Commenting on the publication of today's report on Any Qualified Provider by the Cooperation and Competition Panel (CCP), David Stout, director of the NHS Confederation's Primary Care Trust Network, said:

"Patient choice is an important part of the modern NHS and commissioners have a duty to promote choice for secondary care.

"We support the CCP's view that commissioners have to be able to justify any decisions to restrict patient choice on the basis of value for money for taxpayers or benefits to patients, and agree that such decisions should be fully transparent.

 "Today's report rightly acknowledges that each situation will be different and the extent that any benefits outweigh the loss of choice should be considered on a case-by-case basis.

"The CCP have for the first time provided some clarity in setting out how it would judge such decisions. But commissioners will still be left to decide the right course of action when faced with trade-offs between patient choice and value for money. The suggestion that many current PCT decisions are not justifiable on these grounds is largely unsubstantiated by the detail in the report as the CCP has not investigated specific cases in detail.

"The report also highlights a number of Department of Health policies such as the market forces factor and the original ISTC contracts which have made the trade-off between value for money and patient choice more difficult. We agree these should be resolved as a matter of urgency.

"There are other policies that need to be put right if AQP is to progress, such as the implementation of an effective failure regime for providers which does not pass costs on to commissioners, and a pricing policy that avoids the risk of cherry picking. Until these issues are addressed, commissioners will continue to make decisions on occasions which to some extent restrict patient choice."