Health watchdog (Monitor) warning over services
Published: 10 June, 2010
by JOSH LOEB and SIMON WROE
HEALTH watchdog Monitor has warned bosses at the Camden and Islington Foundation Trust to sort out “issues” in their management or face the consequences.
The government body, which regulates healthcare services across the country, expressed its concerns in an open letter to the board in May.
Richard Arthur and Wendy Wallace, the trust’s chairman and chief executive, had met regulators to discuss “key governance issues” earlier that month.
In the letter Russell Harris, a senior manager at Monitor, said he had “received a considerable amount of correspondence from individual governors and members over the past year, raising consistent themes – allegations of a lack of transparency, limited sharing of information, procedural shortcomings and intimidation of individuals.”
Mr Harris added that administration, “constitutional inconsistencies” and “a lack of capability and capacity within the trust to resolve [those] matters” were “key areas of concern”.
If the trust fails to take “all necessary steps” Monitor says it will review its handling of the organisation and its leadership.
As a next step, the regulators could call in external specialists to resolve the problem. They also have statutory powers to replace the board of directors.
Mr Arthur, replying on behalf of the trust, accepted the watchdog’s concerns over management but disputed any lack of transparency between directors and governors.
This is not the first time interaction between board members has been subject to scrutiny.
Dave Lee, the trust’s former communications boss, apologised to the board in June last year after advising “Machiavellian tactics” in an email to directors. He has since left the trust.
Professor David Taylor stood down as chairman in 2008 following an altercation with a governor.
Mr Arthur outlined a series of initiatives taken in light of the issues raised, adding: “I am sure we can do even more to improve engagement between the two boards.”
Speaking to the New Journal last week, Mr Arthur said the trust was facing “a tough financial climate” but was working hard to make efficiency savings without harming patient care – for example, by treating people in the community rather than in acute wards.
People with “less political clout”, such as mental health patients, could suffer under public sector cuts, he warned.
Mr Arthur said: “We’re faced with a new government and a pretty tough financial climate. The figure usually thrown around is £20billion worth of cuts.
“My concern at the moment is there won’t be money saved by reductions in the fiscal hospital estate but there will still be the same number of cuts to be made. So they will be shifted on to people who have less political clout – mental health patients.”
A trust insider said the Monitor intervention was “the first confirmation from the regulator that something is seriously wrong, and that it’s been going on for some time.”