Hospital Dr News

Consultants “robbed” of say in commissioning

Consultants have been blocked from playing a role in commissioning services because of the “heavy handed” application of conflict of interest rules, the annual consultants’ conference heard.

Bolton consultant psychiatrist Shanu Datta said clinical commissioning groups (CCGs) were having to appoint “token” consultants to their boards who were either retired or worked outside the area because it was considered there would be a conflict of interest if they recruited local consultants.

“I know, I have been through this process and I think ultimately this is a loss for everybody, for consultants and also for the CCG boards because they have not been able to appoint the best quality candidates. As a result of this we have been robbed of our place as consultants at the heart of the commissioning process.”

Although critics would say that consultants could have an influence through clinical senates and local clinical cabinets, the jury was out as to whether these organisations would be effective boards or simply talking shops, said Datta.

Sara Hedderwick, deputy chair of the consultants committee said CCGs had been putting “piddling little adverts in local papers” asking consultants to apply for positions on their boards and this was not adequate.

GP negotiator Chaand Nagpaul, who represents the BMA GPs committee on the consultants committee, said they had objected from the outset to excluding local secondary care doctors from sitting on CCG boards. Hospital doctors had a common interest and duty to put patients above any organisational identity and did not sit on opposite sides of the fence to GPs.

“The fact that the government sees local hospital consultants as having a conflict of interest with local GPs encapsulates everything that is wrong with the English NHS reforms,” he said.

The conference passed a motion urging the BMA to investigate inconsistencies and flaws in the way secondary care doctors are appointed to CCGs and to work with the NHS Commissioning Board to improve the appointment process.

Delegates also highlighted a conflict of interest whereby GP commissioners who run their own private companies can profit by taking work from existing NHS organisations while having no commitment to providing the same quality of care.  They called for GPs to be barred from being involved in companies they are awarding contracts to.

“This is a scandal in the making,” said Derek Machin, a Liverpool consultant urologist. Arranging to be out of the room when decisions were made was not a satisfactory level of probity.

“We have potentially large amounts of public money being decided by people who are totally conflicted,” he said.

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One Response to “Consultants “robbed” of say in commissioning”

  1. Astounded_yet_again says:

    Once again this beggars belief – in what way do consultants have a “conflict of interest” with commissioning boards? The whole point of these boards is allegedly to provide high quality, appropriate, integrated care for patients, which is the aim of consultants and everybody else in the NHS (if it is not, they should not be working for the NHS in the first place).

    If consultants and GPs and other stakeholders design services together, looking at demand and resources within the available budget, that is clearly not a conflict of interest.

    A GP with a private company which might benefit from commissioning however does have a blatant conflict of interest and should not be serving on such a board. And this begs the question of what very busy GPs are doing running private health care companies anyway.

    I continue, like other posters, to be astounded by the lack of understanding by government of how health care provision works, as evidenced by the thread about Bruce Keogh and 24/7 working, and by the way in which they assume that we operate on the same principles as people who run businesses and are concerned with profit rather than providing a service. This project to introduce business models into the NHS clearly started in 1989 or before and just keeps on going through successive governments – those of us who actually provide the care seem powerless to stop the process, now if not before.

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