Tuesday, March 18, 2008

The overzealous auditor - Part 2

While the Thatcher government were battling with the miners of Yorkshire, Nottingham and Kent, another industrial dispute rumbled on for over a year. It was a strike of ancillary workers at Barking Hospital in Essex and was in support of the cleaning staff who had their hours severely reduced as a result of the general introduction of contract cleaning into the NHS. The sad thing about this was that Barking Hospital had a long and successful history of employing contract cleaners before it became required to test the market.

The successful tenderers had previously employed staff on hospital rates of pay and with pension rights similar to those of NHS staff. This had been written into the contract by the health authority. The health authority limited its role to clearly specifying what was required and closely monitoring the contractors own supervisory arrangements. With the clamour to test NHS support services against the market (or "contract out") to reduce costs the successful tenderers at Barking however found they could no longer compete without severely restricting the hours their staff worked.

One saving that was being made by competitors new to the market place was to pay staff on a part time basis only thereby allowing the employer to avoid having to pay National Insurance for their employees. Furthermore the new entrants to the contract cleaning market place did not offer pensions comparable to those in the NHS. The previous contractors did in the end hang on to the Barking Hospital cleaning contract but only by severely restricting the terms and conditions of employment of previous loyal staff. Sadly it appears that when prioritising which staff would have to suffer the most dramatic reductions the opportunity was taken to settle some old scores and not everyone was treated fairly.

For other a year therefore there was a picket line outside of Barking hospital. All deliveries were challenged and in the early days ambulances refused to carry patients across the picket line. I saw a patient with one leg hopping from an ambulance to cross the picket line under his own steam and others on crutches making their way as best they could to out patients. This did not last for long however and in the end ambulances were allowed to cross. The strikers drew the line however at the health authority's own laundry van. Initially the drivers ignored the pickets and continued to collect dirty linen and deliver fresh. But they were under pressure to show their solidarity by refusing to do this any longer. I accepted their predicament and arranged for a rota of senior health service managers to drive the laundry van and do the unloading and loading on a daily basis.

This continued without too much problem for most of the year that the dispute lasted. There was a hiccup however when the laundry staff were asked to stop handling theatre greens from Barking (these are the gowns worn by theatre staff). Although we used disposables as much as we could the Theatre gowns were not then capable of being substituted. I intervened to talk to the laundry staff and shared with them what I understood the true position to be (including the fact that this action alone would stop operations at the hospital). I asked them to reconsider while I waited outside. When I returned to the meeting I was pleased to hear that they had voted to return. When I asked one of the laundry staff (with who I had worked during an induction day I had arranged for myself) how close the vote was she said "it was not close at all - we all voted to return and when Pat ( the shop steward) asked for a show of hands a number of us raised both hands!"

It was against this background that the overzealous auditor decided to launch an investigation. It had been reported to him that a laundry van matching the description of those used by Redbridge HealthAuthority had been seen regularly outside a private nursing home with which Redbridge had no contractual arrangement.

He had calculated the additional mileage that this regular trip would entail and the mileage of the planned route of the hospital van and the additional mileage was broadly equivalent to what would have been travelled to provide an illegal service to a private nursing home. He satisfied himself that his informant was correct about the regular deliveries and collections. He came to me asking that on the basis of this evidence I immediately sack the driver and launch an internal investigation into the laundry staff to see who else was involved in this fraud.

In the circumstances of the industrial action at Barking and the recent reversal of their decision to stop providing theatre gowns to Barking hospital I was concerned what effect these suspicions would have on our ability to continue to treat patients at the other hospitals in the district let alone at Barking.

I suggested to the auditor that as I was due to drive the laundry van that evening to Barking I would check the log myself and the accuracy of the odometer to be satisfied that the discrepancy was real.

Its just as well that I did! No sooner had I sat behind the wheel to note the odometer reading to record the starting mileage than I realised that the odometer recorded distance in kilometers! The form used to log distances was headed up "miles travelled".

Nonetheless I assumed that the overzealous auditor had corrected for this so recorded the start and finish readings, converted them to miles and could confirm that the odometer readings were relatively accurate.

The next day I asked to speak to the auditor and realised he had not corrected for the difference between miles and kilometers. We then quickly calculated that the apparent additional mileage each week was entirely explained by this failure to convert back to miles. This still left the sightings however.

It turned out that the neighbouring health authority (Waltham Forest) had jointly purchased a fleet of laundry vehicles for both authorities the colour scheme of which were the same and the registration numbers were in sequence. What's more the neighbouring health authority did have a contract to provide laundry services for the private nursing home outside of which the auditor had spotted our apparent fraudulent driver!

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