Government moves to keep ‘private interests’ out of key ICS boards

In a committee meeting last week, health minister Edward Argar said the government will bring an amendment to its draft health and care bill “to protect the independence of [integrated care boards] by preventing individuals with significant interests in private healthcare from sitting on them”.

ICBs will take over commissioning of NHS services from clinical commissioning groups, and be responsible for setting the strategy and plans for their ICS.

There has been concerns expressed by Labour politicians that private sector providers would have a seat on these ICBs, increasing the amount of privatisation in health and giving rise to conflicts of interest in awarding contracts for clinical services.

Mr Argar said “we are keen to put this point beyond doubt” by bringing its own amendment. 

The amendment would not prohibit GPs from being ICB board members, and Mr Argar rejected an amendment which sought to prohibit GPs who are not on the standard contract, saying this “would be to limit the ability of primary medical service providers to appoint an ICB member who might best meet the requirements of the local population”.

He said that service provision from the independent and voluntary sector “has been, and continues to be, an important and valuable feature of this country’s healthcare system”. But, he added, “it was never the intention for independent providers, as corporate entities, to sit on integrated care boards, nor for an individual to be appointed there to be a representative of such an interest in any capacity”.

However, the minister said that the government would not extend the same prohibition to integrated care partnerships, the advisory body made up of NHS and other system partners to make plans for the broader health and care needs of the population.

The government “[does] not intend to specify membership for the ICP in the bill, as we want local areas to be able to appoint members as they think appropriate,” he explained.

“We would expect members of the ICP to be drawn from a very wide variety of sources and backgrounds,” he said. “To exclude independent providers from both the ICB and the ICP would, I fear, risk severely reducing the extent to which all parts of the broader health and care ecosystem could be drawn upon in the ICP context.”

David Hare, chief executive of the independent provider representative body the Independent Healthcare Providers Network, greeted the announcement cautiously.

He said: “It is important that the health and care bill supports all forms of partnership working, including with the independent sector, and we await the government’s promised amendment on the future composition of ICBs.”

NHS Confederation ICS Network director Louise Pattern said her members “will be paying particular attention to this amendment and we await the detail of it, in particular how the government defines significant interest in private healthcare.

”The government will need to be careful to avoid penalising those who work in, for example, community interest companies or social enterprises, which have a key role in delivering local services nationwide.” 

A Department of Health and Socal Care spokesperson said: “We do not expect private providers, or those with significant interests in private healthcare, to sit on Integrated Care Boards. We will develop an amendment to put this beyond doubt, and will bring it forward at the report stage.”

Update: this post was updated at 09.47 on 20 September to add a comment from DHSC and NHS Confederation.