Hewitt claims companies' role in NHS care 'to be set locally'

An end seemed in sight to the era of big, centrally negotiated contracts between private healthproviders and the government yesterday when Patricia Hewitt said patients, primary care trusts and family doctors would decide the extent of private sector involvement in the National Health Service.

In a speech in London to the Institute of Public Policy Research, the think-tank, the health secretary risked the wrath of trades unionists and Labour left-wingers by declaring that the government would set no curbs on the extent of private sector provision of NHS care.

"We don't need to set arbitrary targets or limits for one provider or another" - whether the private or voluntary sector, or direct NHS-owned provision, she said.

Instead, the answer to the question "where will the NHS be in five, 10 or 15 years" would come "not from Whitehall but from the choices of patients, the decisions of local commissioners and the creativity of hospital and community staff".

If independent providers "can help the NHS provide even better care and value for money for patients, we should use them. If they can't, we shouldn't".

But the decision to use the private sector would increasingly become a local one, she said. Under questioning, she said: "We are not planning any new central procurements." She "saw no need" for a third wave of independent treatment centres.

Invitations to tender are already out for the private sector to supply under-doctored areas, and to support or supply the commissioning of care.

Beyond that there could, she indicated, be situations where the centre could help with contract expertise and frameworks for negotiations on which primary care trusts and others could call.

"But in future I think the share [of NHS care] that a particular provider will get will depend on local needs and the decisions of patients and commissioners."

The declaration that the government would set no limit to independent sector involvement in the health service angered the health unions.

James Johnson, the chairman of council for the British Medical Association, said the doctors' organisation was "very concerned about the potential open-door policy to the private sector".

Ms Hewitt, however, stressed that the NHS would not become "only" a commissioner, or a "kind of glorified insurance system buying services from the private sector". It would always remain a provider of care "because of the quality and commitment of its staff, in and outside hospitals".

The majority of hospitals and community services would remain publicly owned but their ownership would change to foundation trust status, owned not by the government but by the public and run by their staff.

http://www.ft.com/cms/s/5a2d74c2-4844-11db-a42e-0000779e2340.html

Health Direct wonders whether the labour government’s Secretary of State Patricia Hewitt is losing her marbles.

On the one hand we have here her saying under questioning yesterday "We are not planning any new central procurements."

Then on the other, within the past fortnight we have the outsourcing of the NHS logistics £22 billion contract (5 Sep 06- DHL signs £22 billion NHS supply deal) and the ongoing NpfIT £20 billion white elephant to connect up the NHS. (20 Mar 06 -NPfIT NHS plan is evolving but one-size-fits-all is a fundamental flaw says hospital chief.)

One can’t use the excuse of Hewitt brazenly being economical with the truth so the only other possibility is that her centralised micro managing is losing it’s joined up thinking.