Published: 17/04/2003, Volume II3, No. 5851 Page 5 6

Dr Peter Homa, chief inspector of the Commission for Healthcare Audit and Inspection, was asked to quit by shadow chair Professor Sir Ian Kennedy because of a clash about how the new body should be created, HSJ has learned.

Publicly, both have insisted 'personal differences'were at the root of the rift, which emerged last week.

But sources in the scrutiny world insisted that differences between the former chair of the Bristol inquiry and Dr Homa centred on Sir Ian's determination to create CHAI 'from scratch', and his fear that Dr Homa wanted to build too much on the CHI model. One well-placed source said: 'Peter had a set of assumptions that problems had already been cracked by CHI.'

He confirmed: 'This is not about personalities but about the best way to create a new organisation'.

Sir Ian was keen to 'wrestle with intellectual issues' about what the organisation will be, while Dr Homa was keen to build on the learning from CHI and quickly make managerial appointments, the source said.

But another source said that Dr Homa's views were tested during the intensive recruitment process, which ended with his appointment on February 13. He added that although Dr Homa had spent the balance of his time putting the infrastructure of the body in place, he had been given little opportunity to demonstrate which model he preferred.

A CHI insider said there was 'a classical design flaw in having a hands-on chair', which was a 'model that is fraught with difficulties', and ran contrary to much management and corporate governance good practice. Another source said that the rift simply came down to 'two blokes trying to run the show'.

Privately, CHI insiders admitted to fury about both Sir Ian's decision to ask Dr Homa to stand down, and the way the situation was handled.

Several CHI commission members accused Sir Ian of behaving as though he was an executive chair, and questioned the accountability arrangements for his role.

Sir Ian told HSJ: 'It was made very clear to everybody at the outset that I was being asked to be a hands-on chair, and that in my view on the question of working out what sort oforganisation it would be, I would be heavily involved'.

Sir Ian is understood to have appointed about 10 commission members to CHAI, though a formal announcement has yet to be made. But CHAI commissioners told HSJ they had not been consulted about his decision to ask the chief inspector to stand down.

CHI chair Dame Deirdre Hine told CHI commissioners and board members about the decision on Dr Homa before Sir Ian's first attendance at a CHI board meeting last Thursday.

One commissioner said: 'All commissioners knew before the board meeting started - there was a feeling of awkwardness.'

During the public part of the meeting, at which Sir Ian and Audit Commission chair James Strachan discussed their vision for inspection, one commissioner tackled Sir Ian on issues apparently relating to Dr Homa.

Dame Deirdre closed down debate, as Dr Homa's situation was due to be discussed in a private session, but those present said there was 'a lot of anger and aggression', with the commissioner following Sir Ian out of the room to continue the row.

On Friday, Dame Deirdre confirmed that Dr Homa was to stand down at the request of Sir Ian, following press reports.

She said she was 'saddened and concerned' about the decision, which was a 'serious set-back' for CHAI.

In a press release, she said Dr Homa was the 'obvious and ideal choice for the role... and will be very difficult to replace'.

A CHI source said commissioners felt angry and there had been some tears over the matter. And one commissioner said a lot of CHI directors would now be looking for jobs elsewhere. Dr Homa remains in post as chief executive of CHI.