Concessions in the NHS reforms were made under pressure from the medical professions, health secretary Andrew Lansley admitted in a speech to GPs yesterday.

The government announced in response to the NHS Future Forum’s report that clinical commissioning groups will have to have governing bodies including hospital doctors, a nurse and lay members.  It also said it will give health and wellbeing boards and new “clinical senates” a say in the authorisation of consortia and their commissioning plans.

Mr Lansley told GPs at The Commissioning Show: “For those of you concerned that the listening exercise represents a tearing up of our plans to modernise the NHS, don’t be. For those of you worried that in places the detail of the bill was at odds with the principles of reform, be reassured.”

Questioned by GPs on requiring commissioning groups to have members from other professions, Mr Lansley said: “We want to take people with us.” He said other professions – particularly the Royal College of Physicians – had been “very certain” that they should have “a voice” in commissioning. “We’re going to create a number of substantial opportunities for that to happen,” he said.

But Mr Lansley said wider clinical involvement in commissioning would “fundamentally” happen in clinical networks and senates. He said:  “I don’t think [board membership] is the answer to how specialists and a range of professionals are involved in commissioning.”

A policy statement published on Tuesday said the specialist doctors and nurses who would sit on commissioning groups’ governing bodies “must not be employed by a local provider” to avoid conflicts of interest.

Mr Lansley said it would constitute conflict of interest “if you were to go and appoint the medical director of the principle local health care trust… [but] there may be senior clinicians in a local trust which do meet the criteria. It’s up to you [GPs] to decide that.”

He said the clinician on a board should be a tertiary clinician not involved in the running of the local hospital; someone who lives locally but works outside the area or someone who has recently retired. “These are practical issues,” he said.

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