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GP links to private firms could derail consortia

By Ian Quinn

Exclusive: The Government's commissioning plans will be hugely complicated by the potential for conflict of interest created by the large number of GPs who have links to private companies, a Pulse investigation reveals.

As many as one GP in four has an investment in a private provider of NHS services in their local area, according to a survey of 350 GPs commissioned as part of Professor Martin Roland's guest editor issue.

Leading GPs and directors of companies working in primary care are warning these GPs may be excluding themselves from involvement with consortia, with some having signed deals that specifically prevent them entering into contractual arrangements with other providers.

Ali Parsa, managing director of private healthcare company Circle, said: ‘The white paper is adamant there must not be a conflict between provision and commissioning. It means GPs have to choose. If they have interest in providers of care they should not and can not be commissioning services in those area and should not be on consortia boards.'

Dr Fay Wilson, a GP in Birmingham who runs an out-of-hours company, said she was ‘shocked' at GPs' lack of awareness about the risk of conflict of interest as they begin taking over decision-making powers from PCTs.

She said independent groups of GPs and NHS managers would have to oversee consortia decisions, with clear rules on transparency, or it would be impossible for GPs to run consortia without risking investigation by the economic regulator Monitor.

‘There's no point GPs thinking this doesn't apply to us. We may think they are looking after their local health economy but that doesn't mean there isn't conflict of interest,' she said. ‘The first principal is that people will not be able to commission services that involve them.'

Dr Helena McKeown, GPC member and a GP in Salisbury, is among many GPs who became investors in private companies running Lord Darzi's GP-led health centres.

She said: ‘The Darzi initiative meant centres were forced upon every PCT area. It meant many GPs to keep their services locally run went into the bidding, but because of the expense went into partnership with private backers.

‘It will complicate things because GPs had to sign contracts and may have clauses which prevent them having contracts with other providers in that area. Some GPs may not feel able to join an NHS-only venture.'

The Pulse survey found 27% of GPs had an investment in a local private provider of NHS services, 8% in a company providing non-health services to the NHS and 12% another private company.

Separately, 41% of GPs said they were already aware of a colleague who had made a decision they felt was compromised by financial interests.

In its response to the white paper, the Primary Care Trust Network warns that that the transition will ‘see consortia operating with serious conflicts of interest which need to be controlled'.

‘Too few safeguards over GP decision-making could lead to concerns from patients and other healthcare organisations over the legitimacy of decisions,' it adds.

Dr Richard van Mellaerts, a GP in Kingston, said: ‘Now is the time to get in right in terms of governance. We need to ensure a robust system is in place so it doesn't blow up as some sort of scandal.'

Dr Fay Wilson Click here for more from our guest editor issue Guest Editor Graph Professor Martin Roland on...conflict of interest