One of the barriers preventing voluntary sector organisations from playing a larger role in providing NHS services is the "hopelessness of commissioning in many parts of the country", according to Norman Lamb, the care minister.
Speaking at the Acevo health and social care conference in London this morning, Lamb, the Liberal Democrat MP for North Norfolk, said commissioning was poor in "too many areas".
"It's quite a young science and the skill levels are quite low," he said. "If we're to move to a new system where work is contracted out rather than done centrally, it will work only if the commissioning is good."
Lamb said that too many local authorities procured care services on the basis of who could charge the least for an hour.
"As a result, you get a race to the bottom," he said. "There’s no incentive for providers to help people. It’s in their interest for individuals’ needs to grow so they can get paid for more care. We should be commissioning to improve the lives of people."
He said the traditional way of commissioning services was "professional people making assumptions about what people want or need". Voluntary sector organisations had "pioneered the remarkable idea" of asking people what they needed, he said.
Lamb described the NHS as "like a national religion" that people were reluctant to challenge or change.
"There's a sense that something awful happening in an NHS hospital is better than something awful happening elsewhere," he said.
Lamb told the conference that the voluntary sector had a "central role to play" in meeting the challenges of providing healthcare.
"I hope the voluntary sector gets involved enthusiastically and optimistically, because you can bring so much to the table."