Yesterday Jeremy Hunt, the new chancellor, announced the biggest Budget U-turn in history, throwing out nearly all of Liz Truss’s and Kwame Kwarteng’s tax cuts and announcing a big curb on help for those with rising energy bills.
But this only the half of it. In less than two weeks time big cuts will be announced for public expenditure in a wealthy country and there will be more grim news for the poor – whether pensioners or low income families whatever pledges are given for compassionate Conservativism. But what is the position now before the axe falls on public spending amid a cost of living crisis?
This is the answer given in a well researched report by Barnardo’s the children’s charity, drawing on work done by the polling organisations, Yougov, and the non Tufton Street think tanks, the Institute for Public Policy Research and IPPR North. See Barnardo’s press release here.
More than half the parents contacted have ALREADY cut back on food for the family and one in five parents have struggled to supply sufficient food. Over a quarter of parents say their children’s mental health has been affected and one in five taken out new credit cards – boosting the profits of the banks just as curbs on bankers’ bonuses have been lifted. Sadly a quarter have had to sell some of their possessions to make ends meet and a small number have had to return pets to animal rescue centres because they can’t afford to keep them.
Among the professions, three out of five people are supporting a child, young person or family experiencing poverty and three in five practitioners have either given food or pointed families to food banks. The Mirror today gives a dramatic account from other charities backing up this food crisis.
Barnardo’s calls for more benefit help not less
The charity is calling for an extension of free school; meals to all families; help for all vulnerable children to be able to participate fully in school life; strengthen targeted social security payments to help young people and families manage better; improve mental health services to help children and introduce more family hubs to support people and children.
The problem is what journalists are hearing is likely to be the opposite – real cuts to social security – a mental health service starved of resources and no compassion to extend free school meals.
Banardo’s doesn’t cover issues facing pensioners but given comments on my site the most likely changes for them are the end of the triple lock, the raising of the pension age again- and using the excuse that families are struggling in work to say pensioners can’t have a good deal.
What can’t be exaggerated is that more and more people are being driven into poverty whatever the government says ( they claim the opposite). So unless you are banker or a very highly paid executive getting a big national insurance reduction or an MP or minister life this winter is going to be very grim.
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And a Parliamentary Petition is laid to change another pension injustice affecting millions
The chaotic and collapsing government of Liz Truss is facing rival demands to settle the long running dispute affecting 3.6 million 1950s born women demanding compensation for maladministration and inequality over the six year delay in paying their pension.
Ian Byrne, the Labour MP for Liverpool, West Derby, has tabled a motion supporting Backto60’s demand for full restitution of the lost money – up to £50,000 in some cases- payable through a special temporary Parliamentary measure – to avoid changing the 1995 Pensions Act which set the higher retirement age for women.
Some 35 MPs have backed him including the former Labour shadow chancellor, John McDonnell, who got Labour to back a £58 billion compensation package in the 2019 election campaign; former Labour leader, Jeremy Corbyn and host of other Labour MPs, including Ian Lavery, Tony Lloyd, Mike Amesbury, Richard Burgon and Clive Lewis. It is also supported by Alison Thewlis, the SNP Treasury spokesperson and Chris Stephens, SNP Fair Work and Employment spokesman. Two members of the Democratic Unionist Party, Jim Shannon and Gregory Campbell, also backed the motion. The full list is here.
The initiative from Waspi involves getting its members to send a template letter to their MP asking them to back their version of compensation for 50s women. For avoidance of any doubt here is the full text which would be sent to Chloe Smith, the new work and pensions secretary.
Chloe Smith MP
Secretary of State
Department for Work and Pensions
London, SW1H 9NA
XX October 2022
Congratulations on your appointment as Secretary of State!
I write in the hope that you may be able to ‘reset’ the government’s relationship with the Women Against State Pension Inequality (WASPI) campaign, whom I met during the Summer Recess.
Parliamentary answers (see UIN14559) confirm that no Minister in your department has met the campaign since 2016, which is something I am hoping that you and colleagues will be prepared to put right.
As you will know, last year the Parliamentary and Health Service Ombudsman has found that the Department was guilty of maladministration, in failing to communicate significant changes to the State Pension Age, which were legislated for in 1995. Specifically, the PHSO has concluded “the opportunity that additional notice would have given them to adjust their retirement plans was lost…DWP failed to take adequate account of the need for targeted and individually tailored information… Despite having identified there was more it could do, it failed to provide the public with as full information as possible.”
While the PHSO is continuing to investigate the harm caused to women born in the 1950s, as a result of this maladministration, CEO Amanda Amroliwala has also made clear that the government need not wait for further reports before making an offer of compensation. In a letter to our parliamentary colleague, Andrew Gwynne, she said, “We must now consider the impact of these failings on the women affected and what recommendations may be needed to remedy any associated injustice. We have suggested to the Department for Work and Pensions that they consider being proactive in this respect”.
Meanwhile, WASPI have recently commissioned research which establishes that, by the end of this year, 220,000 women will have died waiting for compensation since their campaign began in 2015. Sadly, another woman dies every 14 minutes.
I have been struck during my conversations with the campaigners that they are therefore extremely pragmatic about achieving a resolution quickly. They are not looking for a long fight with the government, preferring to accept a fair, fast one-off sum for those whose retirements have been devastated by mistakes made at DWP. Specifically, they are not looking to receive ‘lost’ pension amounts, but rather to be compensated for the maladministration at DWP, which caused them to take decisions they might not otherwise have taken, had they been given proper notice of changes to the law. Quite sensibly, they are suggesting higher levels of compensation for those given the shortest notice of the longest delay to receipt of their State Pension.
They have been through four stages of complaint at DWP and now face two further stages of the PHSO process. All the while more of the women affected die waiting, so they are keen to see the proactivity suggested by the PHSO from your department.
Would you prepared to meet with me and with Angela Madden, the Chair of the campaign, together – both so that you can understand the (surprisingly reasonable and pragmatic) position of the campaign, and that they can hear directly from you?
While both they and I recognise that you could not make immediate commitments in any such meeting, I do believe it would be helpful to open a dialogue now rather than have the group getting more and more frustrated that government will not talk to them. The PHSO’s ongoing investigation is not a reason to postpone discussion, since the substance of maladministration has already been confirmed.
At some point, government (of whichever political stripe) is going to be required by the Ombudsman to make an offer of compensation, so it makes sense to begin the conversation now rather than brooking further delay, during which time – sadly – more and more of the affected women will pass away.
WASPI want compensation for maladministration and nothing for restitution
The letter is a massive reduction on the demands made by the MPs. For a start they want NO rather than FULL restitution for the up to £50,000 lost by 3.6millionpensioners. Instead they want an unspecified payment before the Ombudsman decides what level of compensation for maladministration. There is no mention of the £10,000 to £20,000 a head compensation promised by Angela Madden to the 50 people attending the Labour Party fringe meeting last month.
There also is a misconception that the Department for Work and Pensions is required by the Ombudsman to meet them after he has issued his report. This is not true the Ombudsman has no power to require anybody to follow his decisions – as has been shown ( see below) in another case where millions of pensioners have been cheated out of a Guaranteed Minimum Pension also promised in the 1990s.
Finally the letter speaking for the 3.6 million people say they are “reasonable and extremely pragmatic people” quite happy to accept a fast buck settlement of few quid to end this dispute. This is not reflected in the comments I receive on this site.. People are livid, angry, despairing of politicians and feel deliberately cheated by the Establishment of what they see rightly as their dues. They are fed up about being thought to be a soft touch just because they are older women. They are prepared to take on the government and refuse to vote for any politician determined to deprive them of their lost pensions.
New petition on Guaranteed Minimum Pensions
Meanwhile a Parliamentary petition has been tabled by Chris Thompson, a retired pensions expert, to restore indexation for a guaranteed minimum state pension for people outside the public sector.
“I want the Government to change the law to reinstate uprating of state pensions in respect of contracted out occupational pensions known as Guaranteed Minimum Pensions (GMP).
“I believe it is not fair that the DWP ceased to uprate state pensions in respect of certain pension entitlements when the new state pension was introduced. I believe this with done without adequate consultation or notice, and should be reversed. “Sign this petition
This followed a victory for two people after they complained of maladministration ( sounds familiar) by the DWP in not informing them of the change depriving them of indexation when the new pension came into force. The Ombudsman laid down what the DWP should to inform people of their rights, but the DWP has not followed this through properly and refused to engaged with anyone. Over a lifetime this could be worth thousands of pounds of lost pensions – and I urge 50swomen to sign this to put more pressure on the DWP. You might be entitled to extra compensation as well as your claim for your lost pensions.
Finally I don’t like to be the harbinger of bad news -but the total disaster of Liz Truss’s government – means we are now going to be faced with a further two years of austerity after she wrecked the British economy.
Sadly this will mean that the government will be extremely reluctant to compensate other people on top of subsidising people’s energy bills and introducing measures to balance the books. I see Angela Madden has managed to get a meeting with former Tory leadership candidate Penny Mordaunt, the current leader of the Commons, who appears to be involved in a plot to topple Truss with Rishi Sunak. The trouble is it is the DWP who are the ministry who will decide this – and they have just been asked by Jeremy Hunt to impose more cuts on top of long term savings to sack 91,000 civil servants across Whitehall. I can’t see them having any interest in settling this at the moment.
One bright spot will be a report by Australian judge Jocelynne Scutt is expected to pull together all the injustices in this case following the tribunal earlier this year. The report is imminent.
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Trust wants to ban two expert anaesthetists from giving evidence for Dr Mark Day
An epic nine year struggle between junior doctor Chris Day and Lewisham and Greenwich NHS trust over patient safety at an intensive care unit and accident and emergency department comes to a head at 15 day employment tribunal on Monday.
The story began in August 2013 when Chris Day, a junior doctor initially complained about inadequate staffing. It got worse in January 2014 when he was working overnight in the intensive care unit at Queen Elizabeth hospital in Woolwich when two locum doctors failed to show up. He had to cover other wards and A&E and reported his concerns to managers. He saw this as putting patients in such a sensitive area at serious risk.
extraordinary convoluted story
What followed is an extraordinary convoluted story of denial of the problem by the trust, misleading statements, poor investigations, threats of a huge legal bill which led him at one stage to settle the case only for it to be re-opened at a hearing before another High Court judge. There is a detailed blog by Dr Moosa Qureshi on CygnusReports.org which goes into forensic detail of the twists and turns of his case so I won’t repeat all the detail. I recommend you read his account. The costs of the protracted legal action to the NHS trust now amount to little short of £1million
A recent blog on my site looked at one aspect of the case, illustrating what appear to be underhand methods by a former dean at Health Education England to persuade Sir Norman Lamb, then a Liberal Democrat MP, not to pursue Dr Day’s case. Health Education England disowned his action at an employment tribunal and succeeded at being taken off as a party to Monday’s proceedings.
The issue will not go away next week as unusually Jeremy Hunt, the former health secretary, will give a statement to the tribunal, as a witness for Chris Day.
Sir Norman Lamb, also a former health minister, will appear as a witness for Dr Day at the hearing so people are likely to hear a lot more about what actually happened.
Two highly distinguished consultant anaesthetists were also scheduled to give evidence on behalf of Dr Day. They are Dr Sebastian Hormaeche and Dr Megan Smith .
The trust will try during the proceedings to ban them giving evidence.
The case is likely to look at the role of lawyers and also the role of M J Roddis, a clinical management consultancy in this case. They were employed by the trust to investigate this case and Dr Day claims they misrepresented his evidence, played down the problems, and omitted some damaging information about patient care.
The tribunal hearing will not be available on line as the court has decided in advance it will be an ” in person” hearing – even though three of the first five days will be held during a national rail strike.
Nor is it likely to be officially recorded. But Chris Day, who is represented by lawyers paid by the British Medical Association, has engaged a Ministry of Justice approved note taking service so there will be a full transcript of the proceedings.
I put some points to the trust and asked them for any comments they might wish to make but officials did not respond.
UPDATE: Since this post was published the employment tribunal has done a U-turn and decided to hold the hearing online which means it will be more accessible to the press and public It will not be held at Croydon, south London as there was not a judge available to preside over the 15 day hearing.
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This is a guest blog by David E Ward, a distinguished retired cardiologist, formerly at St George’s Hospital, South London, in response to my last blog on the case of Dr Chris Day and a series of blogs on the case of Dr Usha Prasad
The treatment of bona fide whistleblowers working in the British NHS is egregious and primitive. This is amply exemplified by many publicised WB cases over the last 2 decades: Dr Raj Mattu, Dr David Drew, Dr Kevin Beatt, Mr Peter Duffy, Dr Chris Day, Dr Usha Prasad and many others (see Google). Just think for a second or two – is it appropriate to threaten the career, the livelihood, the families of these honest doctors who were only doing the “right thing” by drawing attention to what they honestly perceived were remediable shortcomings? In fact, it is required of doctors to report any perceived shortcomings (Hippocratic Oath and all that and more recently with the “Duty of Candour”).
How is it possible – in the democratic UK – to threaten a doctor with such punitive costs that they are forced to withdraw their legitimate claims or risk potential bankruptcy? Isn’t this behaviour something we might associate with some autocracies toward the east? In the case of Dr Chris Day, the sum spent on pursuing (persecuting) him must now be more than £1,000,000! All to extinguish the career of an honest doctor who sought only to improve the care of patients in his unit. Wouldn’t it have been more sensible (litotes here) to spend that huge sum of money on improvements to the unit in question? (see CrowdJustice, http://54000doctors.org/blogs/timeline).
Successive health secretaries did ” little or nothing” to help whistleblowers
Successive Health Secretaries have done little or nothing to support whistleblowers. Jeremy Hunt (yes, he who did so much damage to the NHS; see Caroline Molloy, http://www.openDemocracy essay) asked Sir Robert Francis QC to report on the issue (see Google) but then ignored most of his recommendations or feebly implemented some (for example, the Freedom to Speak Up Guardian which doesn’t really work, to say the least). The last SoS for Health and SC did nothing at all to support WBs to my knowledge (OK, there is a pandemic). The present one has probably never heard of any of the names listed above or even what whistleblowing within the NHS means! What is more disturbing is that other powers-that-be, for example the NHS Medical Director, the Head of the NHS (whoever that will soon be), other Ministers etc, seem to take no interest in this problem, none whatever. The Health and Social Care Select Committee could take an interest but it is chaired by Jeremy Hunt – who is too occupied with his own self-importance and whose record as SoS speaks for itself – so I don’t expect any action there. Perhaps these grandees are too far removed from day-to-day whistleblowing in the NHS. It wouldn’t take much time to find out what is happening at grass roots.
Time to create a public register of whistleblowing cases
Some tentative suggestions:
1. Create a register of WB cases. Whistleblowing investigations are almost invariably secretive. Why? Apart from clinical details what else need to be anonymised? All reported and ongoing whistleblowing cases should be logged in an open and accessible register kept by an independent (is that possible?) body, preferably independent of the Trust and possibly the NHS and its Byzantine structures. Progress of a case should be openly documented and questions may be submitted. Resolved cases would be available, uncensored, for retrospective scrutiny. Openness might deter shady deals behind closed doors (yes, they do happen). Above all the external investigators should be accountable to the Trust and their own professional organisations.
2. Make cost threats unlawful. No Hospital Trust should be permitted to use the threat of costs against a “little person” (i.e., doctor) who cannot possibly equal the financial power of the taxpayer-funded persecution to defend themselves (yes, for it is us, the taxpayer, who pays the bill for the outrageous sums mentioned above to “thwart” the WB but we have no say whatever in the process). If money is to be spent in this process it should be wisely and fairly spent and shared equally between the participants, that is the victim (the doctor) and the aggressor (the Trust).
3. Make Internal hearings demonstrably independent of both parties. All WB cases which are subject to “internal” hearings (for example Maintaining High Professional Standards panels) are vulnerable to potentially corrupt processes (as some of the above cases probably have been). They should be heard by independently appointed persons (this will require some checking because as we have seen not all so-called “independent” chair-persons are quite as independent as they may appear – see Dr Usha Prasad blogs here) and open to external scrutiny by independent authorities or suitably qualified persons. Minutes of internal hearings should be made accessible. (Employment Tribunal proceedings are already largely in the public domain).
Make falsified evidence a criminal offence
4. Make falsification of evidence by either party an offence (I think there is a name for this beginning with “P”). If defence of a whistleblowing claim by a Trust is found to be untrue or contain false or falsified “evidence”, or in some other way is dishonest (there may be some of that in some of the ongoing current cases mentioned above…) there should be appropriate retribution for the Trust and managers involved. Incidentally, it is usually managers who instigate the persecution and recruit the heavy (taxpayer-funded) lawyer-supported defence without accepting any personal responsibilities themselves. Also, the use of public money in this way could be regarded as fraudulent and a misuse of taxpayer funds.
5. Ensure the original WB claim is clearly stated. The original concern which prompted the WB to speak out should be clearly and concisely stated in language that the “man on the Clapham omnibus” (Lord Justice Greer, 1932) can understand. It should never lose its primal status. It defines the whistleblower in the first place. WB have, by definition, concerns about the environment in which they are working. They make what is termed a “protected disclosure” (Protected Disclosures Act 2014, Health Act 2004). It is remarkable that these concerns are not infrequently submerged (or completely forgotten) by the ensuing investigative process – which is often more about the Trust and its managers avenging a perceived insult by the WB than seeking solutions.
Health Trust managers use lawyers to “crush honest doctors”
Lastly, what is it that Trusts’ and their managers are so keen to defend seemingly at any cost? Very expensive lawyers are used to “crush” an honest doctor, the “little person”. A defence possibly costing much more than it would to correct the shortcomings exposed by the WB in the first place. Is it the Trusts’ or its managers’ reputations that are at stake? Would the CQC ratings be adversely affected if the Trust was found to be at fault? Are there hidden misdemeanours which might be revealed? Why do these proceedings always come across as a potential “cover-up” by the Trust? Shouldn’t the grossly disproportionate defensive stance itself raise serious questions worthy of further investigation?
It is high time the treatment of NHS whistleblowers is once again raised at the highest level (for example, in the House of Commons following the example of Sir Norman Lamb, see report above). Too many professional lives (not only doctors but nurses, physios etc) are being destroyed for no good reason. This is bad news at any time but in the middle of a pandemic it is nothing short of scandalous. Whistleblowing in the NHS is not taken seriously enough and may be a factor persuading some doctors to voluntarily leave the profession before time. In an open liberal society with everyone working for the good, “whistleblowing” should be a routine and acceptable practice. Sadly, it is cause of great distress and stigma.
Last week by Zoom I attended a tribunal hearing – just one in a long running saga between the Epsom and St Helier University Trust and their former consultant, Dr Usha Prasad.
This dispute which is by no means over – she has already had one employment tribunal, one employment appeal tribunal, a reference back to the original employment tribunal – and has still to go to a General Medical Council hearing and an another tribunal over her unfair dismissal claim.
The hearing took I attended just one day but it felt to me that I had just stepped into an unreal world of interminable hospital politics. The issue goes back to 2012 and won’t be settled until 2022. And all this, by the way, is being funded by the taxpayer using NHS funds.
Dr Usha Prasad is a well qualified cardiologist who has been popular with patients but ran into difficulties with staff at the trust and complained she was subject to gender and racial discrimination, bullying and harassment. There are also whistleblower issues which are yet to come out at another hearing.
Three years ago she featured in the current trust’s chief executive’s report for receiving a Patient First Gold Badge award for giving ” a wonderful extra five years of life” to an 81 year old patient suffering heart disease. She is pictured here with chief executive Daniel Elkeles.
Behind these happy scenes however all was not well. Usha felt she was not being treated well by some of her fellow male colleagues and relations between her and her junior doctor Dr Aran Kumar Perikala were strained.
Anonymous letter sent to Jeremy Hunt
The centre of her complaint surrounded an anonymous letter which turned out to have been sent by him in 2015 to Daniel Elkeles, the chief executive, the Care Quality Commission, the General Medical Council, and to Jeremy Hunt, then health secretary and to one of her patients. It was signed as representing the entire cardiology team at St Helier Hospital and made very serious allegations that Dr Prasad was putting patient safely at risk.
She saw this attack by a fellow Indian doctor as sex discrimination and also as racist. It went to an employment tribunal headed by employment judge Katherine Andrews (more about her later) and her complaint was rejected. She appealed to an Employment Appeal Tribunal who upheld three of the letters but said that sending an anonymous letter to a patient and to Jeremy Hunt was going too far. The EAT ordered it to be referred back to the employment tribunal which held a hearing last week.
The hearing was unbalanced from the start. The trust was represented both by a barrister and a solicitor at enormous public expense. She appeared as a litigant in person ( funding herself) but was helped by Philip Howard ,a part time consultant at St Helier, who acted as Mackenzie friend, a pro bono role.
The part time judge, Katherine Andrews -a solicitor – was appointed as an employment judge by Chris Grayling when he was Lord Chancellor in 2013. Coincidently Grayling is also the Tory MP for Epsom and Ewell and is familiar with the workings of his local health trust.
Judge rules clinical judgement is irrelevant
From the start the judge brusquely limited the hearing to the contents of the letter and nothing else. Two other consultants at St Helier, Dr Sola Odemuyiwa, and Dr Ranjit Shail, a consultant physician, who wished to testify about Dr Prasad’s abilities were ruled as ” irrelevant” by the judge as they had no detailed knowledge of the letter. She ruled as ” irrelevant” any discussion about the clinical judgement of Dr Prasad. An issue that her brother in law, Dr Anand Kamath, working as a NHS dentist had committed suicide after being bullied by a primary healthcare trust over a complaint about his record keeping ,when this started, was also deemed to be ” irrelevant ” by the judge.
This left Philip Howard a very limited role to help defend her. His description of the circumstances of Dr Perikala writing the letter were illuminating. He told the hearing that he wrote the letter while all the other consultants were on holiday, did not consult them about it and paid a ” rare” home visit to one of her patients without her knowledge. He was only unmasked when the chief executive thought the entire cardiology department were of that view and other consultants objected. He told the tribunal that the patient had received excellent treatment and had no objections.
You would have thought that he would be the key witness that should be cross examined about why he acted alone and what his motive was. But the hospital trust’s lawyers did not call him and the judge ruled that as it was his belief it didn’t matter whether he was right or wrong. In other words the man can say anything he liked to a lot of important people and as long as he believed it, it didn’t matter a jot.
Not a level playing field
The trust has taken the matter to the General Medical Council where his behaviour could be questioned and certainly the issue of clinical judgement will not be brushed aside there.
The judge ruled against her but she has asked for the whole matter to reconsidered because she has received new information. Some of the time was spent arguing that she had missed legal deadlines to present new information. Given one side is using full time professional lawyers – and she is having to bring a case while still working elsewhere for Mid Yorks Health Trust – on loan from Epsom and St Helier University Trust. – it is hardly a level legal playing field.
Since the first tribunal hearing in 2017 she has effectively been suspended by the trust on full pay and faced losing her job. There are still two hearings to go.
One has to ask why the Epsom and St Helier University Health Trust is spending so much time and taxpayers money on this protracted dispute rather than using the cash to treat patients. When I earlier raised this with the trust they said they didn’t discuss issues about individuals working for them. They have also refused to give me details of how much taxpayer’s money they are spending on disputes.
This story is not over and I shall return to it when there are more developments.
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.
Campaigners for better patient transport at transportforall assembly in London on October 7 pic credit: Christa Holka
A damning report, Sick of Waiting by the transportforall, the excellent body campaigning for disabled people to have proper access to transport across the capital, reveals what everybody thought but nobody knew: disabled people have a lousy patient transport service in London.
As I report in this week’s Tribune magazine a survey of 200 disabled patients found that 37 per cent had missed an appointment due to failures by patient transport and almost half had arrived late for appointments over the past two years. Nearly all of this, as the report shows, was provided by newly privatised services.
A staggering 90 per cent had never been told that they could be eligible for financial help to get to hospital under the Healthcare Travel Costs Scheme while more than half were never told about patient transport when they booked an appointment.
But the health trust that really took the biscuit was Hillingdon Hospital Trust.Not only did they provide one of the worst personal examples of being ultra unhelpful – but they revealed that they had a questionnaire to weed out those they did not want to provide patient transport.
The personal case involved Robin who had previously been taken to hospital by a brother and Hillingdon expected this to continue. But the brother had moved to Spain. And guess what, Hillingdon expected him to come back and take her ( no doubt quoting cheap flights by easyjet – I made that latter point up!)
But the most extraordinary example was the disclosure through a freedom of information request was a questionnaire used by Hillingdon to assess whether people should get patient transport in the first place.
This included the questions ” Do you go shopping?” and “do you ever (my emphasis) go to the pub/cinema/ bingo? ”
I put this to the press office of Hillingdon and they replied: “The Trust does not discriminate against any of its patients. On occasion – for example where someone is very clearly able-bodied – the hospital’s transport team will ask people how they usually get around.
“This is to see if they are capable of getting to and from hospital without using patient transport as we want to ensure this valuable resource is available for those that really need it. This is in line with guidance from the Department of Health.”
I then sent back their own response to the FOI which listed the questionnaire they gave to ALL patients requiring transport. And the press office admitted they didn’t even know about it when they replied disclaiming the story.
They promised the transport manager would respond. And then they found he had taken leave of absence. So might I if a pesky journo was asking embarrassing questions about a dodgy practice.
Perhaps Hillingdon is overrun with bingo playing, binge drinking, shopaholics all demanding hospital appointments, but I very much doubt it.
Of course not all trusts were as bad as Hillingdon. The report praised Guys and St Thomas’s NHS Foundation Trust for its excellently managed patient transport service and the Royal Marsden came out well.
But far too many didn’t and some of the stories of the way disabled people were treated were callous and heart breaking.
Transportforall is laying down a new patients charter, demanding minimum standards, minimum waiting times and real transparency about the services provided by the private and public sectors. Nor is this confined to London. The report cites problems in Kent, Manchester,Dorset, Devon, Cornwall, Coventry, Somerset, Lincolnshire, Derbyshire, Leeds and Suffolk..
It is time this issue went right up the political agenda. As the report says:” a national solution is needed”.
Andy Burnham: backing an inquiry pic credit:Wikipedia
Andy Burnham, the shadow health secretary, has become the first member of Ed Miliband’s shadow Cabinet to back an over arching inquiry into child sexual abuse.
Over the weekend he was joined by Hilary Benn, the shadow communities secretary and Emily Thornberry, shadow attorney general. With others this brings the number of MPs backing the inquiry to 118. Impetus for the inquiry has been heightened following the latest sickening disclosures about Jimmy Savile’s predatory behaviour from Broadmoor secure hospital to other 27 other NHS trusts.
Andy Burnham made his views very clear when he was challenging Jeremy Hunt, the health secretary, over the publication of the Savile investigations in Parliament yesterday as well as confirming to Tim Loughton, one of the Mps and former children’s minister, that he was supporting his letter to Theresa May, the home secretary, calling for the inquiry. There is a full report by my colleague Alex Varley-Winter on the Exaro website with an up to date list of names.
There next question is whether more of the Shadow Cabinet will back the idea.
The tax avoidance scandal that shook up Whitehall is soon to spread to the NHS. As reported earlier following the exposure of Ed Lester, the former head of the Students Loan Company, for channelling his salary through a personal service company to avoid paying national insurance and tax at source. The practice was still going on in Whitehall two years after the event and 125 civil servants who quit have been reported to Revenue and Customs.
Now the NHS is to face the same scrutiny. Reports in Exaro News and Tribune last week highlighted the issue – with the findings now likely to be sooner rather than later.
An inquiry has been ordered by Jeremy Hunt, the health secretary, after Danny Alexander, Chief Secretary to the Treasury requested it.
Another former chief executive of NHS Professionals, Neil Lloyd, was paid £631,000 off payroll over three years.
This time the Health Department sounds uncompromising. A spokesman said:
“Tax avoidance will not be tolerated, and there is no excuse for it in the NHS, or any other part of the public sector.”
The Trust Development Authority, which provides guidance on governance to NHS trusts, is working with Monitor, which regulates the running of health bodies, to carry out the investigation to ensure that the use of off-payroll contracts is in line with guidance.
targeted is anybody earning over £58,200 a year or has been in post for more than six months and being paid through a personal service company.
In my view it cannot come soon enough. Tax avoidance deprives the Treasury of cash that could be used for better public services. Tax avoidance in the cash strapped NHS is actually depriving hospitals and communities of vital cash. All these people also earn a fair whack. They are not those forced to take a one per cent pay rise and see their living standards go down. On the contrary through tax avoidance they get richer on the backs of others.
Last week top BBC figures cut a pathetic stance in front of the Public Accounts Committtee. But two years ago Jeremy Hunt, the culture secretary, actually PREVENTED the National Audit Office from getting direct access to their accounts. Don’t take my word for it, see the actual correspondence between Sir Micheal Lyons, Chris Patten, Jeremy Hunt, and Amyas Morse, head of the NAO released under Freedom of Information to Exaro News. How dare Maria Miller now say she wants direct access to accounts, it could have been done two years ago
Remember the great fuss from the Conservatives on how they were going to hold the BBC to account, expose those mega salaries paid to Graham Norton and Jeremy Paxman and make sure the taxpayer got the best value for their money from the BBC.
Well if you beleive culture secretary Jeremy Hunt and Lib Dem culture spokesman Don Foster, it will be all happening from next year in the new cash frozen agreement to fund the BBC. He has spent the last year telling us about his success in allowing Parliament’s National Audit Office the right to launch any inquiry it likes into whether the BBC is value for money.
To quote him directly: “It is right that licence-fee payers have confidence that the BBC is spending money wisely, so I am pleased that the NAO now has the right to full access to BBC information. Its new power to decide which…