IT HAS been the biggest shake-up of the NHS since its formation and has seen GPs take control of healthcare budgets worth hundreds of millions of pounds.

Gone are the army of managers from the primary care trusts and in are panels of family doctors, who now have the power to decide where and what the money is spent on.

But major concerns have been raised about a potential “colossal” conflict of interest of giving GPs that control, when they also run private health firms that could be bidding for substantial sums of the cash in their pot.

The distinguished British Medical Association (BMA) and the Royal College of GPs have warned that public trust is in jeopardy and have called for those GPs with leading roles in private firms to step down from such powerful positions on the boards of the new Clinical Commissioning Groups (CCG).

An investigation by the British Medical Journal has found a catalogue of alleged conflicts in all four CCGs in south Hampshire.

Four of the six family doctors running the new NHS Southampton City CCG, which this year has a budget of £280m, are directors, or shareholders of companies that could pitch for lucrative NHS contracts.

Their interests include hospital supplies, computers, diabetes, dermatology and ophthalmology and a private hospital group.

Labour has criticised such appointments and claim such directorships should “ring loud alarm bells” when CCGs are in control of such huge budgets to buy services.

Under the controversial overhaul, the new groups are required to allow private firms to compete for contracts – raising fears that parts of the NHS will ultimately miss out.

But NHS Southampton City CCG has hit back, insisting it has “adequate safeguards in place to protect the public from any such conflict of interest”.

John Richards, chief officer of NHS Southampton City CCG, said: “All our governing body GPs are family doctors who are well known to patients in the city and have a long track record of working to improve local services.

“Patients can be confident that the GPs elected, by their colleagues, to serve on the CCG do so solely because they love the NHS and will have the best interests of Southampton patients at the forefront of their deliberations.”

This row comes just days after GPled CCGs took over responsibility from primary care trusts for buying operations and treatments for NHS patients.

The investigation found that among the GPs on the new CCG in Southampton were: n A director and shareholder of Solent Medical Services (SMS), a local provider of diabetes, dermatology and ophthalmology service.

n A shareholder and employee of Avia Health Informatics Plc, which supplies computer software.

n A shareholder in Solent Medical Services plc.

n A director of Southern Alliance Healthcare – a small company limited by guarantee providing vasectomy services in Southampton.

n A shareholder in Circle hospital group.

When asked by the Daily Echo what these “adequate safeguards”

were, health chiefs listed those in place which they are confident will prevent any conflict – including public board meetings and the exclusion of any GP in discussions that involve their other interests.

James Rimmer, chief financial officer at NHS Southampton City CCG, added: “CCG’s work in partnership with a number of bodies, including the NHS National Commissioning Board which is responsible for contracting directly with GP practices to provide their services – this helps remove any conflict of interest between CCGs and GPs.

“As patients will recognise, GPs are often best placed to provide services to their patients, but where any potential conflicts arise, final decisions regarding the awarding of contracts would be agreed at a Governing Body board meeting.

“These are held in public, and GPs with a potential conflict of interest would be excluded from the decision-making process, not only on the board but throughout the whole process.

“We have two independent lay members on our board who are appointed in part to ensure transparent and fairness where conflicts arise.”

He added that if a company, which one of the GPs had a private interest in, happened to offer the cheapest or best option, then they would not automatically miss out because there are clear procedures in place to ensure fairness.

He added: “The CCG is bound by procurement law, just as all public bodies are.

“All decision made about the awarding of any contract must and will be made in a transparent way.

“Our GPs have listed all their interests to ensure this openness exists.”

But despite the safeguards already in place, the BMA remains “very c o n c e r n e d ”

about this and believes those with any conflict of interests should consider stepping down from the CCG governing bodies.

Dr Laurence Buckman, chairman of the BMA’s GPs Committee, said: “We have long called for stronger safeguards against possible conflicts of interest in the new commissioning process.

“In our view, GPs who are directors of, or who have significant financial interests in, companies who might be awarded contracts to provide services should seriously consider their membership of CCG governing bodies.

“Alternatively, they should consider their position within provider companies.

“We support the principle of greater clinician involvement in commissioning, but it must not come at the expense of the trust of patients.