Tuesday 15 January 2013

NHS Partners Network Response Regarding Fair Playing Field

Social Investigations - contacted the NHS Partners Network over their submission to Monitor, regarding the 'Fair Playing Field' review currently taking place.

In order to maintain openess - I have listed the entire response without editing here so readers can make their own mind up.

View the NHS Partners Network submission here.


Let me make it absolutely clear that contrary to some reports at no point have we asked for relief from corporation tax. We have simply pointed out that in undertaking an analysis of the different economic factors that affect public and private sector providers of care, corporation tax is one of those factors that impacts on the private sector, but not on the public sector. We have also made clear that we recognise there are factors that work the other way and we now wait to see how Monitor's wholly independent and impartial analysis concludes the various factors "net out" and whether anything can or should be done about that overall, in the interests of patients not of providers", that being Monitor's remit.

You may not have seen Monitor's statement today, which makes their position on corporation tax clear and is indeed what we expected. It says:

"There is no draft report of the Fair Playing Field Review and Monitor does not intend to provide a running commentary on the review.  Monitor has yet to decide what recommendations it will make to the Secretary of State. However in the light of recent media speculation, Monitor has decided to clarify the position on one specific issue. While it is the case that corporation tax is one of many distortions that the review is looking at, Monitor will not be recommending that private sector providers should be exempt from paying corporation tax."

Answers to Questions
The Guardian recently revealed how tax breaks were part of the first draft of the review, seen by a 'source' -

The submission you made, which a source has handed to me shows your organisation pushed for this to be looked at as part of the review. Comment: Our submissions in response to public consultations are assumed to be in the public domain anyway and we are happy to share them with anyone who asks to see them.

You state how: 'The issues of a 'Fair Playing Field') must be viewed dispassionately through the lens of impartial and quantified economic analysis' However, despite the emphasis on 'economic analysis', no additional information was provided to suggest how they reached the 2/3% figure  stated in their submission. Q. To what do you base this figure on?  A. The full OHE study was provided as a formal annex to our submission and provides the basis for this analysis.

You also mention concerns over the NHS brand and how this may unduly lead to favourtism as the public trust the name. Q. This is why you attach the NHS to your name?  A. No, our name reflects the fact that we work in partnership with the NHS and are part of the NHS Confederation.
The NHSPN considers that the most illuminating piece of independent work on this complex subject was done in 2009 by the Office of Health Economics. This was part-funded by you. Q. Should this be seen as bias? A. No. The report was co-funded by the NHS Confederation and the report itself makes completely clear that it was wholly independent. It went through OHE's normal peer review processes. We played no part in the actual study and we have no doubt that OHE would take any allegations to the contrary very seriously.

You mention that various public attitude research has shown 'remarkably clearly' that patients are less concerned about who provides care provided it is free at the point of delivery and meets NHS standards. Q. Are you referring to a survey you paid for that was conducted by Brunswick?  A.Yes, supported by other authoritative independent reports which also indicate that most of the public are not worried about who provides their care as long as it is free at the point of delivery and is of high quality. For example, The Provider Diversity poll, (Confederation of British Industry, 2009); and British Social Attitudes 2009 (Sage Publishing, January 2009).

You state that private companies are subject to different regulatory regimes but fail to mention FOI. Q. Would your members be willing to be subject to Freedom of Information and thus being more transparent to the public? A. If there was a general application of FoI to all organisations that are not public sector but have dealings with the public sector, we would of course accept that position. Unless that is the case there is no reason for us to be treated differently to any other non-public sector organisation. The NHS Partners Network fully adheres to the NHS Confederation's policies and practices on transparency.

The submission, shows how you consider training and medical education as not being relevant to the 'Fair Playing Field' despite as you admit, many of your members benefiting from this training. Q. Why should this be left out? A. We do in fact recognise there is a legitimate discussion about medical education and training but there is a need for a much fuller and longer analysis of the issues before any conclusions can be reached. The independent sector also undertakes extensive medical education and training which has not been generally understood or recognised and this also needs to be taken into account.

Given your challenge to the public sector over the issues of pensions, training, medical education and the NHS 'brand' Q. Can you see why the public may view your behaviour as devisive and against collaboration? A. We have not "challenged" the public sector on these or any other "fair playing field" issues. We have simply sought to identify and quantify factors which may mean that, should commissioners wish in the interests of patients, to use alternative providers,  then economic factors do not prevent them from doing so in practice. Establishing a fair playing field will in practice facilitate collaboration.
Your document that was a feedback to members during the Health bill 'pause' stated: 'I had a second lengthy meeting with Stephen to discuss the position with him last week, under the auspices of "Reform", with only a handful of other (all like-minded) people present, including 'David Bennett, the chair of Monitor. He has also consistently taken the same line as us throughout.' Q. Are you confidant this connection you have with Mr Bennett will result in a favourable report? A. We are confident that Monitor will produce a properly considered and completely independent and impartial report and we will, like everyone else, have to wait and see what it actually says.

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