The fragmentation of the health service under the NHS reforms has been "horrendous" and the introduction of a health bill was unnecessary for clinically led commissioning, NHS Future Forum representative Ash Soni has said.

Mr Soni told delegates at the annual conference of the British Association of Pharmaceutical Wholesalers (BAPW) on Monday (June 18) that, although there were opportunities for pharmacy around patient-centred services and patient choice in the new NHS, fragmentation and competition based on price was unwelcome.

"What you should have competition for is for high-quality services," Mr Soni said. "But to do this you need to understand the quality and the price you are paying for that quality first: we should look at collaboration and integration; competition comes further down the track."

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	"I think fragmentation of the NHS was a dreadful thing to have done. I think it's horrendous," he added. This view was echoed by Labour's shadow health minister Jamie Reed, who told delegates that the health and social care bill had "atomised the NHS". "Hospitals are being lined up in opposition to each other and whole services are being lined up to be transferred to the private sector," he said.

"The development of a market-based health service in England will likely drive profound social change in a way that will not benefit the citizens of this country who need NHS care the most," Mr Reed added.

But Mr Soni told BAPW delegates the bill offered grounds for optimism around clinically led commissioning. "The NHS has historically worked as a system in which managers design the system without talking to patients or clinicians and as a consequence we got things that didn't work but were seen as the right management way to go," he said.

"So I'm very clear about having clinically led services, but I'll be honest: I don't think we needed a bill to make that happen."