The potential for conflicts of interest when CCGs begin commissioning services was always going to be one of the most controversial areas for the Government’s health reforms.
The BMA, RCGP and NHS Confederation all issued guidance this year on how CCG board members can avoid any ‘reputational damage’ by declaring any financial interest in potential NHS providers and suggesting they absent themselves from any discussions when there is a potential conflict.
To give credit to CCGs, the majority of them have registers of interests – although it is worrying that more than a third do not have them publically available on their websites – and they are developing procedures to transparently deal with the issue.
GPs working in joint partnership with Virgin recently ended their involvement with the private company in order to prevent any accusations of conflict of interest if they award contracts to them.
But is this enough? The Government’s commissioning tsar thinks not, and is suggesting that our investigation showing that more than one in five have a potential conflict illustrates that these interests are a real problem.
In order for CCGs to work, there must be trust from the public. Conflicts of interest are always more about perception than reality, and even though the majority of the links are to one-man bands, or GP-owned collectives, including local out-of-hours providers, they are still likely to tie the hands of CCGs when making unpopular decisions on how to reshape services.
In most cases, this is not a case of shadowy organisations being controlled by big business. There are still links with some major private providers, but these are far less common after the mass Virgin withdrawal.
But there are numerous examples of cases where all the clinicians on one board are shareholders in the local out-of-hours group. There are some individuals who have multiple directorships, causing dangerous murmurings in their local areas.
The suggestion that commissioners hive off all conflicts of interest before April would be a difficult ask for GP commissioners, but in a climate where distrust of most public bodies is at record lows and facing a huge budgetary challenge over the next few years, can GPs afford any suggestion that they are only in it to line their own pockets?
Jaimie Kaffash is a senior journalist at Pulse