How GPs are set to make a killing out of NHS reform

One in three who publicly supports change may have conflicts of interest

He is arguably the medical profession's highest-profile cheerleader for the most radical reorganisation of the NHS the UK has seen. And, as one of Britain's most senior GPs, he holds our trust. But Dr Shane Gordon is also one of a number of GPs backing Andrew Lansley's reforms who stand to profit personally. And that, critics claim, is the embodiment of a fundamental flaw in the new Bill which could dangerously erode public trust in the NHS – the potentially volatile mix of money and medicine.

"Traditionally, the GP is the patient's champion and will fight for them in the health system. If decisions that GPs make could bring about a [personal] financial advantage, people will become suspicious," the Labour peer Lord Hunt insists. He wants explicit safeguards against decisions based on profit over clinical need. There is nothing in the Health and Social Care Bill that explicitly addresses how this web of potential conflict will be untangled.

Dr Gordon, a Colchester GP and chief executive of the North East Essex GP Commissioning Group, the consortium of local doctors who will take over responsibility for commissioning and paying for their patients' treatment, championed the Bill before the Public Accounts Committee last year. He was also the lead author of a letter in support of the Bill this January, signed by more than 50 GPs. His leadership has been gratefully acknowledged by Mr Lansley in Parliament.

The GP, who sees patients just one day a week, openly declares he is a director and shareholder in the Tollgate Clinic, a private health company. It is likely to benefit from the reforms, according to research by the TUC-backed campaign group False Economy.

Critics say the new Bill will lead to a massive expansion of NHS services provided by private companies. Under Mr Lansley's reforms, GPs formed into clinical commissioning groups (CCGs) such as Dr Gordon's will control up to £65bn of NHS funding a year and will be responsible for deciding what care to commission for their patients.

Dr Gordon's company – which already provides minor surgery in the area, including 95 per cent of all vasectomies – expects to double the number of operations it carries out annually and potentially expand the number of services it offers tenfold. Its co-founder Richard Spooner admits it is in a "good position" to take on new contracts.

Dr Gordon also has shares in a second Colchester-based private company, Anglian Urology, which diagnoses and treats sexual and urological conditions.

Dr Gordon told The IoS that he has not declared his interest in the second company because he is a "minority shareholder". He said that while "there are potential conflicts of interest where clinicians involved in commissioning healthcare are also associated with healthcare providers", he insists he "adheres to local policies" to guard against them. "I declare my interests and exempt myself from any commissioning decisions where there are potential conflicts of interest; and I advise patients of any interests when making referrals," he said.

For Clare Gerada, chair of the Royal College of General Practitioners, things are not so simple. "It is not about excluding yourself from the room whenever there is a discussion; it is about how it will drive your decision-making processes overall," she said. "Our NHS works and is cheap, effective, safe and kind because you trust the GP to do the right thing for you, and not make money. Anything that undermines that trust will be a big problem."

Another reform champion is Dr Ian Goodman. Dr Goodman chairs the Hillingdon CCG and is also a board director of Harmoni, the largest UK provider of primary care services, specialising in out-of-hours services. Andrew Gardner, chief executive of Harmoni, said the company expected a "big chunk" of the estimated £150m 111 service – a new 24-hour-a-day non-emergency phone line for patients. He estimated increased earnings for the company of £13m as a result.

Dr Goodman holds shares in Harmoni, but insists he had declared his interests and would "quite rightly be excluded from any decision-making process where Harmoni was bidding".

Dr Gerada estimates as many as one-third of public advocates of the reforms may have similar potential conflicts of interest.

They include Jan Randall, commissioning manager at NHS Kirklees. Her husband, David Randall, founded T19 Associates, a management consultancy created to assist health commissioning and provider groups. Mrs Randall, who has shares in the company, denies there is any personal conflict of interest.

Johnny Marshall, a Buckinghamshire-based GP and chair of United CCG, another pathway consortium, also publicly supports Mr Lansley's reforms. Together with five of the nine CCG board members, he is also a shareholder in Vale Health Ltd, which provides services to the NHS. Dr Marshall acknowledged that he "buys into the moral hazard". "If our actions are in any way perceived as being based on something other than the patient's interest, this would be a big concern. There must be a built-in system to protect against that," he said.

James Kingsland, a Wallasey GP, is paid a yearly retainer of £12,000 by Scott McKenzie, a private company providing consultancy services within the NHS – something expected to increase under the reforms. Dr Kingsland said the company was too small to take on any of the major contracts up for tender, but he said he would "step down immediately" if he thought a potential conflict of interest arose.

Andy Burnham, Labour's health spokesman, said relying on doctors' good faith was not enough. "Patients will be very concerned to know that certain GPs stand to personally gain substantial financial amounts from the new NHS structure."

A Department of Health spokesperson insisted that there will be a requirement for doctors to declare potential conflicts of interest and "for CCGs to ensure transparency and integrity of decision-making".

News
The surrealist comedian at the Q Awards in 2010
people
Life and Style
Six of the 76 Goats' cheese samples contained a significant amount of sheep's cheese
food + drink
News
Russell Brand arriving for the book launch in East London
peopleRussell Brand cancels his book launch debate due to concerns about the make-up of the panel
Arts and Entertainment
Contestants during this summer's Celebrity Big Brother grand finale
tvBroadcaster attempts to change its image following sale to US
PROMOTED VIDEO
Have you tried new the Independent Digital Edition apps?
News
ebooksAn unforgettable anthology of contemporary reportage
Arts and Entertainment
Julianne Moore and Ellen Page are starring together in civil rights drama Freeheld
film
Arts and Entertainment
Sarah Dales attempts to sell British Breeze in the luxury scent task
tvReview: 'Apprentice' candidates on the verge of tears as they were ejected from the boardroom
Voices
New look: Zellweger at Elle's Women in Hollywood awards on Monday
voicesRenée Zellweger's real crime has been to age in an industry that prizes women's youth over humanity, says Amanda Hess
Extras
indybest
Life and Style
CHARGE BOOSTER: Aeroplane mode doesn't sound very exciting, but it can be a (phone) hacker's friend. Turning on the option while charging your mobile will increase the speed at which your phone battery charges
techNew book reveals how to rid your inbox of spam, protect your passwords and amplify your iPhone
Sport
Christiano Ronaldo enjoys his opening goal
champions leagueLiverpool 0 Real Madrid 3: Ronaldo and Benzema run Reds ragged to avenge thrashing from their last visit to Anfield
Arts and Entertainment
Awesome foursome: Sam Smith shows off his awards
music22-year-old confirms he is 2014’s breakout British music success
Arts and Entertainment
Sir Nicholas Serota has been a feature in the Power 100 top ten since its 2002 launch
art
News
Call me Superman: one of many unusual names chosen by Chinese students
newsChinese state TV offers advice for citizens picking a Western moniker
News
Wilko Johnson is currently on his farewell tour
people
News
Let’s pretend: KidZania in Tokyo
educationKidZania lets children try their hands at being a firefighter, doctor or factory worker for the day
News
i100
Voices
'Irritatingly Disneyfied': fashion vlogger Zoella
voicesVicky Chandler: Zoella shows us that feminism can come in all forms
Life and Style
health
Latest stories from i100
Have you tried new the Independent Digital Edition apps?
Independent Dating
and  

By clicking 'Search' you
are agreeing to our
Terms of Use.

iJobs Job Widget
iJobs General

General Cover Teacher

£120 - £125 per day: Randstad Education Luton: The Job:TEACHERS REQUIREDWe are...

Year 6 Teacher

£100 - £120 per day: Randstad Education Hull: Randstad Education are currently...

SEN Teaching Assistant

£60 - £70 per day: Randstad Education Leeds: Special Needs Teaching Assistant ...

Year 4 Teacher

Negotiable: Randstad Education Hull: Randstad Education is urgently recruiting...

Day In a Page

How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?

A crime that reveals London's dark heart

How could three tourists have been battered within an inch of their lives by a burglar in a plush London hotel?
Meet 'Porridge' and 'Vampire': Chinese state TV is offering advice for citizens picking a Western moniker

Lost in translation: Western monikers

Chinese state TV is offering advice for citizens picking a Western moniker. Simon Usborne, who met a 'Porridge' and a 'Vampire' while in China, can see the problem
Handy hacks that make life easier: New book reveals how to rid your inbox of spam, protect your passwords and amplify your iPhone

Handy hacks that make life easier

New book reveals how to rid your email inbox of spam, protect your passwords and amplify your iPhone with a loo-roll
KidZania lets children try their hands at being a firefighter, doctor or factory worker for the day

KidZania: It's a small world

The new 'educational entertainment experience' in London's Shepherd's Bush will allow children to try out the jobs that are usually undertaken by adults, including firefighter, doctor or factory worker
Renée Zellweger's real crime has been to age in an industry that prizes women's youth over humanity

'Renée Zellweger's real crime was to age'

The actress's altered appearance raised eyebrows at Elle's Women in Hollywood awards on Monday
From Cinderella to The Jungle Book, Disney plans live-action remakes of animated classics

Disney plans live-action remakes of animated classics

From Cinderella to The Jungle Book, Patrick Grafton-Green wonders if they can ever recapture the old magic
Thousands of teenagers to visit battlefields of the First World War in new Government scheme

Pupils to visit First World War battlefields

A new Government scheme aims to bring the the horrors of the conflict to life over the next five years
The 10 best smartphone accessories

Make the most of your mobile: 10 best smartphone accessories

Try these add-ons for everything from secret charging to making sure you never lose your keys again
Mario Balotelli substituted at half-time against Real Madrid: Was this shirt swapping the real reason?

Liverpool v Real Madrid

Mario Balotelli substituted at half-time. Was shirt swapping the real reason?
West Indies tour of India: Hurricane set to sweep Windies into the shadows

Hurricane set to sweep Windies into the shadows

Decision to pull out of India tour leaves the WICB fighting for its existence with an off-field storm building
Indiana serial killer? Man arrested for murdering teenage prostitute confesses to six other murders - and police fear there could be many more

A new American serial killer?

Police fear man arrested for murder of teen prostitute could be responsible for killing spree dating back 20 years
Sweetie, the fake 10-year-old girl designed to catch online predators, claims her first scalp

Sting to trap paedophiles may not carry weight in UK courts

Computer image of ‘Sweetie’ represented entrapment, experts say
Fukushima nuclear crisis: Evacuees still stuck in cramped emergency housing three years on - and may never return home

Return to Fukushima – a land they will never call home again

Evacuees still stuck in cramped emergency housing three years on from nuclear disaster
Wildlife Photographer of the Year: Intimate image of resting lions claims top prize

Wildlife Photographer of the Year

Intimate image of resting lions claims top prize
Online petitions: Sign here to change the world

Want to change the world? Just sign here

The proliferation of online petitions allows us to register our protests at the touch of a button. But do they change anything?