Croydoc directors 'should never hold NHS management position again' says MP
DOCTORS whose failings allowed a disgraced GP to run an out-of-hours GP service like his own personal bank account should never again hold a management position in the NHS.
This is the damning verdict of Croydon North MP Malcolm Wicks following a report which details how Croydoc directors systematically failed to hold Dr Ravi Sondhi to account.
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Croydon North MP Malcolm Wicks believes the directors of Croydoc should never be allowed to hold management positions in the NHS again
The 65-page document hid the identities of the doctors using aliases, such as Dr B and Dr J, and the trust which oversaw the investigation has refused to reveal who they are – apart from one.
NHS South West London (SWL) said Dr Agnelo Fernandes, former Croydoc medical director and now one of the most powerful GPs in London, has no case to answer despite his senior position on the board.
Mr Wicks, who has called on Health Secretary Andrew Lansley to investigate Croydoc, criticised the trust's refusal to disclose the names of the other doctors and added that none of those involved should hold senior positions in the NHS.
He said: "The names should be revealed. It's wrong to instigate a cover up for those who were responsible for a quite outrageous failure of corporate responsibility.
"Furthermore, it seems to me absolutely clear, given the level of failure, that none of these doctors should, for the foreseeable future, hold any position of governance in the NHS."
Dr Fernandes, referred to as Dr C in the report, is now the head of Croydon Healthcare Consortium, made up of 20 GP practices, one of the organisations the Government wants to replace primary care trusts by April 2013.
He is also leading a review of healthcare in south west London, which is considering closing maternity and A&E units, and is managing a recovery plan for NHS Croydon, which has a £35m deficit.
A serious incident report, published last week, said Dr Fernandes was not culpable for what happened at Croydoc, despite his senior position on the board.
The GP, who works at Parchmore Medical Centre, in Thornton Heath, was the doctor who blew the whistle on Dr Sondhi, informing primary care trusts (PCTs) in several boroughs that he had made unauthorised withdrawals totalling more than £100,000.
This was in November 2009, months after Dr Sondhi's fraudulent behaviour had come to the attention of the company's auditors.
This week Dr Fernandes refused a request from the Advertiser for an interview and instead released a statement through SWL's press office.
He said: "As soon as I became aware of what was happening, I acted swiftly.
"My role has been investigated and reviewed and there were never any performance issues concerning me.
"The serious incident report makes is clear that Dr Sondhi hid his wrong-doings from the rest of the board."
While the report does clear Dr Fernandes, he was a prominent member of a board which allowed Dr Sondhi, the chairman, to act with utter impunity.
"Individual board members lacked an understanding of their corporate responsibility for the safety of the service," the report said.
"They delegated overall management responsibility to Dr A without recognising they were responsible for holding him to account.
"A number of the board members appeared to lack the knowledge needed to effectively run a multi-million out-of-hours business.
"They were not fully aware of the governance arrangements needed to run such an enterprise."
Dr Sondhi, who was Dr A in the report, ran the service, which covered Croydon, Sutton and Merton, from his £1.4 million mansion in a leafy village in Norfolk.
He repeatedly failed to answer the telephone on call, often took three hours to respond to urgent reports and cancelled shifts without warning.
Dr Sondhi has since been suspended by the General Medical Council.
Dr Fernandes described his former colleague as a "rogue individual".
"We were all taken in by Dr Sondhi," he said.
"I have learned a great deal from this shocking case."
A spokeswoman for SWL said: "This report was primarily about the failings of Dr Sondhi, whose name was already in the public domain from earlier media coverage."
A health trust has said it will prove difficult to recoup the money misappropriated by Dr Sondhi.
As well as making unauthorised withdrawals of more than £100,000, Dr Sondhi was paid £536,115 by Croydoc, a private company funded by the NHS, between 2006 and 2010.
He devised a system where only one GP would cover out-of-hours calls for a population of 950,000and where the doctor on-call would earn £1,323 for an overnight shift.
In July 2009 alone Dr Sondhi, who was also a GP at Portland Medical Centre in South Norwood, earned £23,500, but there was little evidence to suggest he did a lot of the work he was paid for.
A spokeswoman for NHS South West London admitted the trust had no idea of his whereabouts. It is feared the clinician hasmay have fled the country.
"We are currently exploring any legal option to pursue Dr Sondhi but this is not as simple as it might appear," she explained.
"Legal and police advice have been sought, and the board continue to press for recompense.
"But the money Dr Sondhi took was from a private limited company, not the NHS directly.
"The NHS received a poor service and suffered contract breaches and we have to pursue legal options on that basis."
Croydoc has since been replaced by PatientCare 24.
8 Comments
by bondski
Tuesday, February 07 2012, 7:24AM
“I don't know how we got to all of this when the article outlines the greed of Dr Sondhi and whether a full scale investigation should take place. There must have been plenty of cash sloshing about for this company to misappropriate and deny the patients of Croydon proper treatment under the guise of Croydoc and the out of hours service.
I mentioned the right of patients to choose, this has been their right under the previous government but will be extended under the new bill, whether we agree with it or not, Choice is part of the patients rights - my original comments regarding this right, was dont let GP Consortia in Croydon deny patients their right to choose a secondary provider outside the South West London area - so you can choose a good provider like Kings College and St Thomas's etc. I have been informed by colleagues that this is what is going to happen soon, GPs although unable to make you go to a provider in Croydon will encourage you not to go outside - basically to keep the NHSmoney in Croydon. OK for NHS Croydon but I was speaking on a patient perspective and what is best or preferred for them or should I say us.
It doesnt help when NHs Croydon has been "cheated" out of monies by rogue doctors.”
by bagpus123
Monday, February 06 2012, 6:17PM
“And the condems want doctors to run the nhs, what a joke”
by Chris_Wilcox
Monday, February 06 2012, 5:35PM
“@bondski:
Basically, what the people have to understand is that The NHS is not in infinite resource. It's VERY finite. And if your condition is serious and you are unlucky in your timing you WILL have to travel. It's just how it is.
The money in The NHS is not going up ( when you take into account inflation ). It's going down for working age people to free up cash for OAP's and babies. As we have a boom happening with both at present.
So choose as much as you want if it can't be done it can't be done. You might have to go to St Georges, whether you like it or not.
The old PCT's and GP's understood this and were able to direct you ( the patient ) in the right direction ( relying on this integrated model ). Lansley has now stopped this. God only knows why.”
by Chris_Wilcox
Monday, February 06 2012, 5:09PM
“@bondski: I hear where you are coming from, and in theory it is fair enough. But what if there is not the bed-space? Your chosen may be the chosen of many. And without extra money they simply won't have space for you ( well, not all of you ). And that extra money is, obviously, not there.
Ideally your 'centre of excellence' will be passing on its best practices to surrounding centres. So that any variation of performance inside The NHS is limited/ small. Which means your choice:
a) Might not be possible due to a resource shortage.
b) Might not be necessary, as other centres are almost as good.
This is why teamwork between the centres is so important. The experts call it an 'Integrated NHS'. Something that won't happen under Lansleys' Bill, as the Private Providers contracted in to run parts of The NHS keep their secrets to stay in business/ competitive. They won't share in an integrated way. And also won't be able to sink as much into beds due to a possible Shareholder or Profit burden for example. Basically Lansley is not giving you the truth when he says there'll be more choice in a 'safe NHS'. Those Private Providers cannot perfrom to the same standard for the same money. And that is based on analysis of their business models, as well as their own admissions:
http://tinyurl.com/832pjqp
Another point people need to be careful about.”
by bondski
Monday, February 06 2012, 4:55PM
“Just to answer the "rights" bit - I meant that we can choose to go to centres of excellence, for certain treatments, such as St Thomas's, Kings College, Barts and so on - I was not hinting at private providers. I can understand that NHs Croydon wishes to keep the funding within the London South West Region, of which it is part of - the old London SW Region Strategic Health Authority but some of us want CHOICE as we can choose a NHS provider that is nearer than say St Georges and with a good outcome record for a particular speciality that you require.”
by Chris_Wilcox
Monday, February 06 2012, 2:26PM
“@bondski: Re: the 'Rights' bit.
The old PCT could do that to keep funds going to the right places to keep places like Mayday in business ( keep the Local NHS healthy and well funded ).
Under the New Rules they are not allowed to do that. But... You may not get as good a service, as Private Providers are cost-cutting left, right, and centre, to make sure their Shareholders still get their cut. GP's replaced by less qualified nurses for example. Even though GP's are used in The NHS as they are much more likely to spot a mis-diagnosis.
In summary: If you want less of a safety net keep demanding that choice.
As for Agnelo? He's very focussed on fixing up Mental Health around here, as is his deputy Dev Malhotra. I'm quite happy to welcome that, as are the hundreds of other Service Users around here that are affected ( technically it's thousands, but I only get to speak to so many people ). Hopefully the board-members are much wiser now, and will be able to scrutinise more.
But then they're trained to be GP's. Not Accountants, Tax-experts, & Lawyers. Which is why the loss of the local PCT ( NHS SW London ) is so serious. NHS SW London knows this patch like the back of their hand. I am deeply worried about this loss of talent, and hope whoever replaces The PCT will pick up this team and keep it intact. And also fund it properly ( a big issue ); due to The PCT's being Privatised and how that typically leads to profiteering and less of a service ( as we know from The Trains, The Gas, The Electricity, and The Care Homes ).
Malcolm is right to be vigilant. We're all going to have to be.”
by Krystal333
Monday, February 06 2012, 12:27PM
“Surely this is why a committee is set up for? To safeguard? I wonder if the rest of the committee just used to state their involvement to provide another 'title' ?
Heartily agree with Mr Wicks and bondski - those responsible need to be bought to account and seriously have no right to be a Director anywhere else.”
by bondski
Monday, February 06 2012, 8:15AM
“There needs to be a root and branch investigation into this financial scandal, name names- if these doctors are directors then their names are on the register at Companies House and for £1 any member of the public has access to them so why are they not telling us. How many other GPs have been caught up in this? and why didn't the Directors of this company ask probing questions? Next the NHS in Croydon will be trying to restrict us using our rights to choose where we wish to be treated to save money !”