Nick Clegg applauds his peers for making a series of last-minute amendments to his own government’s NHS reforms, as Social Care Correspondent Victoria Macdonald reports.
In the Lords, Health Minister Earl Howe said he accepted a Liberal Democrat amendment on registers of interest. He rejected a proposed amendment from Labour peer Lord Hunt, which would have introduced sanctions for doctors and other members of clinical commissioning groups who fail to abide by rules on conficts of interest.
The debate follows a Channel 4 News investigation into potential conflicts of interest in the new health service. The health and social care bill proposes that so-called clinical commissioning groups (CCGs), made up of GPs, hospital doctors and nurses, should be able to buy care for their patients from NHS hospitals, the private sector, charities or social enterprises.
This is going to explode in the government’s face unless they strengthen the corporate governance around clinical commissioning groups. Lord Hunt
There are concerns that members of CCGs with financial links to providers could be allowed to benefit from these arrangements.
Lord Hunt’s amendment argued that members’ financial interests should be registered and that anyone flouting the rules should be barred from membership of a CCG for up to 10 years. It was defeated by 259 votes to 186.
He said: “I would have thought that the public interest demands that the principles of good corporate governance should apply as much to these groups as any other public body. This is going to explode in the government’s face unless they strengthen the corporate governance around clinical commissioning groups.”
Earl Howe said he would accept a Lib Dem amendment proposed by Lady Barker. “The government have acknowledged the concerns on these issues around conflict of interest. We have listened to these concerns and we are willing to amend the bill accordingly,” he said.
The amendment says CCGs should keep a register of their members’ financial interests that is publicly available. It says that members with “a significant financial interest” in a healthcare providers should not take part in negotiations with the provider.
Liberal Democrat peers, backed by the party leadership, are also seeking other amendments to the NHS bill, which has already undergone extensive change since it was first unveiled as a white paper in July 2010. Peers want plans to increase competition in the health service to be scrapped.
Deputy Prime Minister and Lib Dem leader, Nick Clegg, told the BBC that the changes “will make it clear once and for all that competition is the servant of the NHS and never its master”.
He added: “These final amendments, having of course introduced a huge array of amendments in the past, will provide final reassurance to everybody who is anxious about this bill that the competition provisions in it will not destabilise the NHS and will improve the quality of care for patients.”
The prime minister’s spokesman said David Cameron was “happy” to give Lib Dems peers the assurances they were seeking through their amendments.
He said that while Conservative peers would be expected to support the bill in the Lords, they would not necessarily have to vote against the amendments, which will be debated later this week.
Leaked document shows how doctors can profit from NHS reform. Read Health and Social Care Correspondent Victoria Macdonald on potential conflicts of interest in the new NHS.
A Channel 4 News investigation in March 2011 revealed that under the NHS reforms, GPs could end up making decisions based on profit rather than the clinical needs of patients.
A document leaked anonymously showed how a private company, run by a former hospital doctor, planned to work with GPs, setting out how both would make a profit.
It talked about plans for 5 per cent cost savings from patient budgets, with these savings making money for GPs and the company. But Health Minister Earl Howe told Channel 4 News at the time: “If there are fears that this sort of thing is going to happen – that money can be saved here and there and lining GPs’ pockets in the process – we will not allow that.
“That would break the rules that we are setting out surrounding the money voted by parliament for commissioning of patient care. It will not be allowed – and if there is a lacuna in the Bill, we will put it right.”