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Gag, cover up and secret privatisation: What is the real story behind the NHS clinical correspondence scandal

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NHS archives. Pic credit: Health IT Central

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A week ago the media was full of the huge scandal of over 700,000 clinical correspondence documents – including details of sensitive patient conditions – going missing and  instead of being delivered to GPs being dumped in rooms.

The story was originally broken by the  Guardian in February this year which revealed that NHS England was secretly working on how to sort out it  without disclosing the scandal to the public. Jeremy Hunt had made a perfunctory statement to Parliament in 2016 not disclosing the full state of affairs in July 2016.

Last week the National Audit Office published a very thorough investigation into the scandal – including discovering that somehow the NHS also lost  highly confidential reports dating back to 2005 which identified children subject to child protection orders which must never be disclosed to the public without the individual’s consent. And in 1788 cases it look possible that patient treatment could have been harmed as a  result.

The mislaid and unprocessed correspondence covers GPs and now abolished Primary Care Trusts in the East Midlands, North East London and South West England .

The NHS has paid GPs £2.6m up front  to examine the mislaid documents but they have yet to complete the work so a proper picture can still not be obtained.

In one bizarre incident some 205,000 documents were kept in a room marked “ clinical notes”. The report says: “A subsequent review found that the label had been removed by an SBS general manager because “you don’t want to advertise what’s in that room”.

“ NHS SBS told us that it was important that documents were held securely and therefore not having a label on the door was appropriate as part of this.”

Now this scandal is bad enough but in the small print of the National Audit Office report there lurked another extraordinary scandal – SBS  and its auditors, BDO, decided to frustrate the National Audit Office finding out what had gone wrong.

Both the company and the auditor refused to hand over the files unless the National Audit Office signed an indemnity letter – which  could get them off the hook should enraged patients decide to sue them for their negligence.

The NAO to its credit refused to do so and in its own report says, if it had, Parliament would not have been told the full story. As the report says:

“NHS SBS and BDO felt unable to share with us their reports into the incident unless we also signed a letter (which would indemnify them). This is common practice among audit organisations.

“We declined to sign any letter that would limit our ability to report on the incident.”

Instead the NAO used its statutory powers to force NHS England, which had copies of the documents after signing the indemnity letters, to hand them over.

Now NHS Shared Business Services was set up as a joint venture with the private sector  under the Blair administration in 2004 when John ( now Lord ) Reid was health secretary. It was an equal partnership between the  Department of Health and Xansa Ltd,a British outsourcing technology company 50 per cent owned by the staff. In 2007 it was taken over by Steria, a French  rival, with British staff pocketing millions of pounds as the French paid a 70 per cent premium on the share price.

In 2014 Steria merged with another French rival Sopra creating a French owned global conglomerate. They are now planning to take over a Swedish firm

But two years before Andrew Lansley, then secretary of state for health, quietly and without any public announcement, transfered a single share to the French company, so it became the majority owner and could dictate policy. Just to make sure the Department of Health, which had civil servants on the board, declined to take up the directorships on the grounds of ” conflict of interest”.

I asked BDO and NHS Shared Business Services why they had sought to frustrate the NAO.

BDO replied putting the onus on the privatised company  saying :

“BDO was in no way obstructive or concerned about making its reports accessible to the relevant third parties.” BDO has a contractual duty of confidentiality to clients as well as an ethical duty of confidentiality under the Code of Ethics of the Institute of Chartered Accountants in England & Wales (ICAEW). Therefore, unless required by law or regulation, we cannot disclose information to third parties (such as the NAO) without the express permission of our client. 

The letters dealing with obtaining the necessary consents and agreeing the basis for access are drafted in accordance with professional guidance issued by the ICAEW. As the NAO report acknowledges in its report (paragraph 3.19), this is “common practice among audit organisations”.

 Patients of the NHS are not a party to such letters and therefore their legal rights are completely unaffected.”

NHS Business Shared Services said :

“The recent NAO report highlights a number of failings in the mail redirection service provided to NHS England. We regret this situation and have co-operated fully with the National Audit Office in its investigation. All of the correspondence backlog has now been delivered to GP surgeries for filing and NHS England has so far found no evidence of patient harm. NHS SBS no longer provides this mail redirection service.”

There appear to be contradictions in both statements.  I gather the safe delivery of clinical correspondence  is now in the hands of Capita.

 

Revealed: The bucolic wine buff accountant who let privatisation spivs fiddle London fire brigade

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Robert Napper: Pic credit: Twitter

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He has been fined £120,000 and barred for three years from his professional body for ” professional misconduct ” by the Financial Reporting Council in April for his part in allowing a now bust private firm to fiddle its income from London Fire Brigade.

But before this happened Robert Napper, a partner with Grant Thornton, one of the big accountancy names, had already quietly retired with his pension to live in the rural Oxfordshire countryside and become a pillar of the local community.

Grant Thornton will have to pay a £2.3m fine for their part in allowing Assetco to fiddle the books after the company took over responsibility for maintaining London’s 700 fire engines in a privatisation deal which went badly wrong.

The scheme had been pushed by the now disgraced former Tory chair of the London fire brigade, Brian Coleman, to save money and curb the power of the Fire Brigades Union. Coleman was wined and dined by the director John  Shannon and given a Christmas hamper from Harvey Nicks for his trouble.

The union all along protested about the way the company was run – but even they did not know it was fiddling and inflating the books with false invoices for claims that were never made ( see my earlier blog).

To be fair neither Robert Napper nor Grant Thornton made any money out of it – indeed the auditors ended up as creditors with unpaid bills. But they did allow enormous latitude to the directors of Assetco, John Shannon and Frank Flynn, to fiddle the books and rip off the company, the shareholders and ultimately the taxpayer.

So who is Robert Napper who got duped? He lives in East Hagbourne in South Oxfordshire near Didcot.  It is a village of 1882 people with  a mixture of  modern properties (where he lives)  and many  chocolate box cottages. It has a community shop and post office which Robert Napper is one of the directors.

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Village Cross at East Hagbourne. Pic Credit: Creative Commons Rob Stallard

He was a senior accountant with 23 years experience who as a partner – one of the top paid jobs at Grant Thornton –  and should have known better. The report by the FRC distinguishes between his role and junior staff who were inexperienced in handling Assetco’s accounts.

It also turns out that he is a serious wine buff – his Twitter account includes many pictures of fine wines- and the best food to accompany it. Among these are his Christmas 2015 selection ( see below).

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Robert Napper’s Christmas wine collection

He will have to pay the fine in instalments. I contacted him to ask him if he had anything to say about the scandal or whether he knew the whereabouts of the people who had duped them.

He said he could not comment because of legal reasons though he did say he was not appealing the findings against him.

As for John Shannon and Frank Flynn they appear to have fled the country – he thought one of them could be in Thailand. Anyone who knows where they are could  they contact me and I would be very grateful.

 

 

Equal Pay,Unequal Misery: Unison and the Durham Teacher Assistants’ Dispute

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Durham teaching assistants at their protest meeting over the deal this week.

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The issue of equal pay for equal work is one of most enduring work scandals of our time. Women workers in particular lose out to men but it requires a lot of hard bargaining and money to tackle it.

The most dramatic current case is the long running Durham teacher assistants dispute involving over 2700 teaching assistants in Durham, mainly low paid women.

To implement equal pay Labour controlled Durham Council proposed cuts in  wages of up to £5000 for already low paid teacher assistants earning between £14,000 and £20,000 a year to bring it into line with other low paid workers they employed. The teaching assistants are the backbone of Durham’s schools, helping kids to read and understand basic numbers and when teachers fall sick deputising for them by taking classes.

The council and Unison, the union that is supposed to stand up for low paid workers, evidently were about to agree a deal that would worsen their pay and conditions when they faced a huge grassroots revolt from the teacher assistants themselves.

Feisty women workers called meeting, rallies, marched at the Durham gala and lobbied the sympathetic Labour leadership at last year’s Labour conference securing a meeting with John McDonnell, the shadow chancellor. They were even partly responsible for Labour’s poor performance in this May’s local elections which saw Liberal Democrats, Independents and Tories take seats from Labour.

Their strong action led Unison to change its mind and back them and give them some limited say in negotiating a better deal.

Last week in the middle of the Unison annual conference in Brighton the union claimed it had  negotiated a breakthrough.

UNISON Northern regional secretary Clare Williams said: “Several months of tough talking later, a revised and improved offer has been proposed that will benefit the majority of teaching assistants.

“Strikes and relentless campaigning by dedicated teaching assistants, along with the support of the community, have been crucial in moving the council from its original position.

“Dismissing, rehiring and cutting the pay of so many education professionals would have risked many quitting their jobs. That would have had a huge impact in the classroom.

“Both sides have worked hard to reach agreement over the past few months. The union is absolutely committed to continuing to work with the council to secure the best possible outcome for everyone.”

However within days the promised deal which is based on a complicated regrading started to unravel once the 2700 teacher assistants got individual letters with new terms of employment.

This week a big meeting was called in Durham and the grassroots again began to revolt.

Megan Charlton, one of the leaders of the group, wrote in a blog that she will not be accepting the deal – even though she will get a pay rise in two years time.

She said: “472 Teaching Assistants – 22% of the workforce – will still be losing money. Many are losing £1200 a year, some are losing less, some are losing more (several on our facebook group are still facing losses of £4,000 and that’s AFTER they agree to the extra hours).

“We now have a situation where the vast majority of Teaching Assistants are required to teach at least one session a week. Surely teaching should be an ‘enhanced’ requirement, an ‘enhanced’ skill, not one you would expect from the majority of Teaching Assistants who came into the profession to do exactly that: to assist teaching, not to teach.”

She said if it had been just a ” few anomalies ” she might have accepted the deal but clearly it wasn’t. It will now go out to a ballot.

Durham County Council responded to my inquiry:

The council’s corporate director of resources, John Hewitt, said: “Throughout this process the issue for the council has been the risk of equal pay claims caused by the current teaching assistants terms and conditions.

“To mitigate the equal pay risk, and to ensure that assistant’s job descriptions and grades are appropriate for the work they do, we have  worked really hard with trade unions, teaching assistants and head teachers on a fundamental review of TAs responsibilities and roles.”

“The outcome of that work is that, if accepted, the vast majority of teaching assistants will see an improvement in their financial position after the compensation period.”

To its credit Durham County Council has withdrawn its threat to sack and rehire all the teaching assistants on inferior terms. The problem the teacher assistants have is with their union which they believe rushed into the deal to announce it at its annual conference without checking the full terms.

I wanted to put this to Clare Williams, the regional secretary, and a supporter of ” Team Dave” during the last election but she declined to come back to me.

But it seems to me that  Unison has been too ready to accept this deal and has sold out some of its low paid members without pressing for  further improvements. For them it is  a real loss of cash from a low salary . An equal pay deal has resulted in unequal misery for a fifth of the workforce. And it has been negotiated by a well paid official earning at least three times the money of the lowest paid teaching assistant.

 

An Establishment cover up: The sordid and sad saga of sex abuser Bishop Peter Ball

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Bishop Peter Ball at his trial . Pic Credit: BBC

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The Church of England has finally fully acknowledged the impact of the predatory sexual abuse committed by one of its most charismatic former bishops Peter Ball.

A forensic report by Dame Moira Gibb into both his activities and the cover up by the church  of his behaviour which reached the then Archbishop of Canterbury, George Carey, (now Lord Carey) to protect the Church’s reputation.

It is a grim story only coming light after the former Bishop of Gloucester was successfully prosecuted and jailed in 2015 after  a career  of physically and sexually abusing and exploiting  boys and young men, including some who were particularly vulnerable.

The report says : “He had used his position within the Church to identify those whom he then abused. and admitted two offences of indecent assault and a further offence of misconduct in public office.”

Tragically a young man, Neil Todd, who had first accused him in 1993  of abusing him in when he was 17 killed himself in 2012 when  Sussex Police re-opened an investigation when he was Bishop of Lewes.

Equally culpable, though not an abuser, is Michael Ball, his twin brother and former Bishop of Truro, who ran a campaign after his brother had been given a caution for abusing Todd in 1993 to rehabilitate him using every type of pressure he could find.

None of the authorities, with the exception of Sussex police, come out of this well, Neither the Church, Lambeth Palace, Gloucestershire Police and the Crown Prosecution Service. It is litany of failed responsibility among those in power and also the misuse of power and reputation to protect the powerful.

Peter Ball comes out of this report as a manipulative, sadomasochistic  predator who appears to have used every trick to entice young men from public schoolboys to priests and damaged and vulnerable youths coming to the Church  for his own sexual  gratification. It is not clear  even now at 85 whether he shows any remorse as he refused to co-operate with Dame Moira’s inquiry.

While on the surface being a charismatic leader he and his brother appear to have conned  the Establishment to cover up his  activity and the Establishment appear to have been prepared to do so.

The report reveals how he wanted to whip Neil Todd who was only saved by worried staff at the Bishop’s house who sent him away. He also got youths to strip off in the chapel so they could pray together in the nude and even used a ceremony to anoint a youth’s penis in some bizarre religious rite.

But  as bad is the 20 year cover up . This included dragging Prince Charles into Ball’s defence – by using his privileged access to Highgrove House – to claim, falsely, as an examination of letters between Ball  and the Prince show, that he supported his cause. According to the report even a commercial arrangement that allows Ball and his brother to rent a house off the Duchy of Cornwall was twisted to say this was a Royal favour.

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Lord Carey: Former archbishop of Canterbury Pic credit: BBC

Lord Carey emerges as a very weak character in this sorry saga. On the one level he is aware of Ball’s transgressions and tries to investigate, on another level he intervenes with the aim, whatever he says in a letter to Gloucestershire’s chief constable, to prevent a public trial of a Bishop by just issuing a caution. In the end this is done in return for his resignation as bishop. It is here that Gloucestershire Police and the Crown Prosecution Service, which now admits its mistake, are totally at fault. Lord Carey also failed to pass on information to the police on people Ball abused and defended his reputation to the police.

Then after this ” escape from justice” he and his brother pursue a ruthless campaign to rehabilitate him  as a priest – which is successful. They demand  money from the archbishop to fund their expenses, insist on his reinstatement as  a priest in his brother’s parish  ( at one stage his brother actually threatens to do this without Lambeth Palace’s permission) and he even gets an honorary retired bishop’s post from the  Bishop of Chichester.

The report recommends a strengthening of safeguarding in the Church of England and will be considered by the independent child sex abuse inquiry. But what it doesn’t address – and it is outside its terms of reference – is the glaring issue of homosexuality in the Church.

To put it in its historic context these events take place when people who were homosexuals in public life often lived  a double life for fear of exposure in the press. This was the time when  David Atkinson, the Tory MP for Bournemouth East was publicly a happily married man with a wife and children while secretly leading a double gay life in the House of Commons.

It was also the time when Britain’s first successful black footballer, Justin Fashanu, led a troubled double life attracted to young men, which led to his suicide when the US law caught up with him.

One wonders whether if as now – when to be openly gay no longer is a problem  and gay marriage is acceptable  ( except to the Democratic Unionist party)  Ball could have had a stable relationship instead.  Or was he a predatory abuser anyway? This is not to excuse the Ball twins from the appalling sexual abuse and cover up that followed. But it suggests the Church has got to address a wider problem than just the abuse.

The full report is here.

 

 

Will May’s terrorism clampdown restrict freedom of speech?

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Police at Finsbury Park, north London after the latest terrorist attack this week Pic credit: BBC

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Theresa May promised ” Enough is Enough”  after the two vicious terrorist attacks in Manchester and London Bridge during the election campaign. Since then we have a third attack in Finsbury Park, north London targeting Muslims.

Today a much slimmed down Queen’s Speech promises new laws on security and possibly a U-turn on police cuts. But we need to be vigilant on what measures are taken and ensure that in a rush to clamp down on extremist perversions of the Muslim faith that the law is not used against other people to restrict freedom of speech and robust debate.

This threat was highlighted by none other than researchers at the House of Commons library who produced a timely review of terrorist legislation and also pointed out the pitfalls of badly drafted legislation and loose definitions of extremism.

As I wrote in Tribune last week:

In the Tory manifesto Theresa May had committed herself to creating Commission for Countering Extremism. The Commons library paper says the last Tory government has already got a Counter-Extremism and Safeguarding Bill in the pipeline – which was never introduced because of the snap election.

This included powers to regulate all official out-of-school activities to prevent extremists from using them and banning people with extreme views from teaching in schools by extending the scope of the debarring system, at present used to prevent criminals and sex abusers from getting jobs.

It also included new powers to block people streaming extremist videos from outside the EU and new action to be taken against local councils that did not act to stop extremism in schools.
What is not clear is whether the new legislation would also include measures to disrupt extremist activity, including outlawing some organisations and some individuals, barring them using premises and trying to criminalise people who say they do not believe in democracy and advocate violence even if they have no intention of committing offences themselves. Some of this would involve issuing civil orders against individuals.

The  Commons report  raises a lot of questions:
• Can extremism be defined in a way that offers legal certainty?
• Is it necessary to resort to new civil orders instead of existing criminal offences?
• How will proposals avoid unjustified interference with freedom of religion and expression?
• Is it justified to limit speech which is not in itself illegal?
• How can online extremism be dealt with both by government and social media companies?

It warns: “Unless a consensus can be reached as to what constitutes extremism in the first place, the development of effective measures will continue to prove problematic.”

And the government can hardly introduce a law that singles out Muslims.

These are wise words because the direction of travel is to try to prosecute people for what they say not for what they do – and somehow try and control what is on the internet.

It is a law of unintended consequences as the Commons paper reveals. For while naturally Liberty objected it also led when the idea was debated in 2015 to objections from Christians.

They were protesting that people advocating gay marriage should be banned could face prosecution or denial of access to buildings because they would be described as extremists.

It is delicious irony that tough talk to clamp down on radical extremism could end up alienating  the Tory’s preferred government partner, the Democratic Unionist Party , who oppose gay marriage, unless of course there will be a special exemption for Northern Ireland.  Even Dominic Raab, Conservative MP for Esher, now a government minister at the Ministry of Justice, objected to curbs on free speech, warning it could be used to prosecute other groups – including Christians opposing gay marriage,

People should scrutinise the proposed terrorism bill very carefully when it is published today. The Commons research paper is here.

GRENFELL TOWER FIRE

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I am running these series of blogs from the distraught residents association in London following this fire . They sadly speak for themselves. This absolutely tragic scandal means there must be a full scale inquiry set up by the government. These warnings from the local residents association suggest to me that something badly went wrong over fire safety concerns and that people will need to be brought to book.

The inquiry must be wide ranging and involve all tower blocks that have been recently refurbished in this way across the country not just in Kensington. In the meantime tribute must be made to the London Fire Brigade – which has been the subject of merciless cuts and privatisation – and the NHS hospitals again at the front line so soon after two terror attacks in the capital.

All one can say is that I cannot imagine the horror and fear that distraught families and their relatives are facing tonight after such an appalling event and my thoughts are with them.

Grenfell Action Group

Watching breaking news about the Grenfell Tower fire catastrophe. Too soon (5am) to even guess at numbers of casualties and fatalities. Our heartfelt and sincere condolences to all who have perished, to the injured, to those who are bereaved or are still searching for missing loved ones.

Regular readers of this blog will know that we have posted numerous warnings in recent years about the very poor fire safety standards at Grenfell Tower and elsewhere in RBKC.

ALL OUR WARNINGS FELL ON DEAF EARS and we predicted that a catastrophe like this was inevitable and just a matter of time. Below is a list of links to previous blogs we posted on this site trying to warn the Royal Borough of Kensington and Chelsea, who own this property, and the Kensington and Chelsea Tenant Management Organisation who supposedly manage all social housing in RBKC on the Council’s behalf:

https://grenfellactiongroup.wordpress.com/2013/01/28/fire-safety-scandal-at-lancaster-west/

https://grenfellactiongroup.wordpress.com/2016/11/20/kctmo-playing-with-fire/

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Jeremy Corbyn’s biggest victory: Revitalising democracy

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Jeremy Corbyn rally – as big as a Gladstone or Disraeli rally. Pic Credit; Twitter

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Jeremy Corbyn’s good performance  in the polls last night was not just brilliant for Labour. It was also not just because he produced a left of centre detailed manifesto. It was not even because he avoided ” yah boo sucks”  attacks on the Tories or Liberal Democrats.

His biggest victory last night was because he galvanised democracy and got a new generation of young people to take an interest in politics and bother to register to vote. He did this in the extraordinary space of two months.

On  March 24 Tribune published an editorial highly critical of Labour’s performance in general and Jeremy Corbyn in particular. It said simply Labour isn’t working and this was from a left of centre magazine not the Daily Mail.

Lest it be forgotten then the Tories had a 19 per cent lead over Labour and crucially had a 41  to 29 per cent lead among the  18-24 year old group.  Thus at that time Theresa May even had a lead among students and young workers.

Now in the remarkable space of  just 10 weeks Jeremy Corbyn and his election campaigning team has totally transformed the picture of politics for youth.  Not since the barnstorming performances of Gladstone and Disraeli in the nineteenth century and Churchill in the early twentieth century have such huge crowds turned up at rallies to hear a party  leader speak.

And remember these huge meetings predate the invention of radio and TV let alone the internet and the smartphone.

To get youth as enthusiastic to think they can change events in an age of so many other distractions is a mega achievement which leaders of every other political party should be profoundly grateful to Jeremy. For if the idea of change through the ballot box is not passed from one generation to another democracy dies and dictatorship looms. And given it was against a background of two random terrorist attacks aimed at the young is even more remarkable.

Sadly I must say his dream of encouraging young people to participate in democracy did not seem to be shared by the Conservatives. They did not appear to be encouraging the young to  register to vote – presumably because Lynton Crosby thought it would not get many new votes for the Tories.

And worse on polling day some people – including one person with a blue rosette in Enfield and a UKIP and Tory run council in Plymouth – lied to young first time voters that they needed an ID card to vote at polling stations- presumably in a desperate move to keep  Labour from winning marginal seats. Theresa May does want to introduce ID cards for voting – but I am afraid it is not the law at the moment so it is illegal to mislead voters.

The contrast between Labour and the Tories over democratic rights is still continuing after the election. Theresa May is behaving like a headmistress of a rather badly run prep school  – by pretending that she is still running a successful operation when people are stopping paying the fees. She has lost authority and seems to be developing a  “bunker type”  mentality ignoring the reality that the game is already half up.

There appear so far to be no concessions to the democratic process from the Tories – and the main aim seems to be to ally May with the Democratic Unionist Party in Northern Ireland – probably adding to division there between them and Sinn Fein. Would she ban abortion in the rest of UK if the DUP demanded it? Would she concede to some of their antiquated views about gays? How will this play out over the present crisis in Stormont?

But I profoundly believe that what Jeremy has started cannot be stopped. There may have to be yet another general election after a few months to complete the transformation – though this will be highly risky in the middle of Brexit negotiations. Theresa May called the election believing her own propaganda that Jeremy was a no hoper. Now she has found out the hard way  that he isn’t and no matter how many pages of propaganda Paul Dacre and Rupert Murdoch use to smear him it no longer works.