Croydon health chief turns whistleblower over 'systematic dishonesty' in NHS

PETER Brambleby was once the borough’s most senior and highly respected doctor – but has blown the whistle on 'systematic dishonesty and bullying' at the heart of the NHS. In an explosive interview, the former director of public health tells reporter Gareth Davies the inside story of NHS Croydon’s financial meltdown and his resignation over the scandal

CROYDON'S former director of public health Peter Brambleby resigned from his role and quit the NHS over concerns about "serious financial irregularity" at the borough's primary care trust (PCT).

He has branded a report which exposed the trust's £23 million deficit, but found no-one responsible, a "whitewash".

And, in an explosive letter to Health Secretary Andrew Lansley, he warned: "I am convinced it will happen again."

You can read the full letter here

A £1 million investigation, published a fortnight ago, found "substandard processes" led NHS Croydon to post a surplus of £5 million in 2010/11, when it had actually overspent by at least £23 million.

But the report has forced Dr Brambleby, a doctor of 31 years, to turn whistleblower.

Speaking exclusively to the Advertiser, he has lifted the lid on the PCT's chaotic finances, detailing how the actions of a former nightclub owner turned interim director of finance led public health programmes to be cut, spending to be understated and GPs paid for work which may never have taken place.

Dr Brambleby, 55, has even taken the unprecedented step of retracting financial estimates made in two annual public health reports, such is his lack of faith in the figures on which they rely.

"The margin of uncertainty," he said in a letter to Croydon Council, "is greater than some entire health programmes."

Dr Brambleby was appointed director of public health, covering both the council and the PCT, in March 2010 after holding the same position in Norwich and Yorkshire.

"I heard Croydon had a reputation for financial probity," he explained. "I thought I was finally going somewhere things were done properly."

He became concerned with the conduct of interim deputy finance director Mark Phillips who, despite not being a qualified accountant, had been given responsibility for the trust's funds while permanent director Stephen O'Brien was on sick leave.

"All the money was channelled through Mark, who kept everything close to his chest," explained Dr Brambleby. "In my second year I was given a budget I hadn't signed off. It was £4 million for my staff, contracts and programmes but I hadn't approved it. I was very uncomfortable about that.

"Then my business manager came to me. She was concerned about payments to a GP working outside Croydon, to whom we were making substantial payments – £40,000 a year - to do psychiatric assessments.

"It was a lot of money so I wanted to check it was legitimate. It was so unusual I asked the counter fraud team to look at it, but everything had to go through the finance department.

"I never got to see a written report. I had to chase and chase to get assurances but all I got back from the finance director was 'there's nothing to worry about'.

"Well that wasn't sufficient for me. That's not proper accountability.

"It led me to believe I could have no confidence that even bigger contracts had been properly scrutinised."

Dr Brambleby described how NHS Croydon's chaotic finances meant a programme aimed at detecting early-warning signs among those at risk of heart disease and stroke had to be stalled for two years, then scaled back because "the money went missing".

"Many Croydon residents will now lose out," he said. "I did manage to salvage some of the programme but not in its original form or scale.

"So when the report says there has been no impact on patients and services haven't been damaged, it's simply not true."

The report - set up by NHS London and conducted by auditors Ernst & Young - was commissioned after an internal audit, and then the Audit Commission, missed the deficit.

It blamed "significant deficiencies" in financial processes for the overspend, which it estimated to be £22.7m, but exonerated anyone in a position of responsibility.

Croydon Council refused to accept these conclusions and is in the process of setting up a joint review with four other local authorities.

NHS London continues to insist the deficit was "not entirely the fault or responsibility of any individuals" and that all the money was spent on providing healthcare in Croydon.

In a letter to the Health Secretary, Dr Brambleby said the trust had "conducted a whitewash" in the hope of sparing Mr Lansley from embarrassment, a cover-up perpetuated by a "bullying culture" in the NHS.

He said: "No one dares admit a mistake, or that they don't know or that the system is not working.

"There has been insufficient acknowledgement of the underlying culture that has allowed this to happen."

In a chilling warning, he added: "I am convinced it will happen again, or has already happened. PCTs and hospitals are engaged in a grim game of 'pass the parcel bomb', hoping their financial deficit explodes in someone else's lap."

NHS London remains unmoved, despite Peter Brambleby’s allegations.

Chairman Mike Spyer wrote to Croydon’s former director of public health to respond to his concerns, but said there is little more to be added to Ernst & Young’s report.

An NHS London spokesman said: "This was a thorough and forensic examination lasting over six months by one of the country’s leading auditors. We are confident in its findings. This independent investigation makes it very clear that mistakes were made, but found that this was not the fault or responsibility of any individuals. Importantly, it found no suggestion of fraud or personal gain by any of the individuals involved."

Dr Brambleby’s claims that NHS Croydon’s financial irregularities led to scaled-back public health programmes were also rejected.

"These accounting errors did not result in less money being spent on patients," the spokesman added.

"The overspend was spent on providing healthcare to people in Croydon. However, overspends are not acceptable and the PCT must now live within its means. This was a failure of oversight and accountability, with poor systems and controls in place which failed to pick up on the errors made."

More:

Peter Brambleby's letter, in full

Peter Brambleby: 'I kick myself for not doing more'

Former NHS Croydon chief executive 'ignored my concerns', says Peter Brambleby

NHS Croydon's finances run by former nightclub owner who was not a qualified accountant