Changes to the Health and Social Care Bill: Monitor and regulation

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Part of Reforming the NHS: changes to the Health and Social Care Bill

The comparison below sets out the Health and Social Care Bill's initial proposals as regards Monitor and regulation, what has now changed and some key questions that remain unanswered.

The original proposals in the Health and Social Care Bill

  • Monitor to become the new sector-specific economic regulator for health, with concurrent powers with the Office of Fair Trading.
  • Monitor's primary duty to protect the interests of patients. This is to be achieved by promoting competition 'where appropriate' and regulation 'where necessary'.
  • Monitor also responsible for setting prices (with the NHS Commissioning Board), ensuring continuity of essential services (with commissioning consortia) and licensing providers (with the Care Quality Commission).

What has changed in the proposed reforms?

  • Monitor remains the sector-specific regulator. The Co-operation and Competition Panel will be absorbed within it and their rules will be given statutory force.
  • Monitor's duty to promote competition removed, with a number of changes to focus its powers on preventing anti-competitive behaviour.

What is still unanswered?

  • How will Monitor, the Care Quality Commission and the NHS Commissioning Board work together to ensure that their decisions do not conflict with each other?
  • Should Monitor's role be extended to include prudential oversight of the financial viability of health and social care providers with a significant market share of publicly-funded services?

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