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Health Secretary Andrew Lansley today outlined how the NHS must embrace value-based competition if it is to meet the future needs of the public it serves.

Speaking at the Maximising Quality, Minimising Cost conference, hosted by Monitor, the future economic regulator, and UCL Partners, the Health Secretary outlined how competition must be based on the quality of results for patients and not cost alone. Under the plans to modernise the Health Service, providers that deliver excellence will benefit from more patients choosing their service. Those that do not will have a strong incentive to change and improve.

A recent report from the European Association for Cardiothoracic Surgery showed that survival rates of heart surgery in England had improved as a result of the publication of outcome data by cardiac surgeons themselves. This drove competition and cooperation and forced up standards dramatically, delivering benefits for patients. This is an example of value-based competition.

Health Secretary Andrew Lansley said:

“Our plans to modernise the NHS will finally bring the power of competition to healthcare. Not a free-for-all race to the bottom, but a race for quality, for excellence and for efficiency.

“We will change the default in the health service decision-making, so that it is GPs – the people who see patients every day – and their clinical colleagues across the NHS, social care and local government, who decide what and how services are provides. This is about giving patients and commissioners real choice for the first time.”

Responding to concerns that competition leads to variation and divergence across the country, the Health Secretary said:

“Despite the best efforts of the centre, variation already exists. The difference will be that future variation will be because local communities have chosen that variation. It will be the very opposite of the postcode lottery.

“Because of the nature of competition, some providers will perform better than others, but that does not mean that people will receive worse care than they do now. In fact, the evidence is that where there is effective competition, all producers are driven to raise their game, so that even those providers that are less successful improve, and that those served by them also receive a better service.”

In the future, Monitor will have a vital new role in ensuring effective competition and a level playing field, acting in the interests of patients and the taxpayer. They will also oversee the process of price competition, which is to be allowed only where it is deemed appropriate and where it will not harm quality of service.

The Care Quality Commission will ensure that essential standards in quality and safety are not put at risk. The Health and Social Care Bill, published last week, will for the first time place a legal duty on commissioners to continuously improve quality.

This will create opportunities for frontline staff to develop better services that reflect patients’ needs, for example those patients with chronic diseases where their quality of life is profoundly dependent on the quality of their healthcare.

Notes to editors

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  • Government


  • department of health (national)
  • maximising quality
  • andrew lansley