NHS European Office



European Commission's Expert Panel opinion on competition

On 12 June 2015, the European Commission’s Expert Panel published its opinion on competition as a way of improving efficiency in the use of healthcare resources. The opinion reviews the challenges and key issues in the use of competition across primary, secondary and specialist care and in the purchasing of medicines, giving several relevant examples from across European health systems. The NHS European Office continues to monitor EU developments in this area and will engage as appropriate. 

EU competition rules

EU competition law governs trading market structures and behaviour in order to uphold 'fair play' within the EU's internal market. It regulates anti-competitive behaviours that affect trade within the EU. The application of EU competition policy is a very complex area characterised by legal uncertainty. This makes it difficult to give definitive advice on how competition law affects the NHS. 

European legislation states that competition law applies to 'undertakings', which are classed as any entity engaged in an economic activity regardless of its legal status or the way it is financed.

However, a distinction is drawn when an organisation is fulfilling a purely social function, its activity is based on the principle of solidarity and it is non-profit making. In this case, the organisation is not considered to be an undertaking and therefore is not subject to EU competition rules.  

Whilst the majority of NHS activity could be considered to meet the test of fulfilling a social function on the basis of solidarity and not-for-profit, as the NHS develops the way it delivers healthcare to incorporate patient choice and a wider role for independent healthcare providers, the extent to which it could be challenged under EU competition rules becomes less clear.

The NHS European Office's briefing reviews the legal framework, including relevant decisions of the European courts and UK competition regulators, with a view to informing NHS organisations what EU competition rules may mean for them.  

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