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Don’t mix private and NHS care, GPs warned

Perceived conflict of interest could prompt GMC sanctions, says defence body

Caroline White

Wednesday, 21 August 2013

Doctors must be clear about the professional boundaries between private and NHS care, and not mix up the two, the medical defence organisation MDDUS has warned. They cannot be perceived to have a conflict of interest, it says. 

The warning follows a series of calls from GP members about patients wanting both NHS and private care, with many doctors asking if they can see their NHS patient privately.

Some members also received complaints from patients who believed they were being treated on the NHS, but were then billed for private treatment.

“One common query we encounter is doctors asking if they can prescribe privately for their NHS patients. One example is a doctor wanting to prescribe a flu vaccine privately for a patient who is not eligible to receive it [under] NHS criteria,” says MDDUS medical adviser Dr Naeem Nazem.

“In short, the answer is no, with the only exception being when the appropriate treatment is not available on the NHS,” he says.

“It can be a potentially serious ethical issue if the correct steps aren’t taken. Any act of perceived dishonesty can lead to GMC sanctions and the risk of erasure,” he warns.

“Doctors should keep a clear separation between NHS and private treatment and must act openly and honestly to ensure there can be no perceived conflict of interest. This includes providing the patient with all the necessary information to help them make their choice of treatment,” he adds.

If the doctor believes a private assessment or treatment is required, then they are obliged to refer the patient, but cannot make any financial gain from the patient – either directly or indirectly, he emphasises.

“If a patient wishes to seek treatment privately, then they should be referred, with all relevant information about the patient, including medical history being provided,” he advises.

Patients are entitled to opt in and out of NHS treatment at any stage – as long as they are entitled to it, and are treated in the same way as those receiving all of their care within the NHS.

Dr Nazem also reminds doctors that they should not let any personal commercial interests influence their patient care.

“Doctors who have a financial or commercial interest in, for example, a pharmacy, pharmaceutical or medical devices company, must ensure they do not allow that interest to affect decision making regarding patient care,” he says, citing GMC guidance Financial and commercial arrangements and conflicts of interest.

This states: “If you are faced with a conflict of interest, you must be open about the conflict, declaring your interest formally and you should be prepared to exclude yourself from decision making. Conflicts of interest may rise in a range of situations. They are not confined to financial interests and may also include other personal interests.”

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