Clinical Commissioning Groups (CCGs) are simply rubber-stamping decisions made by private sector influenced support units. GPs sat on CCGs heavily influenced by the private sector, many who sit on the CCG groups AND have voting rights.
In fact, GPs are more than 'guided' when it comes to making decisions such as which private company they sell NHS contracts to, which services to provide and so on.
To add more private sector influence into the mix, GP led CCGs give away many of their powers to their Commissioning Support Units (CSUs), who, as you can guess, are in turn heavily influenced and lobbied by the private sector.
Commissioning Support Units - CSUs
Clinical commissioning is a complex activity requiring, for example, legal knowledge, expertise in running contracts and on-going monitoring of contracts, as well as back office support such as IT, human resources and financial services. Most GPs don’t have the time or skills to carry out all the work of commissioning. So, while CCGs will retain legal accountability for this work, many of the functions of commissioning have already been taken over by Commissioning Support Units (CSUs).
In November 2015 a new Department of Health document about commissioning made it clear that most key commissioning functions would be performed by ‘commissioning support units’, contracted by CCGs and to be outsourced to the private sector by 2015.Hence, although CCGs are supposed to be 'GP led', nothing could be further from the truth. In terms of private sector influence and lobbying, everything is stacked against GPs who sit on Clinical Commissioning Groups.
Most of the advice and lobbying is done by strategists and other CCG officers in the group. To stack the odds further, these strategists also have voting rights. To make matters worse, CSU's are heavily influenced and have forged links with the private sector. Now add 'NHS England' to the list, run by privateer 'Simon Stevens' and we have a recipe for disaster for the publicly run NHS.
As CSUs evolved, they have increasingly allowed the involvement of private firms in the commissioning process itself, and are able to decide, for example, which services will still be provided, who will provide them – and even what NHS England calls the ‘transformation and service redesign’ of the NHS.
Each CSU covers a number of CCGs and they are already forging links with the private sector. Take a look at 'Contract Finder'. Note that the NHS contracts up for sale (tender) to private companies are tendered by MIDLANDS AND LANCASHIRE COMMISSIONING SUPPORT UNIT. This is the CSU for CSR CCG & GTR Preston CCG.
Finally, let's take a further look at what the book 'NHS for Sale' says on the issue..
CCGs are likely to find they have little to do apart from rubber stamp their decisions and those coming down from NHS England, and take the blame for problems. The majority of GPs now believe that they have been set up to take the blame for rationing health care.
Some of the GPs remaining on CCGs have interests in the private health companies bidding for their CCG services, giving rise to conflicts of interest hitherto unknown in the NHS.
At the heart of Andrew Lansley’s 2012 Health & Social Care bill legislation were two attractive and important promises. One was that patients would be at the centre of the NHS, their choices paramount, a promise encapsulated in the repeated undertaking that there would be ‘no decision about you without you’.
The other was that GPs would be given the majority of the NHS budget to buy care for patients as they and their patients saw fit. GPs knew best what patients needed and were to be given the power and the money to deliver it. Time and again GPs were told they would be ‘in the driving seat’, with control of the NHS budget, and that they would be calling the shots on behalf of their patients. These promises have turned out to be worthless, a deliberate deception of GPs and the public.
Unaccountable Commissioning Boards
GPs are supposedly elected to their roles on Clinical Commissioning Groups by their locality GP peers for a period of three years, although many posts are uncontested.
Recent research by Pulse magazine found 95 per cent of CCG board members had not faced any electoral process.Board members have a say in the policy and commissioning decisions of the CCG, but these GPs can often spend as little as one or two half days per week on CCG business. This leaves much of the real day-to-day work to be undertaken by full-time managers, many who are ex employees of private companies or management consultancies, or by Commissioning Support Units, run by NHS England and its 22 sub-regional units.