By Gareth Iacobucci
Exclusive: One GP in 10 on the boards of new commissioning consortia also holds an executive-level position with a private provider, exposing the serious potential for conflict of interest in the Government’s NHS reforms, Pulse can reveal.
Our investigation, based on data released by PCTs under the Freedom of Information Act, finds almost a quarter of consortium board members have some kind of interest in private providers, with others either shareholders or advisers. A Pulse survey last year found a similar proportion of GPs as a whole held interests in private providers of NHS services – with the GPC warning involvement beyond holding shares could preclude them from an active role in commissioning.
Our new investigation gained responses from 73 PCTs about the roles held in their local health economies by consortium board members, although 56 trusts said they were not in a position to provide information – either because boards had not yet been set up, or information on conflicts of interest had not been collected.
The analysis examined the additional roles held by 132 consortium board members across the 17 trusts that were able to provide information – and found that 15 held board-level positions in addition to their roles on shadow consortia.
The findings come as Pulse reveals private firms are being lined up to sit on the NHS Commissioning Board (see page 6), and in the wake of the BMA Special Representative Meeting, which saw fierce debate over whether the NHS reforms would compromise the profession.
Roles held by consortium board members include board membership of private firm Assura’s local GP provider companies (GPcos), board roles at fellow private firm The Practice, and medical directorships of out-of-hours companies.
A further 15 consortium board members were linked to private firms in non-executive capacities, either as shareholders or in advisory roles, including seven with Assura’s GPcos.
An Assura spokesperson said GPco board members elected to consortia would be required to step down before any commissioning decisions were taken, and said a number of those named by PCTs as having dual roles had already done so.
A spokesperson for The Practice said it was ‘acutely aware’ of the need to be ‘transparent and fair’, and was evolving its organisation to support these objectives.
Dr Johnny Marshall, chair of the National Association of Primary Care and of the United Commissioning consortium in Buckinghamshire, stepped down from his role on the board of provider company Vale Health last August, because he felt the potential conflict of interest in sitting on both boards was too much to reconcile.
He said: ‘As the chair of our commissioning organisation, I felt it was inappropriate for me to be a chair or director of a provider organisation with which I could in the future be contracting. There is a public confidence issue here.’
Dr Chaand Nagpaul, GPC negotiator, said: ‘There are real concerns about GPs with a senior-level interest in a private provider and we would suggest as far as possible to avoid such doctors sitting on commissioning boards because of perceived or actual conflict of interest.’
GP reforms’ leaders on boards of private firms GPs’ dual roles
• 56 PCTs unable to provide information
• 17 PCTs recorded possible conflicts of interest
• 132 consortium board members listed
• 15 hold board-level positions with private providers
• 15 have other links to private firms, as shareholders or advisers
Source: FOI responses from 73 PCTs