Ruth, great blog, conflicts of interest are clear issues here. For me, one of the disappointments for me of NHS England's recent (now clearly waning) monopoly over commissioning primary care is the lack of use of that immense power to commission and hold to account for inequality reduction. The Department of Health, NAO and others have done all the analysis to show how systematic, scaled up interventions in primary care will speedily narrow inequalities in life expectancy between deprived and wealthier areas. The power that NHS England had to alter that through its monopoly, was not used to tackle that. Now it looks like the opportunity is lost, I hope that CCGs will do a better job.