IT HAS not been the most inspiring fortnight for accountability in the local NHS.
First, Health Secretary Jeremy Hunt said he was unable to compel Caroline Taylor, the former head of NHS Croydon, to explain a £28 million misreporting of the trust's finances.
Asked to intervene by a committee investigating the scandal, Mr Hunt took six months to say she answered to Sir David Nicholson, the outgoing chief executive of the NHS.
A few days later, Sir David said he too had "no powers" to force Ms Taylor to give her account of what happened, because she was a former employee of the trust.
Yet Ms Taylor is far from a former employee of the NHS; she went on to two senior jobs in London and is now a director of a health programme covering south-east London.
But if it has been a bad few weeks for accountability, then it's been an equally depressing two years.
Overspent
NHS Croydon posted a £5.5 million surplus in 2010-11, but was later revealed to have overspent by £23 million.
The problems only began to come to light after the trust merged with four others to become NHS South West London (SWL) in February 2011, by which time the key players had left for other positions in the NHS.
An independent investigation by Ernst & Young cost the taxpayer £1 million but blamed "processes". NHS London said "no individual was entirely at fault".
Six local authorities, led by Croydon, set up a joint scrutiny committee of their own but key figures refused to take part. One senior manager did give evidence – then NHS SWL chief Ann Radmore who signed off the accounts – but she was hostile and attended with a lawyer.
When Mr Hunt and Sir David ducked responsibility they ended any hope the committee, now formally dissolved, had of getting the answers they sought.
Cllr Jason Cummings, who led the investigation, said this week: "Have they faced us down? Yes. But they have been allowed to. The people that could have compelled them have all chosen not to."
He stopped short, however, of declaring the committee's efforts a waste of time.
"The principle wasn't to go after and punish someone for what happened in the past," he said. "It was to try and make sure it doesn't happen in the future and, in that, I think we have had notable success.
"While it might not get the headlines, it's the more important side of it. Ultimately what we wanted is for it not to happen again, and the chances of that have been significantly reduced as a result of this process."
Progress
While Mr Hunt refused to compel Ms Taylor to account for her actions, he announced that future committees will have greater powers to compel current employees to give evidence.
Cllr Cummings also has more faith in Croydon Clinical Commissioning Group (CCG) than its predecessor – the primary care trust that it replaced in April.
"Those who refused to co-operate with us were people who no patient would recognise, because they sit behind desks and push paper around," he said.
"GPs are on the front line and see the human side. Someone like Caroline Taylor, on the other hand, can be completely dismissive to the consequences of her actions. All the indications we've had is that the CCG is a more open to being scrutinised and, in some cases, has encouraged it."
The unwillingness to face questions extends beyond NHS employees.
Croydon councillors Toni Letts, a former chairman of the trust, and David Fitze, in charge of the audit committee, also snubbed invitations to appear. Labour leader Tony Newman, then vice-chairman, did not give evidence. All felt they either had nothing to add or that the investigation, prompted by council leader Mike Fisher, was politically motivated.
Misgivings
But Labour councillor Sean Fitzsimons, who sat on the committee, said that regardless of their misgivings, the councillors should have cooperated.
"I don't think anyone should have refused to come to the committee, and that goes for everyone," he said.
"There was a strong feeling the original driver behind this review wasn't about going for Caroline Taylor, or someone like that, but to hang Tony Newman out to dry. Whether that was the case, I don't think people should be scared of scrutiny. They should have attended voluntarily."
Asked whether the committee's nine-month effort had been wasted, Cllr Fitzsimons said: "It may not have succeeded in its original intentions, but it has clarified the limitations of the powers available to us.
"The lesson for me is not to allow people to resign before you get to scrutinise them."
Renewed hope? Last week Richard Ottaway called on Mr Hunt to explain why no one at NHS Croydon had been held to account. Not normally one to criticise his own party, the Croydon South MP was left frustrated by the Health Secretary's inability to act. "I've asked Mr Hunt where the buck stops and I'm looking forward to hearing from him," he told the Advertiser. "If I don't get answers pretty soon then I'm going to raise this on the floor of the House."Key players who did not give evidenceCaroline Taylor: The former chief executive of NHS Croydon was head of the trust at the time. She left in February 2011 and has gone on to hold a number of senior positions in the health service in London. Refused to take part in the scrutiny committee and allegedly threatened to sue upon seeing a draft copy.
Mark Phillips: Interim deputy director of finance – and former nightclub owner – left in charge of NHS Croydon's finances despite not being a fully qualified accountant. Ernst & Young said Mr Phillips made "unwarranted adjustments" to the accounts and reported directly to Ms Taylor.
Stephen O'Brien: The director of finance whose extended periods of sick leave left Mr Phillips effectively in control of the finances.
Toni Letts: Selhurst councillor who was chairman of NHS Croydon at the time, and then vice-chairman when she declined to give evidence to the committee. Told Advertiser: "People will judge me as they will. I'm not prepared to talk about it."
David Fitze: Fairfield councillor was chairman of the audit committee which signed off the inaccurate accounts, after they were given the green light by Deloitte and the Audit Commission.
Cllr Tony Newman: Leader of Croydon Labour Party and former vice-chairman of NHS Croydon. Invited to give evidence to committee, but could not arrange date.
