In extraordinary scenes in the House of Commons today, the Health Secretary was accused of a cover up and conflict of interest while presiding over the biggest scandal of lost patients records ever revealed in the NHS by his Labour Party counterpart in an emergency debate and responded: “transparency is not an absolute virtue.”
Hundreds of thousands of confidential patient records contracted to be looked after by a company half owned by Jeremy Hunt’s Department for Health and half owned by French company Sopra Steria were found dumped in a warehouse, potentially risking the health of thousands of NHS patients.
And today the Health Secretary was accused of leaving patients and parliament in the dark about the scandal.
Shadow Health Secretary Jonathan Ashworth exclusively in yesterday’s The London Economic wrote a piece warning the public about the implications of the government’s new health strategy revealed in leaked documents last week which threatens draconian cuts to treatment provision, leading to more privatisation.
“You may not have heard of this new NHS “Capped Expenditure Process” but you soon could very well be affected by the implications. They mean reductions and rationing of NHS services, waiting times lengthening and a postcode lottery for your healthcare,” wrote the Labour MP.
Today he was granted an emergency question of Jeremy Hunt in parliament after the National Audit Office (NAO) released a damning report from its investigation into how NHS Shared Business Services (NHS SBS) failed so scandalously in their contract for the privatised processing of clinical correspondence. In March 2016 NHS SBS informed NHS England and the Department of Health that it had discovered a backlog of approximately 435,000 items of unprocessed clinical and other correspondence. – Potentially devastating for patients and medics treating them, with the NAO uncovering 1,788 potential cases of harm to patients failed by the privatised service, in a scandal set to cost £6.6million.
NHS Shared Business Services is a limited company set up as a joint venture between the Department of Health (the Department) and a private company, Sopra Steria. The Department has a 49.99% share in NHS SBS. In 2015, NHS SBS had revenues of around £87 million from its services to the NHS.
“Is it not an absolute scandal that 709,000 letters including blood test results, cancer screening appointments, child protection notes were failed to be delivered, left in an unknown warehouse, and many destroyed? Does not the NAO reveal today a shambolic catalogue of failure which took place on the secretary of state’s watch?” Jonathan Ashworth asked Jeremy Hunt, before accusing him of initially failing to disclose the blunder: “He talks of transparency but he came to this house in February because we summoned him to the house. And in February he told us that he first knew of the situation on 24 March 2016. Yet the NAO report makes clear that the Department for Health was informed of the issues on 17 March 2016 and in fact that NHS England set up the Incident Team on 23 March – before he was informed – despite him implying that he set up the incident team.”
In a blistering speech you can watch below, Labour’s Shadow Health Secretary, then asked a piercing question about Jeremy Hunt’s conflict of interest in the company involved in the debacle: “he is a board member of Shared Business Services and many honourable members have warned him about problems and delays with the transfers of records… why did he not insist on stronger oversight of this contract? The cost of this debacle could be at least £6.6m for administration fees alone – that is the equivalent of the average annual salary of 230 nurses. Can the Health Secretary say how these costs are going to be met and does he expect these costs to escalate?”
The Labour shadow minister also revealed that the company at the centre of the blunder was owned 50 / 50 by the Department for Health and Sopra Steria, but mysteriously one share was sold to the French firm making them the majority stakeholder, before the Speaker of the House stopped him from continuing due to constraints on time:
“Does he agree with the NAO that there is a conflict of interest between his role as Secretary if State and his role as a board member and further to that can he explain why his predecessor as Secretary of State sold on 1st January one share from the Department to (Sopra) Steria, leaving the Secretary of State as a minority stake owner in the company and never informed parliament and never reported in the Department for Health annual reports of that share?”
An ashen-faced Jeremy Hunt avoided answering these trickier questions, instead replying: “first of all what happened at SBS was totally unacceptable, incompetent and they should never have allowed that backlog to develop,” and reminded Jonathan Ashworth that “SBS was set up in 2008 at the time when the Labour government was rather keen on contacting to the private sector – I know things have changed.”
And before he was drowned out by laughter, Jeremy Hunt added: “Transparency is nearly always the right thing to do. I am the Secretary of state who introduced transparency over standards of care in hospitals.”
“Transparency is incredibly important but it is not an absolute virtue,” continued Hunt, insisting that “if we had informed the public and the HOUse immediately, GPs surgeries would have been overwhelmed – 709,000 pieces of patient data we are talking about – and they would not have been able to get on as quickly as we needed them to do with identifying risk,” claiming he was advised not to go public with the scandal “because that would compromise the important work GPs do to keep patients safe,” – somehow – adding: “And that is why whilst I completely recognise that with the government arrangements there is a potential conflict of interest I do not accept that there was an actual conflict of interest because patient safety concerns always overrode any interests that we had as a shareholder in SBS.”
The National Audit Office released the following statement on their investigation into the privatised patients record debacle today. We publish it in full as it makes a shocking read:
“The National Audit Office has today published the findings from its investigation into how NHS Shared Business Services (NHS SBS) handled unprocessed clinical correspondence. In March 2016 NHS SBS informed NHS England and the Department of Health (the Department) that it had discovered a backlog of approximately 435,000 items of unprocessed clinical and other correspondence. NHS SBS accepts it had a contractual responsibility to process misdirected clinical and other correspondence.
The key findings of the investigation are as follows:
As at 31 May 2017, the review of the backlog of correspondence has found 1,788 cases of potential harm to patients. NHS England and NHS SBS have identified just under 709,000 items of unprocessed correspondence. One-third of GPs have yet to respond on whether unprocessed items sent to them indicate potential harm for patients. No case of actual harm has been identified yet.
NHS England estimates the cost of the incident will be at least £6.6 million for administration alone, and is still discussing with NHS SBS how these costs will be split.
Between 2008 and 2012 NHS SBS entered into contracts with 26 Primary Care Trusts (PCTs) to provide primary care support services. Only 21 of these contracts explicitly included a service to redirect clinical and other correspondence which had been sent to the wrong GP or other clinical providers. None of the contracts contained Key Performance Indicators to measure how well NHS SBS was delivering the service.
When NHS SBS took over the work of forwarding misdirected clinical correspondence from East Midlands PCTs in 2011, it inherited a backlog of unprocessed clinical correspondence. It found 8,146 items of unprocessed correspondence.
Over the next four years the backlog continued to grow, from 8,146 items in 2011 to 205,000 items in January 2014, 351,000 items in June 2015, and 435,000 items by the time NHS SBS reported the incident to NHS England in March 2016.
Managers at NHS SBS had been aware of the clinical risk to patients since January 2014 but did not develop a plan to deal with the backlog. NHS SBS informed NHS England and the Department about the problem in March 2016. The NHS SBS chief executive reported that staff considered this work to be ‘just filing’, although he stressed that this did not excuse the backlog.
The Department decided in March 2016 not to alert Parliament or the public about the incident initially as it considered it too early to understand the full extent of harm that may have been caused to patients.
NHS England were dissatisfied with NHS SBS’s co-operation in understanding the facts and causes of the incident. NHS England did not consider that NHS SBS’s internal review gave it sufficient assurance that the cause of the backlog had been appropriately investigated and the causes clearly established. NHS England considered that NHS SBS was being obstructive and unhelpful in providing the access NHS England sought. NHS SBS told us it planned a cooperative and collaborative approach with NHS England but that it was restricted by the legal requirements of its contracted internal auditor. It was September 2016, six months after the incident was disclosed to NHS England, before full agreement was reached for NHS England’s internal auditor to access the material required for its review.
NHS SBS’s internal auditor confirmed that it could provide reasonable assurance as a result of the process followed by NHS SBS, that all archived materials had been successfully identified. NHS England’s internal auditor concluded that there was no assurance that all unprocessed correspondence had been identified.”