Jeremy Hunt needs to eliminate competition from the NHS

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I am amused (but only very slightly, and then sardonically) by the fact that Jeremy Hunt, the Health Secretary, is having to impose regulation on NHS Trusts to limit the impact of market competition upon their operations.

The whole reason for the vast number of NHS trusts we suffer from in the UK is that they supposed to create competition that exerts upward pressure to enhance efficiency in the NHS. That, though, is just theory. As anyone with real world experience could readily spot,  the real outcome was bound to be increased administration,  empire building,  and most importantly, the collapse of the NHS's  monopoly buying power  and its replacement by a monopsonsitic situation where  sellers hold all the economic power. This is exactly what has happened: agency suppliers of staff have faced many competing NHS bidders for limited resources and, inevitably, the price has risen as a result, entirely because of the artificial subdivision of the NHS imposed upon it by successive governments when, very obviously, central buying power is critical to its economic and operational success.

There is, of course, one very obvious answer to this, and that is to reorganise the NHS into regional authorities combining primary, secondary, tertiary and social care, and with central buying authority across the whole of their geographic domain and  with responsibility to coordinate integrated supply of all services.  Competition has no role to play in such an organisation, but this is not dogmatic choice: this is recognition of exactly what is needed to supply modern health care  at the lowest cost. It is dogma, and dogma alone, that is preventing that happening.

Jeremy Hunt  is demanding £22 billion of savings from the NHS:  my suggestion is one of the best ways to help achieve that goal.


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