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.