In February, the Department of Health laid before Parliament the National Health Service (Procurement, Patient Choice and Competition) Regulations 2013. These Regulations will come into force on 1 April 2013, as part of a raft of new rules that underpin the structure of the re-organised NHS. The Regulations will do what they say on the tin. They say that the NHS Commissioning Board and any Clinical Commissioning Group must act with a view to securing the needs of people who use the NHS, improving the quality of services and improving efficiency in the provision of services.
The Regulations also say that the Board and any CCG must act in a transparent and proportionate way and treat providers equally and in a non-discriminatory way, including by not treating a provider more favourably than any other providers, in particular on the basis of ownership. The Regulations go on to say that commissioners must not act in an anti-competitive way and that the Board and CCGs must not award a contract for health care services where conflicts or potential conflicts of interest arise. It all seems very sensible.
The Regulations are not intended to be toothless: Monitor is given power to investigate complaints and to enforce the Regulations. Indeed, before the Regulations were published, Monitor undertook a consultation exercise in relation to the way it intends to enforce its duty to protect and promote the interests of people who use health care services.
Pharmacy Voice responded to the consultation. Monitor says offenders may be told to take remedial steps or to pay a financial penalty. Alternatively, Monitor may accept undertakings to ensure that breaches do not continue or recur. Monitor will look at the seriousness of breaches, whether there is a need to deter similar breaches, and the proportionality of any remedy. If Monitor does decide to impose a financial penalty, this can be up to 10% of a provider's turnover. Pharmacy Voice announced that it broadly welcomed Monitor's Enforcement Guidance. That was before the new Regulations were laid before Parliament. Pharmacy Voice could not have known that there would be one area of healthcare to which the Regulations would not apply: the provision of pharmaceutical services. When it comes to pharmacy, it seems that the principles underpinning procurement, patient choice and competition are excluded. I have not been able to discover why pharmacy being singled out for different treatment. If this bothers you, I suggest you write to your MP.
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