Commissioning

‘Elephant-sized’ conflicts of interest thrown up by GP consortia structure

The business opportunities for private companies wanting to run or manage GP consortia could create huge conflicts of interest, according to a new investigation.

Documents leaked to Channel 4 News showing how one such company plans to operate shows it making 5% cost savings from patient budgets, with the less spent, the more there is left over to share out in profit.

The programme reports that there seem to be few safeguards against the conflicts of interest that could arise from this arrangement. One expert, Professor Kieran Walshe, who advises the Health Select Committee on the NHS reforms, told reporters: “What this document says is that the GPs in a commissioning consortium, which is a public body, would let a contract to manage the money of that consortium to a company - an integrated care organisation - that those GPs themselves part own. So that’s like me as a public servant letting a contract to me or to a company I run and that is a massive, an elephant-sized, conflict of interest.”

The leaked documents refer to Integrated Health Partners (IHP), and propose that in three to five years, the overall business should become profitable enough to attract City investors.

The head of IHP, former hospital doctor Dr Oliver Bernath, told the programme: “What this is trying to do is not just pay someone more and hope that good things will happen but say we only pay a certain reward if good outcomes were achieved and savings were achieved.

“So in a sense it reduces risk to NHS of overspending as someone else shoulders the risk and has negative consequences if they fail to do so.

“You can’t just make savings at the cost of patient care quality, because the points are related to patient outcomes and patient satisfaction as control mechanisms of course.”

The Department of Health said it would “not allow” profits to be made at the expense of patient care or choice, and that the NHS Commissioning Board and Monitor will develop binding guidance against it.

Shadow Health Secretary John Healey said: “We will argue that GPs playing a lead role in commissioning should not be able to profit either directly or indirectly through they companies they are associated with, because I think that is part of the essential ethos of the NHS and is certainly central to retaining trust in their GP and in the NHS itself.”

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