By Dr Minh Alexander retired consultant psychiatrist 21 March 2023
UHB has failed in its duty as a public body to routinely publish details of any spending over £25K in the last five years.
All public bodies should do so as a matter of government policy.
Prior to this period, UHB’s predecessor body Heart of England NHS Trust published spending transparency data, but there appears to be no trail of UHB doing so.
In the last five years, UHB has resisted FOI requests for this data, and it has only released data when ordered to do so by the Information Commissioner.
Even after determinations by the Information Commissioner which found that the public interest required disclosure, UHB reverted to its old ways and failed to publish subsequent spending data.
UHB previously claimed when resisting FOI requests from the public that publishing the spending data would increase the risk of fraud.
I asked the NHS Counterfraud Authority if it ever advised NHS bodies to permanently suspend publication of spending data as a counterfraud measure. NHSCFA replied that it had not and that it had no remit to issue such guidance.
Under a new Chair, UHB has now released all five years of hidden spending data in response to an FOI request. It has done so late, and only after an indication that a referral would be made to the ICO if there was any further delay.
This is the raw financial data released by UHB:
UHB spending data released 8 March 2023
The material was supplied in an unhelpful form, with entries mixed up in random date order, with some material from outside of the requested period mixed into the data.
In its FOI response letter, UHB claimed that the decision to stop publishing financial transparency data was made collectively at the executive director level.
Surprisingly, UHB claims that this important decision was not recorded.
“We do not hold this information, as the decision referred to above was not formally recorded”
The spending data is now being shared partly to ask for help from all to assess if there is any possible reason why UHB has been so secretive in hiding this financial data from public view.
If anyone thinks they understand why there has been such secrecy, please do send comments to BBC Newsnight or Michele Paduano BBC Midlands Health Correspondent, who are covering UHB.
I have started organising the FOI data into years and under different areas of expenditure.
This is a spreadsheet of the data sorted into each of the five years, with extraneous years removed:
UHB spending data for 2018, 2019, 2020, 2021 and 2022
The data still contains items that were not asked for, in terms of spending amounts under £25K, but if desired, these can be excluded using the “filter” option on Excel.
There was no indication from UHB on whether all transactions under £25K had been included in the released data.
For the purposes of a quick and dirty look at the data, I am including all items of expenditure in the five year period, even in the knowledge that UHB may not have released all items of spending under £25K.
The data seems to be missing some items of expenditure currently under investigation by BBC Newsnight. It may well be incomplete in other respects.
We already know that UHB released inaccurate information about GMC referral outcomes, and has so far failed to correct this despite several approaches to the interim trust Chair Yve Buckland.
We have also seen UHB excoriated by the Employment Tribunal for withholding such a large number of significant documents in the Reuser whistleblowing case that the judge determined that he could not rule out deliberate dishonesty by UHB or similar future failures by trust management.
“Whilst I stopped short of finding any deliberate dishonesty on the part of the respondent, or the key players involved, I could not rule that out”
Please therefore do take the data with a large pinch of salt and bear in mind that UHB is a desperate organisation under intense scrutiny.
With that caveat, these are some broad findings so far.
Total spending and number of transactions
UHB’s disclosure showed at least over two billion in spending over five years, through almost twenty thousand transactions.
All PFI payments were made to Consort Healthcare (Birmingham) Ltd.
Current officers of this company are listed as:
Annually, all the largest items of any spending related to expense area “New Hospital PFI Payments”.
These were the annual total spends under the expense area “New Hospital PFI payments”
Total spending on expense areas labelled “Public relations” and “public relations umbrella”
amounted to £422,654.15 over the five years.
There were a total of 25 transactions
Nineteen of these transactions were with Big Cat Ltd Birmingham based company.
Legal fees and services
Under expense type “legal fees”, UHB has spent at least £3,331,378.19 in the five years covered by the FOI.
This is a spreadsheet giving a breakdown of the companies who received the payments:
UHB spend under expense type “Legal Fees”
Bevan Brittan was the law firm which co-authored an FPPR investigation which reportedly cleared former UHB CEO David Rosser. I say “reportedly” because the report has never been published.
According to this disclosure: UHB spending on Bevan Brittan’s services in the five year period came to a total of £481,190.6 and broke down as follows:
This seems likely to be an underestimate because UHB previously disclosed that it spent £497K in total on Bevan Brittan’s services in just the three years between 1 April 2017 and 31 March 2020.
Litigation continued after March 2020 as Tristan Reuser’s case in the EAT and ET rumbled on, there was an FPPR investigation involving a Bevan Brittan partner and David Rosser’s GMC defence was, according to an observer at a trust meeting, picked up by the trust. These alone would have incurred substantial costs.
University of Birmingham
As a teaching hospital trust, UHB is closely linked to the university.
According to the disclosed spending data, UHB spent a total of £50,286,941.81 on 247 transactions with UHB in the five year period.
A spreadsheet giving details of the transactions can be found here.
Alongside this financial relationship, the University was asked about whether it should now withdraw its award of an honorary professorship from David Rosser in the light of ET, GMC and other findings. It has not so far responded.
Purchase of “Healthcare Non NHS”
Under this category, UHB made a total purchase of £86,081,036.99 in the five years covered by the FOI.
The largest ten payments were as follows:
Cumulatively, UHB paid the most to Diaverum and Fresenius Medical Care.
There were 1396 payments to Diaverum UK ltd and Diaverum Facilities Management, totalling £33,938,705.2
There were 1383 payments to “FRESENIUS MEDICAL CARE RENAL”, totalling £22,743,634.4
A spreadsheet of all transactions listed under “Healthcare NON NHS” can be found here.
UHB Facilities Limited
In 2013 UHB set up a subsidiary company, UHB Facilities Ltd, reportedly for the purposes of VAT advantages.
The company’s current officers/directors include David Burbridge UHB Chief Legal Officer, Mike Sexton Chief Finance Officer, Peter Hirons UHB Facilities Manager,
UHB Facilities Ltd has a Financial Controller, Karen Cutler, and a commercial director Alan Ewan, for whom I cannot identify roles at UHB.
In the five years covered by the FOI, UHB paid UHB Facilities Limited a total of £14,067,213.71.
A spreadsheet with the details of the transactions can be found here.
Assure Dialysis Services Ltd
UHB set up another company in 2013, UHB Satellite Dialysis Limited.
On 11 November 2014, the company’s name was changed to Assure Dialysis Services Ltd.
The company’s branding was non NHS:
The company website stated:
“Assure Dialysis Services is a venture providing dialysis care for the patients of the Queen Elizabeth Hospital Birmingham (QEHB) and we therefore have an extensive partnership with University Hospitals Birmingham NHS Foundation Trust, which manages QEHB.”
Another part of the website stated:
“Smethwick Dialysis Centre (SDC) is a satellite dialysis unit of the Queen Elizabeth Hospital Birmingham. It functions like all other satellite units and a QEHB consultant manages patient care alongside the staff at Smethwick Dialysis Centre.”
The current company officers/ directors are David Burbridge UHB Chief Legal Officer, Dr Mike Hallissey, UHB Medical Director of Education, Robert Watkins Senior Finance Manager UHB.
David Rosser was previously a director of Assure Dialysis Services Ltd between 2014 and 2018.
Dr Clara Day was previously listed as one of the doctors who worked at Assure Dialysis Services Ltd.
Clara Day is now Chief Medical Officer of the ICB which is controlling the reviews of UHB.
In the five years covered by the FOI, UHB reportedly paid the company a total of £4,670,604.76.
A spreadsheet with details of all disclosed transactions can be found here.
UHB set up this company in 2011.
Current company officers/directors include David Burbridge UHB Chief Legal Officer, Yma Choudhury UHB Managing Director Division 1, Mike Sexton UHB Chief Finance Officer and Inderjit Singh UHB Chief Pharmacist.
In the five years covered by the FOI, UHB reportedly paid Pharmacy@QEHB LTD a total of £265,122,325.5.
Details of the transactions can be found in a spreadsheet uploaded here.
Circle Health Group
Cardiology and cardiac surgery services have been controversial at UHB, with critics citing the trust’s scapegoating of cardiac surgeon Ian Wilson, whom they believe was unfairly vilified through the trust’s alleged manipulation of the media and irregular use of data.
Moreover, the BBC revealed in January that UHB has a cardiac surgeon – Neil Howell – who has been paid for five years but has not operated;
UHB seems to have purchased significant services from Circle Health Group relating to its cardiac directorate.
Payments to Circle Health Group in the five years totalled £2,858,365.
See this spreadsheet for more details.
Of the total paid of £2,858,365, £2,800,693 of this was accounted for by expenses areas “cardiac directorate” and “cardiac surgery”, including £1,359,461 expenses described as “management consultancy fees”.
Babylon International Limited
UHB controversially hired Babylon.
“Babylon Disrupted the UK’s Health System. Then It Left”
This is what UHB has disclosed about its spending on Babylon – a total spend of £7,746,874.53:
There are a multitude of other stories and information contained in this financial data. I hope it is of interest to some and helps to shed more light on UHB.
With best wishes.
Transcripts of BBC Newsnight broadcasts about UHB:
PHSO alleges it has been excluded from NHSE/ICB’s reviews on UHB & ICB’s factual inaccuracy to the Joint Health Overview and Scrutiny Committee
What the UHB Freedom To Speak Up Guardian told the BBC
When is a Professor a Professor: Does the routine use of honorifics reduce confidence in public life?
Mr Tristan Reuser’s whistleblowing case: Scandalous employer and regulatory behaviour on FPPR