Clinical Commissioning Groups- who guards the guardians?

I have been following the decisions made by the recently formed local Clinical Commissioning Groups with some interest. They seem to have something of the iconoclast about them. Firstly, the change a long established arrangement with the local drug and alcohol treatment provider ADSIS that has existed for many years for a Birmingham based service.

Shortly afterwards I read that the GP out of hours service in Basford is under review. The service which has been run as a not for profit organisation by local GPs fear that a large private health organisation will take over the contract and that a company with no local knowledge will have a detrimental impact on patient services.

Companies like Care UK have developed an expertise in running out of hours services and I imagine that such an enterprise will be running if the service is put out to tender.

And finally the news that Maternity and Gynaecological services are under review and that according to staff at UHNS a private company has already been identified by Stoke CCG which will take over some aspect of the service. This is not so far-fetched as I believe that Wirral maternity services were transferred over to the private sector last December.

I have a number of concerns. What can stop local CCGs turning all contracted services over to private health companies? It seems to me that the CCG have no or very little democratic impact into its decision making processes. I was under the impression that the local councils either at Stafford or Stoke had input through its Health and Wellbeing mechanism. If this is not the case to adapt a Roman saying who guards the guardians of the local health economy?

Secondly, it is apparent that the relationship between private health companies and the NHS is increasingly becoming blurred. Doctors can at the same time be employed by private health companies and by the NHS. There are cases of senior health managers leaving NHS posts and becoming representatives for private health companies. When loyalties become adumbrate than it ought to be a matter of concern especially where taxpayers money is involved.

The pressure group Corporate watch investigated the tax affairs of private health companies such as Spire, Care UK and Circle Health. These companies have done business with North Staffs PCTs providing services for local patients. Yet these companies avoid tax to the tune of millions often by routing profits through off share tax havens.

To make large profits from public bodies and dodge tax strikes me as ” something for nothing” behaviour which is deplored when it’s a fraudulent benefit claimants.

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