London: The public is being put at risk by dozens of private ambulance firms because they are not being properly inspected by the health regulator, The Mail on Sunday has discovered.
In one case, the owner of a fleet of ambulances in the Midlands was allowed to drive vehicles and work as a paramedic despite having criminal convictions, including ones for kidnapping, assault and downloading child pornography.
The company, International Medical Assistance (IMA), which has contracts with NHS trusts and provides emergency support at public events, was given a licence by the Care Quality Commission (CQC) last November.
Court papers show the CQC granted the registration in full knowledge of Jan David Morales’s 21 child porn offences, for which he was jailed for two-and-a-half years in 2005.
But it took the CQC until April this year to stop him from working with patients or driving ambulances, even though he was on the sex offenders register and considered a potential risk to children and vulnerable adults. And even today the company still has its private ambulance licence. The Mail on Sunday has been told by senior sources in the private ambulance industry that dozens of other companies have never been properly inspected, with Criminal Records Bureau (CRB) checks on potential criminals not being followed up.
Yesterday, the CQC released figures revealing that of the 245 private ambulance companies it has registered, only 54 have been inspected. NHS trusts spend millions of pounds a year on private firms to make up the shortfall in non-emergency patient transport.
Peter Littledyke, acting vice-president of the National Association of Private Ambulance Services, said: “Our members have very little faith in the CQC. There are a considerable number of services that look good on paper but should not be trading, and certainly not registered with the CQC or any other regulatory body.”
The legal papers, from a tribunal hearing this year, show that the reason inspectors failed to discover Morales’s full offending history was that they had relied on his wife, Luz, to provide a CRB check. It was only when Staffordshire Police contacted the CQC that inspectors realised the potential risk to the public posed by 60-year-old Morales.
A full police check showed that in 2006 he was cleared by a jury of raping a disabled woman in the back of one of his ambulances. Morales had denied the charge.
In July this year, Morales challenged the CQC’s decision to stop him working with his ambulance company. A social care tribunal in Birmingham agreed to hear his appeal in private, which meant the case could not be reported.
But in a judgement published in the past few weeks, the tribunal ruled against Morales, describing him as aggressive and a potential risk to the public, particularly children.
A CQC spokesman said: “During an inspection in early February 2012, we identified serious concerns around a number of issues, which resulted in us taking action to prevent Mr Morales from driving a vehicle in the course of providing the service, and from having any direct contact with people using the service.
“CQC is taking action to cancel the registration of IMA, meaning the company would no longer be able to provide services. However, because this process is subject to a legal challenge, we are not able to comment further at this stage.”
Littledyke says he knows of other examples where the CQC has failed to regulate. In one case a private ambulance operator who was a “known suicide risk” was approved by the regulator to run a service.
Another private ambulance owner says he knows of a case in which a patient complained that inspectors had failed to check the qualifications of on-board paramedics who had no more than “Boy Scout first-aid” certificates.
In other cases, lifesaving equipment on the ambulances, including oxygen tanks and defibrillators, was not properly checked, it is alleged.
The CQC’s own inspections have also uncovered serious concerns with some of the services they have already registered. In one example, a patient complained that a member of the ambulance staff failed to obtain her consent before carrying out a procedure involving the recording of an electrocardiogram (ECG) in the back of an ambulance. The woman objected because the ECG was carried out by a young male paramedic and her breasts were exposed.
The CQC said: “We are strengthening internal processes to support inspections of independent ambulance providers by creating regional networks.
“We are at the early stages of a two-year inspection cycle for independent ambulance providers and are on track to complete it. We prioritise inspections, inspecting first the services that are suspected of being less safe.”
An IMA spokesman said it had taken steps to remove Morales’s directorship and stop him from having any operational role in the business.
He said that a new owner would take over Morales’s financial interest and Mrs Morales would remain with the company. Mrs Morales said that she had told the inspectors about all of her husband’s convictions before IMA was registered.