Category Archives: Conflict of interest
CCGs had to release data on payments from private companies and charities under the Freedom of Information Act. With researchers at Bath University and Lund University in Sweden, the BMJ compared the data to the details published in CCGs’ online registries.
NHS clinical commissioning groups, who are in charge of buying health services for their local areas, received payments, including sponsorships and tickets to sporting events and concerts from the building pharmaceutical and hospitality industries.
The BMJ worked with Piotr Ozieranski, a lecturer in the department of social and policy sciences at the University of Bath, Shai Mulinari, a sociology researcher at Lund University in Sweden and Emily Rickard, a research assistant in Bath’s department of social and policy sciences, who intend to publish the full findings of their research in the coming months.. Piotr Ozieranski’s comment: “It seems rather peculiar that CCGs are permitted to accept any payments or benefits in kind from private sector companies”.
Only £1,283,767 of £5,027,818 paid from 2015 to 2017 was declared on public registers
This, despite the revised NHS England guidance which requires CCGs to maintain and publish registers of their conflicts of interest and procurement decisions. This was revised and strengthened after finding, in 2015, that CCGs had paid many millions of taxpayers’ money to companies, hospitals and surgeries in which their members had financial or professional stakes.
National Health Clinical Commissioners responded: “This BMJ investigation seems to imply that there is some wrong doing on the part of CCGs by working with external companies and pharmaceutical organisations, which we would strongly challenge.
Not so: the investigation does not relate to working with these industries, it implies that funding of recreational activities for CCG members, most of which have not been declared as required, is the ‘wrong-doing’.
Paul Glasziou, professor in the Centre for Research in Evidence-Based Practice at Bond University, Gold Coast, Australia, says that doctors are often unaware of the effect of drug companies’ activities on their own behaviour:
“Pharmaceutical company dominance of the funding of continuing medical education can result in prescribing that harms.
“Clinicians are often naive about the persuasion tactics used by some companies. So we urgently need better ‘inoculation’ against these tactics, as well as better regulation and funding of balanced continuing education.”
Since clinical commissioning groups were launched in England in 2013, there have been concerns about the conflicts of interest among those who commission health services while also providing them. But the Association of the British Pharmaceutical Industry said that drug companies had an important role in supporting healthcare organisations.
“100 tenants a day lose homes as rising rents and benefit freeze hit” – The Observer July 2017.
In the same month, a Joseph Rowntree Foundation study attributed 80% of the recent rise in evictions to the “no fault” process under section 21 of the Housing Act 1988.
Two months’ written notice is all that private landlords need to do: they don’t need to give any reason when they ask tenants to leave.
It allows the worst landlords to ignore disrepair – tenants who complain are given notice – a process officially recognised under the name ‘retaliatory eviction’.
Read more about retaliatory eviction’ – the subject of Commons Briefing paper SN07015 by Wendy Wilson – published on June 13, 2017.
Jeremy Corbyn raised the issue forcefully in Wednesday’s Prime Minister’s Questions
Mr Corbyn reviewed the government’s record:
- Homelessness is up by 50% and rough sleeping has doubled. Homelessness and rough sleeping have risen every single year since 2010.
- Evictions by private landlords have quadrupled since 2010. There is no security in the private rented sector.
- One-for-one replacement of council housing sold off through the right to buy was promised, but just one in five council homes have been replaced.
- Hundreds of thousands of people are on housing waiting lists.
Campbell Robb, chief executive, said: “With the possibility of eviction with just two months’ notice, and constant worries about when the next rent rise will hit, the current rental market isn’t giving people – particularly families – the stability they need to put down roots. The stable rental contract offers renters a five-year tenancy and gives landlords more confidence in a steady income, all within the existing legal framework”.
Scotland for best practice to date: the Scottish secure tenancy
In Scotland, under Jack McConnell’s Labour government, by an order under section 11 of the 2001 the Housing (Scotland) Act tenants of local authorities, housing associations & tenants who are members of fully mutual co-operative housing associations, from 30 September 2002, became Scottish secure tenants.
Read the excellent terms here. Will a Labour government in this country adopt this Rolls Royce standard model and also introduce a stable rental contract for those in private accommodation? Or will the profit motive win the day?
In last week’s Prime Minister’s Question Time there was a fiery intervention by MP Dennis Skinner who told Theresa May about research showing that the High Speed 2 rail line was going out of its way to stop disruption to “leafy suburbs of the south”:
“[In] the leafy suburbs of the south, the first 140 miles, 30% of it has been dedicated to tunnelling to avoid knocking houses down.
“Yet in the north we are now told that the percentage is only 2% for the whole of the north. “And why? Because HS2 says it’s too costly, knock the houses down.
“Will she arrange for a meeting with people from my area in order to avoid another 30 houses being knocked down in Newtown part of Bolsover.
“Isn’t it high time that this government stopped treating our people like second class citizens?”
Theresa May replied by extolling her government’s service to these second class citizens citing resounding names Northern Powerhouse and Midlands Engines; the reality?
The north struggles to attract high-calibre teachers . . . Its secondary schools have, on average, funding of £1,300 less per pupil than those in London. In April this year the FT reported research findings that schools with the poorest children face much greater cuts per pupil than those with the most affluent children under the government’s proposed funding formula. (Brian Groom FT)
Knowsley and Liverpool are two of the most deprived areas of the country: council spend per head in these areas has been reduced by £400 and £390 respectively. In Wokingham and Elmbridge, two of the wealthiest parts of the country, the corresponding totals are £2.29 and £8.14.
A scheme to compensate councils for the council tax freeze, for example, is calculated on the value of properties in the area, meaning that the higher the value of local homes, the larger the relief package: Surrey gets a vastly bigger pay-off than Teesside. (Tom Crewe, LRB essay)
The local authorities with the highest levels of deprivation and more reliant on central government grants, were relatively worse off. Cuts to the poorest metropolitan districts averaged 28% compared with more affluent authorities (2010-2015). National reviews painted a stark picture of closures and restrictions to services. (Steve Schofield, Conservative austerity and the future of local government)
Time for change!
Broken Britain 9: ‘populism’ is really ‘anti-elitism’ – a backlash due to economic and political inequality
Stephen Latner, an FT reader, reminds columnist Philip Stephens – and a whole range of commentators – that it would be more accurate to describe “populism” as “anti-elitism” and acknowledge that the backlash is not down purely to economic factors but political as well . . .
Philip Stephens had explained that the explanation for a rising sense of grievance and a collapse of trust in the old political order is to be found in the answers to the opinion poll question asking people if they expect a better life for their children:
“Voters are now more likely to answer no than yes. The march to progress, they assume, has ended . . .The pain is made the more acute when a small minority can indeed pass on great power and wealth to their children . . .”
Latner adds that many voted for Brexit because of the perceived elitism of the EU (“an unelected, non-transparent, central bureaucracy”) and sees that new technology – ‘the digital age’ – is ensuring that elitism will come under fire and more centralisation of political power will be seen as elitist and unacceptable.
Stephens supplies the element missing from Latner’s analysis – the added burden of a political elite allied with the wealthiest corporates:
“At its simplest, establishing trust is about behaviour. Today’s elites should ask themselves just when it became acceptable:
- for politicians to walk straight from public office into the boardroom;
- for central bank chiefs to sell themselves to US investment banks
- and for business leaders to pay themselves whatever they pleased”.
At the moment, due to imports, this country’s food security ratios are high – see map:
But 28,000 farms in England went out of business (132,400 in 2005 to 104,200 in 2015, DEFRA), many due to farmgate prices below production costs.
Meanwhile the AHDB advisers inflicted on them thrive, advertising for Sector Strategy Directors to be paid £62,000 – £76,000 for working 35hrs per week
The farmer drawing attention to this – who works far longer than 35 hours for far less return – comments “How easy it is to spend someone else’s hard earned income. An independent organisation (independent of both commercial industry and of Government)??”
A government website explains that the Agriculture and Horticulture Development Board is a non-departmental public body funded by a compulsory levy on British farmers. growers and others in the supply chain.
It “has a role in the processes of national government and operates to a greater or lesser extent at arm’s length from ministers”.
AHDB advisers working half the hours at more than double the average farming income frequently offer sage advice: their mantra: “improve productivity”. The FT quotes reflections by Phil Bicknell, market intelligence director at the AHDB who sees only three options:
- The most desirable: securing a free-trade deal with the EU,
- The least: putting up protectionist barriers or
- opening up trade to low-cost competition from around the world.
Notably absent is any sustained concern about a fair price deal for food producers and the prudence of supplying the home market first before trading any surplus.
Between 2013 and 2015, according to figures from the House of Commons library, smaller producers left the industry and during that period, milk prices fell by about 30%.
The Gosling Report finds that for farmers in Northern Ireland the sale price for the majority of commodities they produce does not even cover the input costs; this applies equally to most other British farmers. Paul Gosling comments:
“Meanwhile, large processors, large corporate food wholesalers and corporate retailers continue to maintain their enormous unsustainable profits”.
Farmers in the rest of Britain in the same position should act with those in Northern Ireland. They require legislation similar to that submitted by Fairness for Farmers in Europe (an association of 30 farm organisations in Britain, Ireland and the EU) to the 2010/11 CAP review. This would state that farmers must be paid a minimum of the cost of production plus a margin inflation linked for their produce; if the ‘free’ market moves up the farmer will get the benefit, however, when it falls the legislation is there to provide the safety net limit of drop.
AHDB please note: as a matter of urgency with Brexit negotiations under way, all farm groups could campaign for legislation on just farmgate prices, stating that a minimum of the cost of production plus a margin inflation linked must be paid at the farmgate for all food produced in Britain.
Readers wishing to know more about NI Farms Groups’ campaign should contact:
56 Cashel Road, Macosquin, Coleraine, BT51 4NU
Tel. 028 703 43419 / 07909744624