National Advocacy Trust investigated over alleged conflicts of interest

By Natalie Akoorie of

An investigation has been launched by the Health and Disability Commissioner after a volunteer disability advocate lodged a complaint calling for an independent investigation into a national advocacy service over what he claims are unsettling conflicts of interest.

Health and Disability Commissioner (HDC) Morag McDowell said while she had no reason to be concerned with the quality of the advocacy service, she confirmed the HDC was investigating the complaint.

The National Advocacy Trust (NAT) receives almost 25 percent of the HDC's annual $14.3 million in taxpayer funding to advise and support people who complain about health and disability providers, treatment and services.

But Glenn Marshall claimed the trust, which has 34 advocates and receives $3.5m in funding each year, had not declared or addressed a series of alleged conflicts involving some board members and is demanding the HDC commission an immediate external investigation.

The alleged conflicts he wants investigated are:

• why a trust board member is also the director of advocacy at IHC/Idea Services, the country's largest disability services provider, with $315m annually in taxpayer funding and which has been found by the HDC in breach of patient rights a number of times in recent years;
• why several board members have been paid for consultant services they provided to the board, with more than $350,000 in fees paid since 2008 to an accountancy firm where one member is the director and a majority shareholder;
• whether proper procurement processes were followed in obtaining the professional services of those board members;
• and whether the swap to another insurance provider where a board member is a shareholder was put out to tender.

Tania Thomas became a board member of the NAT in 2018 and was made IHC's director of advocacy in August last year.

Marshall said in his complaint Idea Services, a subsidiary of IHC, had been found in breach of the Code of Health and Disability Services Consumers' Rights a "significant" number of times by the HDC in recent years.

One case involved a 23-year-old autistic man who suffered repeated sexual assaults while in the care of Idea Services.

Marshall believed it was untenable for Thomas to remain on the board while director of advocacy at IHC when the national advocacy service was tasked with "providing an independent service to our disabled community, including in regard to complaints made about IHC/Idea Services".

"The conflict of interest is glaringly obvious."

According to the trust's financial records, board member Matthew Doyle is listed under related party transactions last year, with $44,048 to be paid to PKF Doyle and Associates The Accountants Limited for accounting services.

Doyle has been a board member of the trust since mid-2007, and from 2008, financial records on the Charities Commission show PKF Doyle and Associates has been paid $356,524 in accountancy fees.

The fees have climbed from $17,485 in 2008 to $35,991 in 2022. Doyle was also one of two board members who signed off the trust's financial statements prepared by his firm.

Another long-serving board member and former chairman, Randal Southee, who was appointed to the board in June 2007, was paid $15,000 last year for consultancy services, and trust chairwoman Sarah Hutchings was paid $3750 for chief executive recruitment.

Marshall requested an investigation into whether the services had been properly procured, as well as whether a recent switch to a new insurance provider where Doyle is also a shareholder was tendered out, because he said it appeared there was no financial advantage to the trust to change providers.

Last year, the National Advocacy Trust, which operates the Nationwide Health and Disability Advocacy Service, including an 0800 helpline, recorded a $496,000 deficit. The year before that, it had a surplus of $65,500.

NAT took over management of the 0800 helpline from the HDC in July 2020.

In the last financial year, advocacy services received 2971 complaints and resolved 2922 complaints, McDowell said.

"The service achieved a high satisfaction rating of 92 percent of consumers and 96 percent of providers reporting being satisfied, or very satisfied, with its complaints management process."

Trust financial records for last year show the six board members' combined costs went up to almost $85,000 compared to $65,500 in 2021.

The bulk of its $3.58m fund went on wages and salaries of $2.15m, but other operating expenses that had increased from 2021 included conference costs of $43,730 where there were none the year before, legal expenses of $70,000, up from $3547 in 2021, and staffing costs of $107,436, up from $51,028.

Some costs had gone down, including phone and internet by more than $5000 to $67,956 and rent, rates and car parking by $9000 to $355,334.

Marshall's complaint to Health and Disability Commissioner Morag McDowell over the alleged conflicts asked that a "thorough, professional, and independent investigation" be launched.

"As a volunteer disability advocate, I find all of the above information unsettling. HDC and its advocacy arm NAT hold an important role in protecting our vulnerable disabled community."

IHC Group chief executive Ralph Jones said Thoma advocated for people with intellectual disabilities in her role as director of advocacy at IHC, and that she was "well-regarded and sought out throughout the sector".

"Tania acts in accordance with our policies, and we have confidence she discloses and manages any conflicts appropriately in her important work."

McDowell said the purpose of her role was to promote and protect the rights of health and disability services through the Code, and she confirmed the HDC was investigating Marshall's complaint.

"We are unable to comment while we are still considering concerns raised by Marshall. Once we have done this, we would like the opportunity to comment further."

She said the trust board was aware of the complaint.

McDowell said the NAT was an independent charitable trust contracted by the director of advocacy on behalf of the Crown to provide advocacy services.

"Our director of advocacy works closely with the trust to ensure it continues to provide quality services.

"Advocates undertake a number of activities designed to raise awareness of people's rights under the Code. I have no reason to be concerned with the quality of their service.

"They provide support for people who are often vulnerable, to assist them with their concerns about health and disability services."

Doyle and Southee did not respond to questions.

* This story was originally published by the New Zealand Herald.