Published: 31/01/2002, Volume II2, No. 5790 Page 22 23
It would seem NHS chief executive Nigel Crisp has forgotten that board members were involved in waiting-list deceits ('Managers who fiddled lists to meet targets were paid off in secret deals', news, 20 December), and their conduct would be more than adequately covered by the NHS corporate governance codes, including the code of conduct for NHS boards.
This code underpins executives' and non-executives' ethical behaviour, and covers issues related to probity, accountability and openness.
As an ex-trust chief executive, he should have been well aware of the details, which have been in operation since 1994. He should have known that every board member explicitly signs up to the corporate governance codes.
Failure to uphold them is not compatible with being a trust board member.
He also appears to have conveniently forgotten the accountable officer memorandum for trust chief executives, circulated by his predecessor, Alan Langlands, in 1997. This states: 'The codes of conduct and accountability issued to NHS boards by the secretary of state under cover of EL(94)40 on 28 April 1994 are fundamental in exercising your responsibilities for regularity and probity. As a board member you have explicitly subscribed to these codes; you should promote their observance by all staff.'
The National Audit Office and the Department of Health also appear to have overlooked possible fraud implications, as waiting-list figures, trust performance and remuneration committee decisions are intimately linked.
Is the directorate of counterfraud services too busy chasing poor patients who engage in deceit to obtain free medicines to bother investigating such matters?
Did Mr Crisp or junior health minister Lord Hunt even consider fraud to be possible from the deceitful behaviour in trusts named in the NAO report - and if so where is the evidence?
Perhaps the Commons public accounts committee needs to look again at the NAO report's wider aspects.
Perhaps it should investigate whether taxpayers' money has been used appropriately in pay awards and pay-offs in those trusts. Some trusts' investigations seemed rather superficial, and failed to clearly establish who exactly was aware of the waiting-list manipulations. Motivation behind manipulations may not have been only about saving jobs. If the government is serious about stamping out fraud in the NHS, this is not a matter to which it can turn a blind eye.
Dr Nigel Dudley Consultant in elderly medicine St James's University Hospital Leeds