Social work and end-of-life care

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NHS merger proposal that includes patient benefit in anti-competition decision

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Some months ago, I commented on a report of a foreign competition review of hospital mergers and said it would be interesting to see what the UK competition authorities did, faced with a hospital merger. Here is a lawyer’s view of the first one. The Office of Fair Trading looked at a proposed merger between hospital trusts around Bournemouth, decided they were potentially anti-competitive and referred them to the Competition Commission. As with the foreign case that I commented upon, the main concern, reported by the lawyer, were:

It is clear from this first case that the OFT’s chief concern was that the merger would result in diminished choice for patients and commissioning groups and therefore reduce incentives to compete on quality, which would have a detrimental impact on patients using these services.

The OFT identified at least two key parameters for competition between the Trusts:

1 competing to attract patients; and

2 competing for funding from commissioners of NHS services.

What this tells us is that there is a potential, when looking at proposed mergers in the NHS, for someone outside the NHS to look at them and see what the evidence is that patients will benefit, including convenient access, not at what the managers say about how they can save money. This provides a new area where campaigners looking at NHS reorganisations can apply pressure to the healthcare system. No independent body has ever looked before at this kind of evidence.

This is potentially a good counter-balance to financial pressures towards NHS mergers that disadvantage patients, if campaigners can use it.

Here is the link to the report: OFT’s first review of NHS Foundation Trust merger – Lexology.

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Written by Malcolm Payne

31 January 2013 at 11:35 am

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