THE NHS has been criticised for failing to hold individuals to account for the cover-up of widespread financial mismanagement at NHS Croydon, a report published today has said.
The Joint Health Overview and Scrutiny Committee has called for the NHS to identify and take action against those responsible for the £28 million misreporting of finances at the primary care trust in 2010/11.
It has called on Health Secretary Jeremy Hunt to compel former chief executive Caroline Taylor, who refused to appear before the committee, to answer questions about why the trust posted a £5 million surplus when it had in fact overspent by £23 million.
The committee disputed the findings of a £1 million independent report set up in the wake of the scandal, which uncovered the financial mismanagement but found no one at fault.
It found "significant motivation" for senior officers – none of whom appeared before the panel – to disguise the extent of the financial incompetence at NHS Croydon to safeguard their own positions.
Committee chairman Jason Cummings said: "What has become clear from the committee's review is that the accounting errors were deliberately hidden.
"This was not the result of any system failure but a consequence of the action of individuals, who have still to explain their actions.
"We have been faced by a wall of silence from key witnesses in the NHS and subsequently there are still some questions that remain unanswered.
"In particular, we still don't know why the accounts were altered and whether patients had been directly affected.
"This cannot be right, and now we call on the Department of Health to carry out rigorous investigation and ensure the relevant officers can be publicly held to account."
The review was conducted by six local authorities in south-west London, led by Croydon Council.
It was joined by Kingston, Merton, Richmond, Sutton and Wandsworth councils, which formed a joint health and overview scrutiny committee in September 2012.
The authorities felt the £1 million report commissioned by NHS London and undertaken by Ernst & Young did not provide proper accountability and that "professionally weak individuals" might remain in the NHS.
The evidence it received, from figures such as Dr Peter Brambleby, former director of public health, led the panel to conclude that Mark Phillips, interim director of finance, did not meet the mandatory professional requirements and was not suited to lead the finance team during director Stephen O'Brien's sustained period of sickness.
The report admits the refusal of Taylor, Phillips and O'Brien to appear before the committee meant it was not able to get a clear picture of the financial mismanagement, and has left crucial questions unanswered.
It called on Mr Hunt to grant future committees extra powers to compel senior NHS officers to cooperate fully in future investigations.
After leaving Croydon, Taylor was given the top job at NHS North Central London. This month she was appointed the Trust Special Administrator for troubled South London Healthcare. The press release mentioned nothing of her time in Croydon.
Two current Croydon councillors, Labour's Toni Letts, former chairman of the trust, and Conservative David Fitze, then chairman of the audit committee, also refused to give evidence.
The panel disagreed with NHS London's insistence that there was no adverse impact on healthcare in Croydon, mainly because practices were so poor it was impossible to track where the money had been spent.
Dr Brambleby told the Advertiser last year that a programme aimed at detecting early-warning signs among those at risk of heart disease and stroke had to be stalled for two years, then scaled back, because "the money went missing".
The report, published at midday today (Monday), noted a "culture of complacency" and "low accountability" at NHS Croydon, fostered by the high number of interim appointments, criticised internal and external auditors for missing the irregularities, and said board members and the scrutiny committee had been "too passive" in identifying and addressing the problems sooner.
Clinical Commissioning Groups, the GP-led organisations which replaced primary care trusts at the start of April, are recommended to review qualifications of all staff who have responsibilities for budgets.
Cllr Cummings said: "We are satisfied that efforts have been made to address concerns raised by Ernst & Young but we are also recommending a number of extra measures to make sure this never happens again.
"The public needs to have confidence in the NHS and be sure that their money is in safe hands." For in-depth analysis and reaction to the report see this week's Advertiser, out Friday.
