GPs–‘conflict of interest!’

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MORE than a third of GPs on the boards of the new clinical commissioning groups (CCGs) in England have a conflict of interest resulting from directorships or shares held in private companies, a new analysis by the BMJ shows.

An examination of the registered interests of almost 2,500 board members across 176 CCGs provides the clearest evidence to date of the conflicts of interest that many doctors will have when the GP-led groups are handed statutory responsibility for commissioning around £60bn of NHS healthcare services.

The BMJ article says: ‘Our investigation shows that conflicts of interest are rife on CCG governing bodies, with 426 (36%) of the 1,179 GPs in executive positions having a financial interest in a for-profit private provider beyond their own general practice – a provider from which their CCG could potentially commission services.

‘The interests range from senior directorships in local for-profit firms set up to provide services such as diagnostics, minor surgery, out-of-hours GP services and pharmacy, to shareholdings in large private sector health firms that provide care in conjunction with local doctors, such as Harmoni and Circle Health.

‘In some cases most of the GPs on the CCG governing body have financial interests in the same private healthcare provider.’

Last week the BMA’s UK consultants’ conference passed a motion expressing concern at ‘the clear conflict of interest of GP commissioners who run their own private companies’ and called on GP commissioners to ‘be barred from being involved in companies that they are giving contracts to’.

Dr Buckman, the chair of the BMA’s GP committee (GPC), said: ‘GPs who are directors of, or who have significant financial interests in, companies who might be awarded contracts to provide services, should seriously consider their membership of CCG governing bodies.

‘Alternatively, they should consider their position with provider companies.’

Chaand Nagpaul, the BMA’s lead GP negotiator on commissioning and a GP in Harrow, called for the NHS Commissioning Board to issue more robust guidance on handling conflicts.

Nagpaul said that he supported the idea of CCGs co-opting additional members to help make decisions where conflicts existed, but he said that it was crucial that this extra help did not just focus on lay members, as it could ‘dilute’ clinical commissioning.

He warned: ‘It would undermine the whole concept of clinically-led commissioning to not have clinical input.’

Former BMA Council member Anna Athow commented: ‘The response from the doctors’ union, the BMA, boils down to making pleas with the government to deal with conflicts of interest.

‘This grovelling approach to GP commissioning means that our union effectively goes along with GPs on CCG boards handing out NHS contracts to private companies in which they have a financial interest.

‘Nothing could be worse for patients than an elite group of GPs handling millions of NHS money and, at the same time, having an interest in the profitability of private health companies.

‘The GPC should immediately ballot GPs for industrial action to boycott CCGs forthwith, and the BMA Council should be calling on the rest of the union to support this stand.

‘The BMA has it in its power to pull the rug from under the hated privatisation measures in the H&SC Act. It should use it.’