Health and Social Care Bill
Liz Kendall (Leicester West, Labour)
Subsection (1) of new section 14V of the National Health Service Act 2006 says:
“The Board must publish guidance for commissioning consortia on the discharge of their commissioning functions.”
Amendment 211 seeks to ensure that
“A commissioning consortium must ensure that in the use of its resources conflicts of interest are managed to prevent members benefitting financially from the consortium’s commissioning arrangements.’.”
In other words, these two amendments seek to ensure that conflicts of interest between those GPs responsible for commissioning services and the responsibilities of the providers of services are very clearly set out, and that GPs who are commissioning those services should not be able to benefit financially from those commissioning arrangements.
During earlier discussions, we have already discussed the need to ensure that conflicts of interest do not arise. Government Committee members believe that there are two ways of doing that: first, through very clear guidance from the NHS board, if it is established after the deliberations of the Committee and the House; and secondly—crucially—through their financial arrangements.
The Minister has said that he believes that all those conflicts of interest can be sorted out in the GP consortia constitutions, but I do not believe that that is possible, because the constitutions would end up being far too long. In fact, GPs who set up commissioning consortia would themselves need, and I am sure appreciate, guidance from the board on how to separate those conflicts of interest and ensure that they do not occur.
Being sure that GPs do not financially benefit from commissioning responsibilities is critical for the House as a whole. I know we are not on clause 23 yet, but we are discussing the amendments together. It is vital that conflicts of interest are managed to prevent members from benefiting financially from the commissioning arrangements.
The amendments are pretty straightforward and clear. Accepting them would provide an extra lock on the situation, alongside arrangements set out in a constitution. Unless there are further measures—“rules and regulations” is the wrong term—in the Bill to ensure that conflicts of interest are managed, I am afraid that there will be very real concern about the effective use of taxpayers’ money and concerns from those who provide other community primary services such as pharmacists, who we discussed. They will fear that GPs will simply commission services from themselves.
I do not believe that that would be the case everywhere. Many GPs will want to look at other services to commission, but these two amendments would make those conflicts of interest much more clearly managed and accountable, which is why we tabled them.