Concerns over NHS consultants conflict of interest
Author: Mark Gould
A new study reveals that hundreds of NHS consultants own shares or equipment in private hospitals where they work and to which they refer NHS patients.
The research was carried out by an independent think-tank the Centre for Health and the Public Interest (CHPI), which says it exposes a potential conflict of interest between the consultants’ income and their patients’ best interests.
“The prevalence of financial incentives in the English healthcare system is first and foremost a patient safety risk,” said David Rowland, the report's author and the think-tank’s director.
“If doctors stand to gain financially from treating patients this can influence their clinical decision-making. Patients are therefore at risk of receiving treatment which is unnecessary and harmful.”
CHPI's report Pounds for Patients? calculates that a total £40 million has been spent by NHS trusts in private hospitals where their consultants own shares. The report is based on analysis of declarations about share and equipment ownership that private health firms are legally obliged to make, accounts lodged at Companies House, NHS trusts’ financial reports and freedom of information requests.
Out of 265 NHS consultants who own shares or equipment and work in the NHS, only 19 have declared these interests publicly. Rowlands says this breaches NHS England’s guidance on Conflicts of Interest.
The consultants who own shares and equipment in the private hospitals also carry out work in them and receive a fee for doing so. In some cases, the consultants receive a fee each time their equipment is used, the report found. The consultant specialties with the largest number of shares or equipment are in oncology, orthopaedics – particularly hip and knee replacements, and ophthalmology.
NHS trusts are sending growing numbers of their own patients to be treated in private hospitals because their own services are so busy that they cannot treat them themselves. Much of that involves surgery for hernia repairs, hip and knee replacements or eye conditions. Trusts pay for privately provided care from their own budgets, though the sums private operators can charge is capped.
The report also reveals that in order to encourage consultants to refer patients to their hospitals some private hospitals have provided them with lavish hospitality. This includes individual trips to cricket and Wimbledon matches worth over £1000, golf tournaments, dinners, Christmas hampers and comedy nights.
NHS England guidance prohibits NHS consultants from receiving more than £75 worth of corporate hospitality. But the report says it is unclear whether the nature of this corporate hospitality would breach the Bribery Act 2010.