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		</div><p><a href="http://londonglossy.com/wp-content/uploads/2011/01/call-for-new-debate-on-nhs-reform.jpg"><img class="alignnone size-full" title="David Cameron speaks to delegates at the NHS Confederation conference" src="http://londonglossy.com/wp-content/uploads/2011/01/min-call-for-new-debate-on-nhs-reform.jpg" alt="David Cameron speaks to delegates at the NHS Confederation conference"/></a></p>
<p>The head of the NHS Confederation has called for a &#8220;constructive dialogue&#8221; about the effect of greater competition in healthcare.</p>
<p>Nigel Edwards, chief executive of the independent membership body, wrote to NHS organisations as MPs prepared to debate the Health and Social Care Bill for the first time in the House of Commons today.</p>
<p>The reforms under the new bill would mean increased competition between the NHS and private companies, with GPs given greater powers to commission treatment.</p>
<p>But Mr Edwards said the debate over the use of markets in healthcare had been &#8220;unhelpfully polarised&#8221; and warned the issues had been &#8220;poorly understood&#8221;. He added that opportunities to improve care could be missed without a proper debate.</p>
<p>In the message, Mr Edwards said: &#8220;The idea of harnessing the power of markets and competition to create change has underpinned much of recent healthcare reform in the UK and other countries. But in this country the debate is unhelpfully polarised, characterised more by assertion and dogma than by evidence.</p>
<p>&#8220;The issues seem poorly understood and opportunities to improve care could be lost unless we achieve a more constructive dialogue.&#8221;</p>
<p>He also said healthcare was &#8220;not a single market&#8221; and needed a flexible approach.</p>
<p>&#8220;Some fear that competition will lead to fragmented services,&#8221; he added. &#8220;This is more likely to be the result of poor management and procurement than a direct result of markets.</p>
<p>&#8220;There are ways of organising care so competition is between integrated services that provide the whole package a patient needs. Competition does not have to create fragmentation, just as a monolithic structure does not guarantee integration.&#8221;</p>
<p>Mr Edwards said the Government needed a &#8220;sophisticated&#8221; understanding of the impact any policy change would have on healthcare.</p>
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