Published: 12/12/2001, Volume II2, No. 5835 Page 8 9

The Department of Health says it would be 'exceedingly difficult' to claw back pay-offs made to managers accused of fiddling waiting lists, or to place sanctions on those who authorised payments.

In its response to the Commons public accounts committee investigation into inappropriate adjustment of waiting lists, the DoH admits poor procedures allowed senior managers accused of fiddling lists to quit with cash payouts totalling£260,000 without having to explain their actions.

But though its lawyers are examining whether pay-offs could be clawed back - or retrospective sanctions taken against those who authorised payments - the DoH said it had so far received advice that pursuing such claims would be 'exceedingly difficult'. It is awaiting a final ruling.

The report by the National Audit Office that sparked the inquiry revealed that two managers from Plymouth Hospitals trust received£146,000 and that Surrey and Sussex Healthcare trust paid a manager£95,000 in compensation. The report named 10 trusts involved in inappropriate adjustments.

In its response to the inquiry, published two weeks ago, the DoH accepts public accounts committee criticisms that identifying and taking disciplinary action against senior figures involved in fiddles 'fell well short of good practice'.

The committee criticised the way in which some of those allegedly responsible were allowed or encouraged to resign during the process, offered pay-offs and employed elsewhere in the NHS.

The committee was particularly scathing of Barts and the London trust. Inappropriate adjustments went on for four years there, NAO said. Chief executive Ray Pett resigned in September 2000, two months before an internal investigation started. At a hearing in January this year, MP Nick Gibb attacked the decision to 'name and blame' junior staff while the involvement of senior managers was seen as 'a matter of corporate responsibility'.

Asked what happened to the chief executive, NHS chief executive Nigel Crisp said Mr Pett 'took the view that as this was happening under his stewardship, it was appropriate that he should go, though he was not directly involved. He has left and is not working in the NHS.'

Just days after his resignation, Mr Pett became a director of Health Care Projects, a company involved in bids to manage over a dozen NHS organisations undergoing or planning to be rebuilt under the private finance initiative, including his former trust.

The DoH said the newly introduced code of conduct for managers would tighten accountability and promised new standards for future disciplinary investigations.