Clinical Commissioning Conflicts of Interest – Please, Someone, Do Something!

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This post is not about procurement technology in the NHS today, but a different aspect of the wider questions around “NHS procurement” in its totality.

We got another example of the Lord Coe philosophy on conflict of interests last week. You may remember he decided that there is no conflict between his income from and role with Nike and his position as head of world athletics. That is because “I’ve declared it”. That is of course nonsense. A conflict of interest exists. Whether it is material, and whether it makes Lord Coe, a paragon of virtue I’m sure, likely to do anything that shows bias towards Nike, are totally different questions. The conflict exists and he should give up one of those roles, particularly given the ethical scandals the whole sport faces.

Similarly, the situation whereby doctors who are involved in awarding billions of pounds worth of contracts to organisations in which they have a direct interest is a clear conflict of interest. We have been saying this to the point of tedious repetition pretty much since the new rules on clinical commissioning groups first came into play in the UK health service in 2012. Last week, the Times and the BMJ ran a feature on this as if they were the first to come across this.

“Clinical commissioning groups (CCGs) in England have awarded hundreds of contracts worth at least £2.4bn (€3.4bn; $3.7bn) to organisations in which their board members have a financial interest, a joint investigation by the BMJ and The Times has found”.

The people involved claim that they excuse themselves from meetings when these decisions are made, or that the money flowing to them is all “re-invested” in healthcare for the benefits of the patients. But as in the Coe case, that does not solve the basic problem – there is a conflict of interest. It could also erode trust between GP and patient, if we all start wondering what exactly motivates our doctors and whether they benefit directly from the treatments they recommend to us, for example.

NHS England is doing an audit now to see how conflicts of interest are being managed, but no-one seems to be taking responsibility for this. Surely the simple answer is to state that no-one who sits on a CCG Board can also have an interest in an organisation that receives income from it? That does not seem beyond the wit of the NHS or Department of Health to put in place, surely.

It's also another example of how the political self-immolation of the Labour Party is affecting wider issue sin the UK. You might have thought this is the sort of thing the opposition might want to make a fuss about. But apparently not - Jeremy Corbyn's willingness to shoot people or bow to the Queen seems to be the only Labour topics of interest, including to the party's own MPs.

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