Speaking today at a Westminster Health Forum conference, the NHS Confederation's NHS Partners Network director David Worskett said the NHS must not turn its back on choice and competition.

Responding to Deputy Prime Minister Nick Clegg's reported views on the role of Monitor, David Worskett said that well-managed competition would be one of a number of  key levers the health service would need in order to respond to the huge demographic and financial challenges facing it in the years ahead.

He said:

"All systems need competitive challenge. It can come in different forms, and needs to be expertly managed and tailored to suit the sector it is applied to. If you are going to have meaningful choice for patients - and that should be a given - then you must have a means of managing competition between those providers so that it is beneficial not damaging.  

"There is now a danger that if the NHS turns its back on competition, it may be depriving itself of one of the levers it needs to help it adapt and respond to the huge demographic and financial challenges it faces in the next 20 years, whilst maintaining and improving patient care."

Mr Worskett said patients, and the development of real patient choice, would benefit from tailored, sector specific application of competition rules.

"Good economic and competition regulation can promote the integration of services. Integration and competition are not fundamentally incompatible. But to manage them constructively together you need a strong specialist economic regulator, which is why watering down the role of Monitor could have exactly the opposite effect to the one desired. We need to grasp the fact that Monitor is the answer to concerns about the role of competition, not the cause of them. A specialist competition regulator is vastly preferable to having the application of competition law developed by the courts.

"We should be mindful that poor commissioning can be hugely damaging to the integration of services. More attention needs to be paid to whether that aspect of the reforms will really deliver the integrated care we all believe in."