Everyone has an interest in healthcare. Almost every person will have encounters with the healthcare system and statistics suggest that a majority will have some form of contact each year.
As doctors working within the health service we have an additional form of interest and GPs, largely working as independent contractors, have another form of interest in the organisation of healthcare.
It is precisely this interest and experience in local health services that the government hopes to harness in Clinical Commissioning Groups (CCGs). These are positive forms of interest and should be complementary to other health interests. Problems will only arise where these various interest are in conflict.
This is not a purely theoretical consideration. A current large government consultation has had to be partially repeated due to a single undeclared conflict of interest.
There has been a lot of attention paid to potential conflicts of interest since the White Paper was published 2 years ago. GPs were to be both commissioners and contractors. The clearest areas where conflicts might arise are in the commissioning of services from general practices. For this reason the management of practice contracts is to be handed to the National Commissioning Board (NCB) and its regional offices.
CCGs may still want to commission specific enhanced services from practices, particularly in relation to referral and medicines management. The exact relationship between the NCB, CCGs and practices continues to be announced in a gradual fashion.
Potentially conflicting interests should be declared and published in a register of interests. This will be a requirement of the CCGs' constitution. Whilst this is reasonably standard for employees and board members of commissioning organisations, the current guidelines extend this to practices and GPs as members of the CCG.
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