Conflicts of interest are "rife" in the new organisations which will commission NHS services, according to a report.
GP-led clinical commissioning groups (CCGs) are at the heart of the new NHS structure - introduced in the Health and Social Care Act - and will take over local NHS budgets in England next month.
But the British Medical Journal (BMJ) reported that more than one in three of the GPs who will buy patient services have a conflict of interest due to directorships or shares held in private companies.
The groups, which are to replace local primary care trusts, will distribute around £65 billion of the NHS budget for services in their regions. They will be responsible for planning and commissioning hospital, community health and mental health services on behalf of almost all of England's population.
The BMJ analysed the registered interests of the board members of 176 out of the 211 commissioning groups. Following a series of freedom of information requests and analysis of CCGs' websites, the authors found that 426 of 1,179 GPs in executive positions, or 36%, have "a financial interest in a for-profit private provider beyond their own general practice".
The authors wrote: "Our investigation shows that conflicts of interest are rife on CCG governing bodies. The interests range from senior directorships in local for-profit firms set up to provide services such as diagnostics, minor surgery, out-of-hours GP services, and pharmacy to shareholdings in large private sector health firms that provide care in conjunction with local doctors, such as Harmoni and Circle Health."
The news comes as the NHS Commissioning Board announced that all 211 CCGs are ready to take charge of local health budgets. The NHS Commissioning Board has issued a code of conduct to CCGs stating that board members must remove themselves from decisions from which they could materially benefit.
But doctors' leaders have expressed concern that clinical input into commissioning decisions may become diluted if too many doctors are forced to remove themselves from particular decisions.
Dr Laurence Buckman, chairman of the British Medical Association's GPs committee, said: "While the majority of GPs have no involvement in private companies, we have long called for stronger safeguards against possible conflicts of interest in the new commissioning process.
"In our view, GPs who are directors of, or who have significant financial interests in, companies who might be awarded contracts to provide services should seriously consider their membership of CCG governing bodies. Alternatively, they should consider their position within provider companies."
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