Briefing Paper P037 Government NHS White Paper Proposals: Regulating Healthcare Providers


As part of its work Hastings Voluntary Action have produced this briefing - as part of a series on the Governments NHS White Paper.

A General Presumption of Freedom from Regulation

The Governments belief is that the “natural condition of organisations ought to be one of freedom rather than being shackled. In this way the Dept of Health will support organisations to develop and mature; they will be accountable but not infantilised. The Government’s approach is that where specific control
mechanisms are needed for providers, these should in general take effect
through regulatory licensing and clinically-led contracting, rather than
hierarchical management by regions or the centre.

Foundation Trusts Throughout the UK

Regulating Healthcare Providers’ makes the case for releasing foundation trusts so we have the most vibrant social enterprise sector anywhere in the world. Monitor will be given new powers to defend the interests of patients and the public, through regulating prices and protecting choice and competition. In the White Paper ‘Equity and Excellence: Liberating the NHS’, the Government set out that all NHS trusts will become foundation trusts by 2013. These bodies will also be given new powers by:-

  • removing the statutory private income cap to give trusts opportunities to expand the services they offer to patients - but ensuring that they remain focused on providing NHS services;
  • removing statutory borrowing limits that are not imposed on voluntary or private providers;
  • making it easier for a foundation trust to merge or take over another trust; and
  • giving more flexibility to foundation trusts to allow greater staff and patient involvement – with the possibility of some smaller organisations being led only by employees

Economic Regulation

Monitor will be developed into the economic regulator for all of health and adult social care in England. Monitor’s principal duty will be to protect the interests of patients and the public in relation to health and adult social care services, by promoting competition where appropriate, and through regulation where necessary. Monitor will be required to exercise its functions in a manner consistent with the Secretary of State’s duty to promote a comprehensive health service in England and have regard to the following objectives:

  • maintaining the safety of patients and individuals accessing services
  • securing ongoing improvements in quality of care
  • providing equitable access to essential health and adult social care services
  • supporting commissioners in maintaining continuity of essential services
  • securing ongoing improvements in the efficiency of services
  • promoting appropriate investment and innovation
  • making best use of limited NHS and adult social care resources.

Monitor will license providers of NHS services in England and exercise functions in three areas: regulating prices, promoting competition and supporting service continuity. Its statutory remit will be limited to the provision of health and adult social care services.

Further information

A full downloadable copy of the consultation paper can be found via the Department of Health website:-

Responding to the Consultation

Responses to the questions in this consultation document should be sent to or to the White Paper Team, Room 601, Department of Health, 79 Whitehall, London SW1A 2NS by 11 October 2010.



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