Published: 31/10/2002, Volume II2, No. 5829 Page 6 7

The code of conduct for NHS managers will also cover private providers and contractors and must be applied to existing contracts - even though private sector bodies were not consulted.

A clause near the end of the code avoids explicit mention of the private sector, but says: 'In order to maintain consistent standards, NHS bodies need to consider suitable measures to ensure that managers who are not their employees but who (i) manage their staff or services; or (ii) manage units which are primarily providing services to their patients also observe the code.'

A Department of Health spokesman confirmed this week that this would apply to private sector managers managing NHS staff or private healthcare bodies with units primarily providing services to the NHS.

NHS bodies 'do not have a choice' about whether to ensure that private providers observe the code, he said, but 'it is for them and their partners to discuss and agree how that will be done'.

This could be either through 'voluntary agreement' or 'formal contractual arrangements', he said. 'For existing contracts this will involve agreeing a variation.'

If the private partner would not agree to a variation, that was 'something the NHS body would have to take into account when considering further contracts with that organisation'.

Norman Rose, director-general of contractors' body the Business Services Association, said: 'The idea that we are treated no differently than internal people is good - we all want high standards.'

But he added: 'My concern would be that there has been no consultation that I am aware of with the private sector. If It is binding on us, it would be nice if we had been shown it at least.

'We have got to make sure that it is as workable when you are an outsourced manager, and with the retention of employment model coming into force [in private finance initiative contracts] there are other tensions to be taken into consideration.'

Roger Kline, health sector consultant at Unison, which lobbied for the code to cover the private sector, welcomed the move: 'We'll be working to make sure this is what happens locally.'

Asked if private healthcare providers or contractors had been consulted, the DoH would only say there had been 'a wide-ranging consultation'.

Alan Farmer, human resources director of contractor Sodexho, was 'in general supportive' of the code. 'It is in line with how we expect our managers to perform.'

Paul Preston, managing director of BMI Healthcare, a firm interested in providing diagnostic and treatment centres to the NHS, said: 'We foresee no issues for our managers in complying with this code. In fact, the content would be equally applicable to all our staff.'

But he said the code 'does not appear to specifically cover some of the underpinning values we would expect to be an integral part', such as seeking continuous improvement in the quality of patient care, or whistleblowing where there are concerns about a colleague.

A Bupa spokeswoman said the detail of the code was 'still being considered'. She added: 'The high profile standards outlined in then code are the sort of standards we would expect our general managers to adopt in any case.'

A spokesperson for the Independent Healthcare Association said the issues in the code were addressed in the Care Standards Act. 'In that respect, I believe we adhere to the principles of the code.'