Watchdog looking for a clean bill of health

THE DISTRICT Auditor looking over the shoulder of NHS officials is a relatively recent innovation which arrived with the government reforms that introduced the internal market.

It is a system that has long existed in local government and has periodically caused deep political embarrassment when incompetence was laid bare, and even led to prosecutions where wrong-doing has been exposed.

The intention was to recreate the system within the NHS with one team overseeing operations in each region, district and family health service authority.

The Audit Commission, which appoints the teams, maintains that the strategy is beginning to bear fruit with the public interest reports exposing the financial scandals at West Midlands and Wessex health authorities.

The public interest report is one of the most effective weapons in the District Auditor's armoury. It is invariably the result of a special investigation into incompetence, mismanagement or wrong-doing which may have come to light through the auditor's day-to-day activities or a complaint from the public.

In the report, the District Auditor will outline what steps the management must take to right the situation. But it also signals that the auditor believes things are so bad that the public has a right to be told.

If the auditor feels that the problem resulted in financial loss due to 'wilful misconduct', he or she may go to the court to obtain an order that those responsible should repay the money.

But the auditor may decide that difficulties in an authority, while serious and in need of rectification, do not demand the public shaming of officials. In this case a private report will be issued.

Which course District Auditors follow is for their discretion, but one complicating factor may be a continuing police investigation into the circumstances. Then an auditor may feel the problem warrants a public interest report but because of the investigation would issue only a private report.