Management consultants McKinsey are bidding for a place on the government's controversial list of approved primary care trust commissioning support suppliers.

Management consultants McKinsey are bidding for a place on the government's controversial list of approved primary care trust commissioning support suppliers.

The bid raises questions about conflict of interest because the company drew up the fitness-for-purpose review through which all PCTs are scored on their skills - including commissioning.

And HSJhas learned that the extent of the commissioning expertise being sought from private companies may be far more extensive than previously thought.

Firms will be invited to bid to take over PCTs' entire commissioning processes rather than being limited to offering support in certain key areas.

Unions have raised questions about the McKinsey bid, saying any move to advise PCTs on their commissioning services would be anticompetitive.

McKinsey drafted the government's PCT fitness-for-purpose review, drawing up the commissioning diagnostic and organisational assessment tools as well as the chief executive competency framework used to rate PCT performance.

Head of health at Unison Karen Jennings said the union would make take legal action if the McKinsey bid was successful: 'We will definitely challenge this, given McKinsey's close relationship to Number 10,' she said. 'I can't believe their [McKinsey's] effrontery.'

She accused McKinsey of having their 'snouts in the trough'.

In June, the Department of Health published a controversial contract notice in the Official Journal of the EU,inviting companies to join a list of eligible providers to offer PCTs commissioning and managerial services from 2007. It was redrafted after a widespread outcry.

Despite the furore, private companies last month concluded the first stage of the bidding process by completing the DoH's commercial directorate pre-qualifying questionnaires, which signals their intention to bid for a place on the list.

Companies which achieve inclusion on to the list will be eligible to offer PCTs a range of commissioning expertise. This could lead to the complete outsourcing of commissioning work to the private sector.

According to the DoH's memorandum of understanding, the most far-reaching option is the 'end to end' package, which will offer PCTs the opportunity to outsource completely their commissioning work and expertise to a private provider.

There is also the option of a 'micro' package, whereby firms will offer PCTs a particular service such as social marketing or risk assessment; and a 'macro' package, which will give PCTs one or more related groups of services such as assessment and planning, or the commissioning of mental health services.

Other companies which hope to be added to the framework include Bupa, UnitedHealth, Tribal Group, US healthcare insurance company Humana, and South African healthcare insurer Discovery.

Asked if Bupa could also face questions over conflict of interest between its acute provider arm and provision of commissioning expertise, its head of commissioning service Dr Natalie-Jane MacDonald said the company was setting up a separate company to bid for the work.

'It will be something that is distinct and separate from our provider side and it will also be separate from our insurance business,' she said.

The DoH hopes the contracts with companies added to the framework will be complete by next January, enabling PCTs to procure commissioning expertise from February 2007.

Asked whether a McKinsey bid would be anti-competitive, a DoH spokesperson said: 'We can't confirm the names of individual bidders but the DoH recognises that in any contractual arrangement it will be vital to ensure that conflict of interests do not occur and this will be part of the evaluation process.'

McKinsey declined to comment.