Intended for healthcare professionals


Campaigners step up fight to “kill off” commissioning regulations

BMJ 2013; 346 doi: (Published 05 April 2013) Cite this as: BMJ 2013;346:f2168
  1. Gareth Iacobucci
  1. 1BMJ

Opponents of controversial regulations that will require large sections of the NHS to be tendered to the open marketplace have stepped up their fight to “kill off” the proposals, ahead of a crunch parliamentary debate and vote later this month.

The regulations, which critics say will lead to widespread privatisation and fragmentation of the NHS, will be subject to a debate and vote in the House of Lords1 on 24 April, following a “fatal motion” laid down by Philip Hunt, deputy leader of the opposition in the House of Lords.

Ahead of the key debate, the website Open Democracy has published 15 testimonies2 from a mix of leading doctors, campaigners, and academics, outlining the importance of blocking the legislation in its current guise.

The Department of Health has already been forced to redraft the regulations,3 published under section 75 of the Health and Social Care Act, following pressure from general practitioners (GPs), royal colleges, and opposition politicians.

But opponents to the plans maintain that the changes have not dealt with their fundamental concerns,4 after legal advice obtained by campaigning group 38 Degrees5 concluded that clinical commissioning groups would still be required to put all services out to tender, unless there is only one provider available to provide the service.

The BMA’s general practitioners committee has also passed a vote demanding the withdrawal of the legislation,6 while the House of Lords Secondary Legislation Scrutiny Committee has accused ministers of allowing “insufficient time” for proper scrutiny of the revised regulations.

The reactions published by Open Democracy include a passage from Hunt, who wrote: “The public will never forgive the governing parties for undermining one of the nation’s most popular services. Let’s hope that enough Tory and particularly Lib Dem peers understand their wider responsibility and support my motion to kill off the regulations.”

Also responding was Clare Gerada, chair of the Royal College of GPs, who wrote: “The new reforms, of which these regulations are a key part, remove the legal framework for a universal, publicly provided, publicly managed, publicly planned, democratically accountable health service.”

John Ashton, president-elect, Faculty of Public Health, added: “Despite government denials, expert legal opinion is that the regulations, even as revised, will make it obligatory for the new market structures, the CCGs [clinical commissioning groups], to put all services including NHS hospitals out to tender in the marketplace.”

Kambiz Boomla, a GP in Tower Hamlets, East London, and member of Tower Hamlets CCG, warned: “These regulations are likely to be the death of clinically led commissioning, and the birth of lawyer led commissioning.”

Crossbench peer David Owen urged fellow Lords to scrutinise the changes carefully. He wrote: “The basic choice for peers is, do we support our own scrutiny procedure? Or do we continue to allow the government to make changes to the NHS, without proper consultations, democratic authorisation and on specious grounds of urgency?”


Cite this as: BMJ 2013;346:f2168


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