Accidents and emergencies at the health board


By Kenneth Roy

From all the public accounts we have trawled in recent weeks, there is a seasonal award for the most colourful. It goes to a public body so accident-prone that it ought to be consigned to its own A & E department.

We first became aware of NHS Forth Valley two years ago when it produced an unusual excuse for refusing to divulge to the Scottish Review details, deliberately withheld, of the pension benefits of its senior management, in contravention of Treasury guidelines. Other boards took the line that to release such information would breach data protection rights – stuff and nonsense, as it transpired. NHS Forth Valley turned us down on the ground that we could ‘reasonably’ obtain the information elsewhere. When we went to the nominated ‘elsewhere’, the Scottish Public Pensions Agency, we were referred straight back to the health board, which then had to think of a different reason for refusing to answer our questions.

We were not to know at that stage – we have only just discovered – that this experience was not untypical of the strange goings-on at this health board. The annual accounts for 2010-11 disclose a catalogue of events so remarkable that the only mystery is why so little of it has ever seen the light of day.

The year before (2009-10) had not been overly auspicious  – the board’s auditor, Scott Moncrieff, sharply pointing out that NHS Forth Valley had no fewer than 481 equal pay claims outstanding against it and ‘strongly encouraging’ the management to ‘form a view of the potential liabilities’. Such an illuminating detail, possibly symptomatic of a larger problem, failed to cross the radar of the Scottish media, which was distracted by the idea of robots being employed at the new Forth Valley Royal Hospital.

Any criticism of the PFI deal for this project was brushed aside by the board chairman, who famously went on record with the astonishing statement that the people of the Forth Valley did not care how their new hospital was being financed.

Meanwhile, however, NHS Forth Valley was about to enter its annus horribilis. The non-executive directors – including ministerial appointees – learned, not only that the board was required to save £30 million in 12 months, but that there was no obvious way of achieving this target in full: so the organisation was officially in a position of ‘high risk’. It was also failing to meet the official target for staff absence – a target which the board considered ‘challenging’.

Against this disconcerting backcloth, there then occurred a bizarre sequence of unforeseen happenings.

• Falkirk Community Hospital was broken into. PCs, laptops and USB sticks were among the items removed. The office of the information commissioner said it was ‘satisfied’ that the NHS board had taken steps to secure the stolen data. This incident should have prompted a review of security at the board’s hospitals; perhaps it did. Three months later, however, Stirling Royal Infirmary was broken into with the loss of more PCs and laptops.

• Because of a ‘disc and back-up failure’, records of around 15,000 patients were lost. The information commissioner again became involved, receiving an assurance that the board was ‘actively taking steps to prevent a similar incident’.

• A member of the board’s staff uploaded sensitive personal information about 56 patients and 107 employees onto a memory stick. It was then lost or stolen; a teenager found it lying outside a supermarket. The information commissioner’s tolerance was stretched to breaking point. He asked for – and got – a signed undertaking from the board’s chief executive about the use of unencrypted USB sticks.

Enough for one year? Not quite.

NHS Forth Valley was the subject of two inspections by the taxman. HMRC found that one of the board’s non-executive directors – who had been treated as self-employed – had received substantial income from the board since 2005, and ruled that this office-bearer should have been paying PAYE all along. Evidently unimpressed by protestations that his or her tax obligations had been accounted for, HMRC slapped a bill of £51,634 on the health board for tax and national insurance dating back five years, and imposed penalties and interest of £6,985.

Whatever the rights or wrongs of the case, this was a rare indignity to be visited on a public body – so rare that, on Monday afternoon, we asked the board for the name of the non-executive director as well as clarification. At the time of going to press two days later, we have still not received an acknowledgement of our email.

It is the responsibility of non-execs on any public body to act as guardians of the public interest. Were the non-execs on NHS Forth Valley aware of this catalogue of accidents and emergencies? If they were, it would be reassuring to have evidence of a robust response.

Or must the dirty work be left to the robots?


Courtesy of Kenneth Roy – read Kenneth Roy in the Scottish Review