Shopping for healthcare

Did you ever envision that shopping might be a key part of your professional career? Core skills: clinical acumen, scientific knowledge, communication style, surgical skills, research methods, and . . . shopping? Or, to give it its correct title: commissioning.

Clinical commissioning is the management and spending of healthcare budgets, usually allocated by central government. The budget is used to purchase medicines, medical devices, and healthcare services from various providers.

Commissioning in healthcare has always been a highly debated issue, and in the UK, a hot political issue, with the major parties having opposing ideological approaches to the best way to procure healthcare. The Labour party advocates the use of NHS services in preference to private providers; budget management by business managers; and national checks and drivers to improve quality. The Conservative party advocates - and has implemented - handing budgets over to GPs; allocating NHS contracts to “any willing provider”1; and driving up quality through competition.

In the UK, the controversial Health and Social Care Bill became law in March 2012. This was an attempt by the Conservative led government to reduce top down control of the NHS and to bring “an end to the pointless upheavals, politically-motivated cuts, increased bureaucracy and greater centralisation that have taken place under Labour.”2 It proposed the biggest reorganisation of the NHS since it was established. Primary care trusts (PCTs) were abolished, and instead clinical commissioning groups (CCGs) were established. These are groups of GPs who will be responsible for commissioning services for patients in their area. The bill attempts to apply market-based principles to healthcare purchasing, allowing private companies to compete for contracts alongside NHS providers. It also proposes cutting the number of health bodies (or quangos).3

Despite major …