Pity the poor patients in Yorkshire. Hot on the heels of the Haxby scandal, which saw GPs mail-shotting patients special offer in-growing toenail ops in your own lunchtime deals (£146.95 a pop), we now have Assura East Riding LLP (another bunch of suits dressed as GPs) huffing and puffing all the way to the Competition Panel about alleged predatory pricing, not by their local Asda, but by their local NHS trust. AER claim that York Teaching Hospitals NHS Foundation Trust tendered a below cost orthopaedic service, and won, and as a result the local PCT told AER and its bid to, ahem, bog off. You can read the sordid details of AER’s complaint to the CCP here (pdf, 2.3Mb).
The complaint is notable for at least three reasons. The first is that it clearly demonstrates that competition on price for NHS service provision – which La La says wont happen – is already happening. Although actual tender prices have been wiped, it is clear from the remaining text that the Foundation Trust undercut AER’s bid, in all likelihood by quite a lot. Indeed, part of the substance – if that is not too strong a word for AER’s rambling obsessions – of AER’s claim is the trust couldn’t possibly provide the service for the tendered price, and thus were offering the service below cost, either to tank the opposition, or as a loss-leader, to draw patients into its clutches.
The second, and perhaps more serious, concern is that this complaint – about a trivial outbidding – gives us a taste of the ludicrous avalanche of futile complaints that will engulf the NHS as aggrieved any willing cowboys, miffed that someone else has bagged the deal, whinge their way through the complaint system. The cost, in time lost, damaged relationships and wasted money will be unparalleled.
And thirdly, we might note in passing, that while transparency is said to be a central guiding light in the commissioning process, what we see here is the fog of ‘commercial interests’ blotting out that light. The complaint, all eighty three pages of it, tells us much about the petty nature of business bickering, but key information – the price – has been wiped. We can’t even judge for ourselves the reasonableness or otherwise of the bids, let alone AER’s convoluted – Dr No for example quite lost the plot on why predatory pricing is harmful to the taxpayer – claims.
Predatory pricing may help shoppers to choose between Asda’s cucumbers and Tesco’s tomatoes, and competition wrangling may go some way towards ensuring some sort of quasi-fairness in the vegetable market, but these commercial practices really really are not the way to run a comprehensive national health service. It’s about time the Lords got down to business and told Lansley and his ludicrous Bill to bog off.