Competition at a cost of inter-professional and inter-organizational collaboration — report

Despite evidence questioning the effectiveness of such changes, the Toronto Star revealed this week the McGuinty government is considering a plan to have hospitals compete with each other for the right to perform certain procedures and treatments.

March 1st Civitas, an independent international public think-tank, released a comprehensive overview of research into market-based policies in the UK health system.

The report questions whether such reforms were responsible for reduced wait times, improved access to patients, and increased provider efficiency given other simultaneous factors. Those factors include substantial increases in funding and what they define as “targets and terror” – a strict emphasis on targets with repercussions for failure. “Targets and Terror” is not far off from the Ontario government’s present accountability agreements.

The Civitas report concludes “the available research indicates that the NHS may have found itself in a lose-lose situation – taking on the extra cost of competition without experiencing the benefits. The report particularly cautions that such reforms de-motivate staff and leaves few NHS organizations attempting to deliver innovative models of patient care.

Civitas specifically sates that “contestability or the threat of competition may be driving up efficiency but at the expense of inter-professional and inter-organizational collaboration.” Given the emphasis of the Ontario government on integration of health service providers, this report should be a wake-up call.