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

The original proposals in the Health and Social Care Bill

  • 'Any willing provider' will be able to provide NHS-funded services.
  • Providers to be permitted to offer services at less than the mandatory tariff price.

What has changed in the proposed reforms?

  • Any willing provider now called 'any qualified provider' and will be phased in gradually from April 2012.
  • Amendments made to outlaw price competition.
  • Amendments to outlaw any policy to increase or maintain the market share of any particular sector of provider.

What is still unanswered?

  • How will the any qualified provider policy work, will commissioners be able to commission whole pathways of care and how much flexibility will there be for them locally?
  • Under fixed prices, how will commissioners extract value for money from providers?
  • Will small voluntary sector providers be able to compete with larger providers?

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