Is Serco acting in patient's best interests?

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Claims of clinical negligence can arise out of all kinds of treatment, whether they be by the NHS or privately operated contractors.


The result of getting it wrong can be devastating for those involved. Given how NHS reforms are very topical with increasingl concern over threats of privatisation, here I take a look at private contractor Serco and some of the reported incidents which have come to light.

In Cornwall a six year old child died as the result of not getting the right treatment in time to prevent what transpired to be a burst appendix.


Let's have a look into how it was reported and why a local MP has called for the private contact given to Serco to come to an end. Were the parents of this child pointed in the right direction?







Cornwall Liberal Democrat MP has called for an after hours private contract with Serco to be stopped. Worryingly this isn't just down to an isolated incident.


Does this raise doubts over standards of clinical care and the role of private contractors like Serco in providing medical care?


BBC coverage of the unfortunate death of a child in Cornwall.



An inquest recorded a verdict of death by natural causes after a six year old died of a burst appendix. A triage nurse hadn't asked the right questions and doubts have been raised as to the advice given by a private healthcare firm according to the BBC coverage.


Here's how the BBC covered it...


"Man asked to examine son in hospital car park"


28 September 11 16:27


The father of a six-year-old boy who died as a result of a burst appendix was asked to examine him in a Cornish hospital car park, an inquest was told.

Ethan Kerrigan's father Lee had taken him to Penrice Hospital's out-of-hours clinic in June last year after his son had been vomiting for several days.

Mr Kerrigan was then told to phone the out-of-hours medical service and Ethan was not treated. He died the next day.
The coroner recorded a verdict of death by natural causes at the Truro hearing.

The inquest heard that Ethan had been unwell with stomach pains and vomiting for a few days before he died.

In the early hours of 15 June, his father took him to Penrice Hospital in St Austell.

When he arrived he was told to phone out-of-hours service Serco, which he did from the hospital's car park, the inquest heard.


'Lovely, caring boy'


On the phone, a triage nurse asked him to examine Ethan's abdomen.

Mr Kerrigan and Ethan's mother, Theresa Commons, both told the inquest that the nurse had asked them to give him ibuprofen, a hot water bottle and make an appointment to see a GP the next day, saying there was nothing to worry about.

The next day, Ethan collapsed in the doctors' surgery in Roche and died later at the Royal Cornwall Hospital, near Truro, from acute gangrenous appendicitis.

Jackie Whitmarsh, from Serco, told the inquest that an investigation had been carried out.

She said the organisation had found that the triage nurse had failed to ask enough questions.

She told the coroner the nurse had been put under six months' close supervision and the organisation had brought in new guidance on dealing with abdominal pain in children.

Assistant Cornwall coroner Barrie van den Berg recorded a verdict of death by natural causes.

Ethan's parents thanked doctors at the GP surgery and at the Royal Cornwall Hospital for trying to save their son's life.
Mr Kerrigan, from Roche, said Ethan was a "lovely, caring little boy".


"I'm so proud he was my boy."


In a statement, Serco said that the death was "a terrible tragedy".

It said: "Serco is committed to providing the highest quality of service to the NHS and the people of Cornwall and the Isles of Scilly, and like any responsible healthcare provider, we seek continuously to learn lessons and to improve how we work.
"Since then we have worked with the local NHS to develop enhanced protocols for handling illness in young children, and these have now been in place for some time".


www.bbc.co.uk/news/mobile/uk-england-cornwall-15094116

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Earlier call to end Serco contract in 2007 by Liberal MP





This time it was back in 2007 when the same MP called for the doctor contract to stop


Here's the coverage at the time...


"Health bosses are 'encouraged' by Serco's improvements
West Cornwall's MP is renewing his call for the company which runs Cornwall's out of hours GP service, Serco, to have its contract terminated."

Liberal Democrat Andrew George said it followed "another serious incident" over a baby with breathing problems.

He says a foreign national doctor was not sure how to call an ambulance and instead called the police after sending the family home to wait. Serco admitted the incident was a mistake and was being investigated.


Improvement plan


Mr George said he was told the baby had momentarily stopped breathing during the weekend.

The family took the child to see an on-duty Serco GP in his constituency, who then sent them home and called the police.

Mr George claimed the case was another example which "demonstrates why Serco is unfit to continue with the contract" and that its service was "significantly unsafe".

Serco Health Communications Director Dave Rowson said the family was sent home by the GP by mistake.

He said that decisions by GPs were scrutinised by Serco and the PCT and that it had been "recorded as an incident".

He said: "There are national quality standards that we have to attain."

"Those standards take account of safe clinical care

"We are absolutely committed to making a success of the Cornwall contract."

Serco has come in for much criticism since it took over the out-of-hours service in April 2006, replacing the GP co-operative KernowDoc.

However, last week Cornwall's Primary Care Trust said that it was encouraged by Serco's performance after it met most of the targets set out in a 20-day improvement plan.

Serco is an international service company which supports governments, agencies and companies in a number of fields, including defence, education, health, local government, technology, transport and the commercial sectors.

Link

news.bbc.co.uk/1/hi/england/cornwall/6500059.stm

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Here's more about the Liberal MP's concern over the latest incident reported on the 29/9/2011


Cornish MP criticises out-of-hours GP service





St Ives MP Andrew George criticises Cornwall's out-of-hours- GP Service[/b]


"Boy examined in hospital car park"

"MP calls for doctor contract stop"

An out-of-hours GP service in Cornwall has been accused by an MP of putting patients' lives at risk.

St Ives MP Andrew George's criticism follows the inquest on a six-year-old boy who died from blood poisoning.

Serco told the boy's father to take him to a GP the next day.

But Mr George said cost-cutting was keeping people "out of hospital in clinically dangerous circumstances". Serco said its "protocols" for illness in children had been changed.

The inquest heard that Ethan Kerrigan had been unwell with stomach pains and vomiting for a few days before he died.

In the early hours of 15 June, his father, Lee, took him to Penrice Hospital in St Austell.

But when there he was then told to phone the out-of-hours service Serco. On the phone, a triage nurse asked him to examine Ethan's abdomen.

'Terrible tragedy'

Mr Kerrigan was told to give him ibuprofen, a hot water bottle and make an appointment to see their GP the following day.

Ethan collapsed in the doctors' surgery in Roche and died later at the Royal Cornwall Hospital, near Truro, from acute gangrenous appendicitis.

Mr George said: "We've always been concerned about a private company which has to meet key performance indicators, which has to do with how quickly they answer the phone and whether they get a clinician talking to, at least, if not seeing, patients within certain time periods."

Mr George said the system was "always under pressure" from the hospitals to drive down costs and to avoid what they considered to be "unnecessary and avoidable admissions".

"You only know that they are unnecessary and avoidable in retrospect. Until you've got a diagnosis of someone's condition it could be potentially serious", he added.

In a statement, Serco said the death was "a terrible tragedy".

Since Ethan's death it had "worked with the local NHS to develop enhanced protocols for handling illness in young children, and these have now been in place for some time", it said.


www.bbc.co.uk/news/uk-england-cornwall-15107111

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Here's a seemingly well researched article taken from a blog post over Private Funding Initiatives. We can't vouch for its accuracy, but it may raise some salient points & provides some background into Serco.


What is happening?

In November 2006 a GP surgery in Harthill, Lanarkshire was effectively put up for auction by the local health board when a 5-year contract for the running of the practice was tendered. Among the bidders is the private sector company Serco.

Has Serco got a good record of providing GP services?

No. The company runs an out-of-hours GP service in Cornwall. It won the contract in April 2006, undercutting local GPs by reducing staff, clinics and cars. Since then, many people have had problems seeing a doctor in the evenings and at weekends, and Cornish MPs have warned that patients’ lives are being “put at risk”. Serco missed almost all of its targets, including emergencies and urgent home visits. Only 55% of emergencies received a visit within one hour in the peak holiday month of August 2006, and the service regularly failed to hit the 100% target for non-urgent cases that should be attended within 6 hours. It was even forced to fly in doctors from Eastern Europe because of a shortage of local GPs willing to work for the company.

One GP who resigned said that during a busy shift a non-medical supervisor “insisted” they leave a patient who was in a potentially life-threatening situation” to go to the next appointment.

In Wales Serco acquired another GP out-of-hours service by buying out a company called ‘Clinical Solutions UK’. (CSUK) This company was essentially [our moderation - allegedly] a fraud – a Welsh Audit Office inquiry showed that CSUK’s identity, financial
and clinical background were ‘insufficiently checked’. Despite this, when Serco purchased Clinical Solutions in March 2005 it re-employed the company’s chief executive – but not before he had cashed in his 10,000 shares. [Moderation - this is an allegation]

What other business does Serco have in the NHS?

Serco is involved in the controversial PFI (private finance initiative) scheme
for building hospitals. It was part of Octagon, the consortium that developed a PFI hospital in Norwich. Octagon made a £95m wi ndfall when it altered its borrowing terms – money that it refused to share with its public ‘partners’ unless contractual benefits were added. This led to it being called ‘the unacceptable face of capitalism’ by a House of Commons select committee.

So why is this happening?

The UK Government has changed the way GPs are contracted to work in the NHS. There are now a variety of contracts, one of which is the alternative provider of medical services contract, or APMS. This allows private companies like Serco to run GP services – and make a profit. This change is part of a broader push, initially coming from the English Department of Health but recently embraced by the Scottish Executive, to increase the role of the
private sector in the NHS and privatise parts of the service.

What exactly is Serco?

Serco is one of a new breed of company that could be termed a ‘public sector corporation’ as approximately 98% of its turnover and revenue are derived from contracts outsourced by public bodies. These projects include operating speed cameras, electronically tagging offenders and running the Manchester
Metrolink. Serco has governmental links at the highest level. It is involved in controversial PFI schemes, and has PFI, PPP and joint venture contracts with the MoD, Home Office and Department of Transport. It even runs airports in Iraq for the US and has counter-terrorist contracts including detecting radiological substances coming into the UK. Serco’s revenue in 2005 was
£2.26bn, up 38% from the previous year, with profit before tax up 28.5%.

What does Serco want with Harthill?

The NHS has a huge budget that is rapidly being opened up to the market.

Private companies see that the vast sums up for grabs in the lucrative parts of the NHS will quickly offset potential ‘loss leaders’ like Harthill. Serco wants to establish its name within the NHS. But it is also testing the political water. In some areas in England, local resistance has made that water too hot for the
private sector. The same can be true in Lanarkshire.

Find more detail on Serco at www.keepournhspublic.com

29-year-old Andrew Preston, sole owner of Clinical Solutions, admitted to making a significant profit by selling his company and related shares to Serco. Between 19th October 2004 (only 2 weeks into the contract), and March 2005 Cardiff Local Health Board (LHB) awarded CSUK £58,726 to manage what
the company claimed were unprecedented levels of demand. According to the Weslh Audit Office,

“when we examined the figures we found that the supposed extra demand simply wasn’t there”. When Preston cashed in his shares, Serco’s share price was 321p per share. The £32,000 wasn’t used to pay off his company’s £59,000 public debt.
The medical director of the Serco team bidding for the Harthill surgery was until August 2006 clinical director of NHS Lanarkshire's out-of-hours service. The revolving doors syndrome isn’t unknown to the company. David Steeds, a former director at Serco, became CE of the Private Finance Panel, the
government agency initially responsible for the Private Finance Initiative; Serco subsequently won several major MOD and Dept of Transport PFI contracts. According to his latest profile at the PFI
Infrastructure Company, Steeds was responsible for all Serco’s PFI activities. His intimate knowledge of pricing structures would have come in useful for the company’s bid prices. Before joining PFIC Steeds was development director at Qinetiq, the highly controversial privatisation of the MODs’ research division.

Source: tpuc.org/forum/viewtopic.php?p=111425

"by slimline66 » Fri May 07, 2010 11:03 pm"


Link used by blog post writer is within the article post.

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The same article as the above post contains reference to an email related to the BMA

BMA : "Consultant voices fears about ambitious private partnership" (Serco) - 11/11/09 PDF Print E-mail


Written by Emma Ginn
British Medical Association
From this week's BMA News


Mark Porter Consultant voices fears about ambitious private partnership

Article date: 11 November 2009
By Edward Davie


"Concerns been raised about a public-private partnership that has taken over a trust’s pathology services — and plans to expand.

GSTS Pathology is a 50-50 partnership between the Guy’s and St Thomas’s NHS Foundation Trust and private company Serco. It has been running the trust’s pathology services since earlier this year.

Consultants remain as NHS trust employees but are seconded to the new organisation for up to 50 per cent of their clinical sessions.

The organisation, which is the preferred bidder for the trust’s Bedford laboratory, is also in talks with King’s College Hospital NHS Foundation Trust about running its pathology services.

When questioned by 'BMA News', GSTS Pathology managing director Kevin Cox did not deny that the company was aiming to win a 30 per cent share of the pathology services market in England.

Concern about price of complex testing


GSTS’s ambitions were revealed at a CCSC pathology subcommittee meeting by Guy’s and St Thomas’s Local Negotiating Committee chair Anthony Wierzbicki.

London chemical pathologist Dr Wierzbicki, who works for GSTS while on secondment from Guy’s and St Thomas’s, said he believed the price of complex testing would ‘increase significantly’ if and when GSTS took over a ‘critical mass’ of the market.

He also had concerns about the terms and conditions of seconded consultants.

Dr Cox said that while their ‘activities day to day’ were managed by GSTS, seconded staff retained their NHS rights.

CCSC pathology subcommittee chair Anne Thorpe said she was ‘very concerned’ about NHS consultants being seconded to privately-run enterprises.

'Terms and conditions of service must not be downgraded or ignored'

BMA central consultants and specialists committee chair Mark Porter (pictured) said ‘Pathology services are vital to the NHS and to patients. Putting them out to private or shared ownership in this way can be portrayed as change for the better. Too often though the experience of consultant pathologists is that an assertive management sees them as work units rather than integrated members of an NHS team. Terms and conditions of service must not be downgraded or ignored in the pursuit of price efficiency.’

Concerns about NHS marketisation prompted the BMA to launch its Look After Our NHS campaign.

But Guy’s and St Thomas’s associate medical director Jonathan Edgeworth said: ‘The contract expects a 30 per cent efficiency improvement over the next three years and we have already developed new tests and driven down phlebotomy and cervical screening waiting times. I sit on the trust side and hold GSTS to account. Because it is a 50-50 split half of any surplus comes back to the trust.’"

www.medicaljustice.org.uk/content/view/948/69/

A thread on AboveTopSecret: www.abovetopsecret.com/forum/thread530592/pg1

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