I've just returned from a visit to Kuala Lumpur in Malaysia after being invited to act as an external examiner for the Master of Family Medicine programme run by the UKM (National University of Malaysia), UM (University of Malaya) and USM (Science University of Malaysia). Although the core of medical practice is similar across the world, there are striking differences in the organisation and delivery of health services between the UK and Malaysia. As well as examining, I was also able to give several lectures during my stay in Malaysia.
NHS budgets are under considerable pressure. It is therefore unsurprising that many NHS Integrated Care Boards (ICBs) In England will aim to prioritise price in contract awards, But this approach is a significant threat to community-centred healthcare. While competitive tendering is a legally required, an excessive focus on costs in awarding NHS contracts risks overshadowing key factors such as established community trust, local expertise, and the long-term impact on continuity of care. This shift towards cheaper, often external, commercial providers threatens to cut the links between communities and their local health services. The argument that competitive tendering is solely about legal compliance, and not cost, is undermined by the very nature of such tendering, which by design encourages the lowest bid. This approach risks eroding the social fabric of local healthcare provision, where established relationships and understanding of specific community needs are essential. Establishe...
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