesthetist, Fife,
  99. Rajiv Chandy, consultant gastroenterologist, St Helens and Knowsley NHS Trust,
  100. Jennifer Mindell, clinical senior lecturer, Health and Social Surveys Research Group, Research Department of Epidemiology and Public Health, UCL,
  101. Paul Mullen, Penny Lane Surgery,
  102. Phillip Bennett-Richards, GP, Aberfeldy Practice, Tower Hamlets,
  103. Julie Hirst, public health principal, Derbyshire,
  104. E Murphy, GP, Bristol,
  105. P Martin, Queens Road Partnership, London,
  106. Simon Lowes, radiology specialty registrar, Newcastle upon Tyne,
  107. Peter Fleming, professor and consultant paediatrician, University Hospitals Bristol,
  108. Richard Grunewald, consultant neurologist and secondary care representative on Hull CCG,
  109. Joanne Reeve, GP, Liverpool,
  110. Martin Schweiger, consultant in communicable disease control, Leeds,
  111. Jonathan Coates, GP registrar, Newcastle,
  112. George Farrelly, GP, The Tredegar Practice, London,
  113. M A Chamberlain, professor, rehabilitation medicine, Leeds (retired),
  114. Geoffrey Lewis, consultant cardiac anaesthetist, Leicester (retired),
  115. Jane Young, consultant radiologist, London,
  116. Brian Scott, Emeritus consultant physician, Lincoln,
  117. John Gibbs, paediatrician, Chester,
  118. Aileen Landers, staff grade ophthalmologist, Kingston Hospital NHS Trust,
  119. Pete Deveson, GP, Epsom,
  120. Grant Ingrams, The Crossley Practice, Coventry,
  121. Martha Leigh, GP, Wapping Health Centre, London,
  122. Jeff Gawler, retired neurologist,
  123. Amy Ford, specialty registrar, Clatterbridge Oncology Centre,
  124. Jonathan Nixon, St Andrews, Fife,
  125. Margaret McCartney, GP, Glasgow,
  126. David Bareford, Worcester,
  127. Surinder Singh, GP and senior lecturer in general practice, UCL,
  128. Kate Lockwood, doctor,
  129. Michael Cripwell, GP, Islington.,
  130. Peter Ehrhardt, consultant paediatrician, Leeds,
  131. David Bell, consultant psychiatrist, Tavistock and Potman NHS Foundation Trust,
  132. Pam Wortley, retired GP, Sunderland,
  133. Laurie Tomlinson, honorary consultant, Addenbrookes Hospital,
  134. Julie Hotchkiss, Ashton, Leigh and Wigan Primary Care Trust,
  135. Steven Ford, retired GP, Haydon Bridge,
  136. Gill Turner, consultant paediatrician, West Northumberland, Hexham General Hospital,
  137. Gerard Reissman, GP, Newcastle,
  138. David Lewis, general practitioner, Vauxhall Primary Heath Care,
  139. Chris Johnstone, GP, Paisley,
  140. Mike Tomson, GP and trainer, Mathews Practice, Sheffield,
  141. Payam Torabi, SHO (GP VTS), department of clinical gerontology, King’s College Hospital,
  142. David Bell, London,
  143. D Tomson, freelance consultant in patient centred care,
  144. Alex Tulloch, senior clinical researcher, Health Services and Population Research Department, Institute of Psychiatry, King’s College London,
  145. Sally Johnston, GP, Hampshire,
  146. Jane Dickinson, Newcastle,
  147. Elisabeth McElderry, GP, Devon,
  148. Wendy Ross, GP, Newcastle,
  149. Kim Holt, consultant paediatrician, London,
  150. Mary Logan, GP locum, Enfield and Waltham Forest,
  151. Hilary Klonin, consultant paediatric intensivist, Hull,
  152. David Jenner, GP, Cullompton,
  153. Jude Danby, NHS GP, Bradford,
  154. V Goodger, GP principal, Hereford,
  155. John Puntis, consultant paediatrician, General Infirmary at Leeds,
  156. Harriet Dickson, GP, Exeter,
  157. Derek A Gould, professor and consultant radiologist, Royal Liverpool NHS Trust,
  158. Anna Livingstone, GP, Limehouse Practice, London,
  159. Dianne Lefevre, psychotherapist, Basildon,
  160. Bryony Kendall, Aintree Park Group Practice, Liverpool,
  161. G Singh, Rosebery Medical Practice, Loughborough,
  162. Peter Hall, chair, Doctors for Human Rights,
  163. Jonathan Darling, senior lecturer and honorary consultant in paediatrics and child health, Academic Unit of Paediatrics and Obstetrics and Gynaecology, Leeds Institute of Medical Education,
  164. Adrian N Hamlyn, consultant physician, Dudley,
  165. Anita Patel, Barnet,
  166. Jonathan Erskine, research associate, Centre for Public Policy and Health, School for Medicine, Pharmacy and Health, Durham University,
  167. Brian Fisher, GP, London,
  168. Richard Hughes, professor, London,
  169. Clare Highton, chair, City and Hackney CCG,
  170. Helen Venning, retired consultant paediatrician, Grantham, Lincs,
  171. Ron Singer, President, Medical Practioners’ Union—Unite,
  172. Steve Brearey, consultant paediatrician, Countess of Chester Foundation NHS Trust,
  173. Jim Sikorski, Sydenham Green Group Practice, London,
  174. David Paintin, Emeritus reader in obstetrics and gynaecology, Imperial College School of Medicine at St Mary’s, London,
  175. John Feehally, professor and consultant nephrologist, University Hospitals of Leicester, professor of renal medicine, University of Leicester, and president, International Society of Nephrology,
  176. Wendy Savage, professor, London,
  177. Kathy McAdam Freud, GP principal, London,
  178. Victoria J Holt, GP lead, urgent care, Homerton University Hospital, London,
  179. Alison Gill, respiratory ST6 doctor, Leeds,
  180. Tony Waterston, retired consultant paediatrician, Newcastle upon Tyne,
  181. Richard de Souza, GP, Portslade, Brighton and Hove,
  182. Nicholas Hopkinson, consultant chest physician, London,
  183. Mike Beadsworth, consultant in infectious diseases, tropical medicine, and clinical pharmacology, Liverpool,
  184. Andrea Franks, consultant dermatologist, Chester,
  185. Helen Daley, consultant community paediatrician, Child Health Services, Fareham,
  186. Paul Cullinan, professor in occupational and environmental respiratory disease, Imperial College (NHLI) and Royal Brompton Hospital, London,
  187. Adriana Basarab, consultant, Department of Infection, University Hospital Southampton NHS Foundation Trust, Southampton,
  188. Jonathan Folb, consultant microbiologist, Liverpool,
  189. Hugh Gurling, professor of molecular psychiatry and honorary consultant psychiatrist, Mental Health Sciences Unit, University College London,
  190. Pam Zinkin, London,
  191. Simon Kirwin, specialist registrar in liaison psychiatry, London,
  192. Ernst Buhrs, GP, Liverpool,
  193. Raymond Brown, consultant paediatrician,
  194. Andrew West, consultant child and adolescent psychiatrist, Reading CAMHS and PPALS,
  195. Gary Marlowe, GP, de Beauvoir Surgery, London, ,
  196. Griffith Fellows, retired urologist,
  197. John Main, consultant nephrologist, South Tees Acute Hospitals NHS Trust,
  198. Jackie Applebee, GP, London,
  199. M Koperski, PEC chair, Camden, London,
  200. Phil Jones, consultant intensivist and cardiothoracic anaesthetist, St Bartholomew’s Hospital, London,
  201. Alison Macfarlane, School of Health Sciences, City University London, London,
  202. Naomi Beer, GP, Jubilee Street Practice, London,
  203. Rebecca Mason, specialty registrar in public health (ST3), Mersey Deanery,
  204. Robert West, emeritus professor of epidemiology, Wales Heart Research Institute, Cardiff University,
  205. Maggie Eisner, training programme director, Bradford Specialist Training Scheme for General Practice,
  206. Alison Smailes, GP, Tower Hamlets, London,
  207. Philip Timms, consultant psychiatrist, START homeless team; honorary senior lecturer, King’s College London; Psychosis Clinical Academic Group (Recovery), South London and Maudsley NHS Foundation Trust,
  208. David Knight, Barnabas Medical Centre, Northolt,
  209. Coral Jones, GP, London,
  210. Barbara Wesby, retired GP, Lambeth, London,
  211. Laura Lyttelton, GP examiner and appraiser, Hackney, London,
  212. Richard Morrison, retired GP,
  213. David Bossano, St Leonards Practice, Exeter,
  214. Jonathan Walker, consultant in critical care and anaesthesia, Royal Liverpool University and Broadgreen Hospitals NHS Trust, Liverpool,
  215. Gerry Davies, senior lecturer in infection pharmacology, Institutes of Global Health and Translational Medicine,
  216. Peter Godfrey, GP locum, Devon,
  217. Ingrid Wolfe, child public health research fellow, London School of Hygiene and Tropical Medicine, London,
  218. Emmanuel Nsutebu, consultant infectious diseases physician, Royal Liverpool Hospital,
  219. Nicola Stevenson, consultant chest physician, Wirral Hospital,
  220. Sheila Cheeroth, Limehouse Practice, Gill Street Health Centre, London ,
  221. Jo Miller, GP, Huddersfield,
  222. Guy Johnson, Edinburgh,
  223. R Noor, GP, North London,
  224. Alyson Hall, honorary consultant child and adolescent psychiatrist, East London Foundation NHS Trust.,
  225. David Bostock, 14 Davenport Park Road, Stockport,
  226. Benedict Michael, NIHR doctoral research fellow, Institute for Infection and Global Health, University of Liverpool,
  227. John Sharvill, GP, Balmoral Surgery, Deal, Kent,
  228. Jamie Macpherson, GP, Coventry,
  229. David Lewis, GP, Watford,
  230. Richard Ma, GP, London,
  231. John Middleton,, director of public health, West Midlands,
  232. Anne Jeffreys, salaried GP, chair of East Yorkshire and Humberside LMC,
  233. Jim Cole, GP, London,
  234. John P Boswell, public health specialist, Stirlingshire, Scotland,
  235. Bob Bury, consultant radiologist, Leeds,
  236. Sally Mitchison, retired consultant psychiatrist, Sunderland,
  237. Ann-Louise Kinmonth, emeritus professor of general practice, University of Cambridge,
  238. Gail Young, retired GP, Newcastle upon Tyne,
  239. Iain Maclennan, doctor,
  240. Pat Munday, retired consultant genitourinary physician, Flaunden
  1. drjcdavis{at}

An open letter to the BMA and the Academy of Medical Royal Colleges calls on them to make a joint public statement of opposition to the amended section 75 regulations

On 1 April the government is due to enact enabling legislation to the Health and Social Care Act, which will in effect require clinical commissioning groups to enter into competitive tendering for all NHS services. This contradicts clear promises made in the letter that former health secretary Andrew Lansley sent to clinical commissioning groups on 16 February 2012, which stated “it is a fundamental principle of the Bill that you as commissioners should decide when and how competition should be used to serve your patients’ interests.”1

The original section 75 proposals were withdrawn after widespread protests. Amended regulations were tabled, but there is widespread consensus (including Counsel’s opinion) that these do not change the underlying thrust. The amended regulations state that commissioners are not required to advertise if “satisfied” that the services can be provided …

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