The NHS and Social Care Reforms are a platform to increase competition and collaboration between the sectors. It is not a new concept, but competition should be welcomed openly. The NHS and Community Care Act (1990), that introduced the “Internal Market” and GP Fundholding, is our example. Despite the many changes in these organisations, competition has not been weakened and is still a daily practice in various forms. On reflection, the delivery of services would synchronise to policies on resource availability and would continue to do so in today’s economic climate. The powers of professionalism in partnerships would create opportunities to reformulate strategies capable of managing competition within the sector.
The competition within an organisation should not be seen as a fight between departments, but rather as a market opportunity that encourages negotiation along specialist service delivery. The new delivery methods for health and social care will require that GPs compete with other local authorities to obtain hospital services/treatments, mental healthcare services, community clinics, and any other contracts. The health bill, which will give legal certainty and legality to high quality service delivery and maximum utilization of resources, will be a key element in the implementation of the new approaches to health and social care. Competition has been a practice in private sector for many years and has maximized the quality of services delivery as well as flexibility on the wider consumer market.
Why should professionals and other support staff be ambivalent about the concept of competition and partnership work, which has been the buzzword of recent years? According to professionals, integrated care results in efficiency, effectiveness, and efficient utilisation of skills, as well as maximisation of resources, and reductions in duplication between agencies. This indicates savings across the sector. Critics might argue that competition leads to a loss of social and health care. Patients become commodities, which means that profits are passed on or taken from one profit center to the next. However, this could be true in some cases. In any business, whether it’s a welfare service, profit-making organization, the main objectives are to minimize waste, delegate responsibilities and create a cost center that is capable of monitoring spending according to budgets.
Competition could be seen in the current economic climate as an antithesis to collaboration between agencies. It ensures maximum financial resources and labour capital. In the private sector, however, government legislation, regulations, and courts can strengthen cooperation if they believe companies are “collaborating” over price fixing, or practicing monopoly. Our references can be drawn from superstores that are regulated by the “Trading Standards”. This means that they cannot fix prices or charge too much to consumers. Practically, no superstore would be able to dominate the entire grocery market. The public sector cannot have both its cake and eat it, and that is in parallel with health and social care organizations. The legislation and policies that limit monopoly within the sectors allow agencies to enjoy the cost-cutting forces of competition without having to atomize services and disregard the public’s interests.
Retrospectively, the greatest strengths of the agencies are their professionalism. Social workers, nurses, occupational therapists, and doctors will all agree that their ethical and training commitments put the needs of patients and users first. Other interests are important, such as their own pay, safety, and standard of living. One way to put it is that clinicians internalize the conflicts that will inevitably arise, and we are happy for them to move on to the reconciliation. Recent times have seen services and care prioritized within the eligibility matrix. However, professionals can still practice their principles.
Although the fundholders (GPs, Social Workers and Commissioners) can compete, their shared professional identity does not allow for competition that could lead to anarchy. The NHS and social services rely on non-professionalised staff such as managers and support staff, including commercial departments, facilities management teams, and financial services personnel to manage their budgets. Competition can be accepted as long as everyone believes they are part and parcel of the same organisation, such as the chief executive of the local authority, the chief physiotherapist, and the receptionist for the sector.
According to legislation and policies that govern welfare institutions, professionalism and organisational behavior are both restraints on reckless trade. Restricting economic principles and markets in modernized services will not provide protection for service users or patients. They would otherwise be treated as consumers who have no choice in the market. The GPs, social services, and hospital consultants are considered partners in care. This is due to their professionalism and shared sense of belonging to the larger welfare system. A contract is the best way to support legality and agreements. It will, by its very nature, supervise and regulate social and health care delivery. This is to protect patients and service users who may be at risk due to the nature of their condition.
The term partnership has been a common word in the public service, especially when spending is high. The previous government spent a lot of energy and time trying to align the interests between councils, NHS, and other service providers in health and social care. The coalition government, on the other hand, should provide details about what is working and support policies that were put in place by the New Labour administration.