The NHS trust in charge of Watford General Hospital is facing questions over who was responsible for its botched handling of urgent cancer referrals, which may have cost the lives of two patients.
An independent investigation published this week revealed a number of serious leadership failings at West Hertfordshire Hospitals NHS Trust as patients with suspected cancer were getting lost in the system.
However, the trust has remained tight-lipped on who's is responsible for blunders and will not even say if any staff have faced disciplinary action.
Elected mayor Dorothy Thornhill said: "It's an absolutely legitimate concern. If such a failing happened in the council I would expect people to be held accountable."
Watford MP Richard Harrington criticised past trust management for not identifying the problem sooner.
He said: "It's common sense, if you are doing that job you would chase it up. People have brains, it's not just a system - it was their job.
"I cannot understand why anyone wouldn't have done that and why they didn't naturally follow up on the patients.
"I have written to the chief executive to ask who is still there, who's responsible and could a responsible person have found the error. I also want to know if they are not at the trust, if they are still working in the NHS."
Labour's parliamentary candidate Matt Turmaine said: "It is clear that grave errors have been committed in the management of cancer referrals. It is not acceptable that patients are allowed to drop off a list on the basis of having missed an appointment. Systems and processes should have been in place to ensure that such mistakes don't happen.
"The consequences of this are not just bad admin management, they have directly impacted people's lives. Who was responsible?"
Problems with the way two week urgent cancer referrals were being dealt with were discovered by the trust’s new management team last year.
An investigation found it was breaching national rules as patients who missed their first appointment after being referred were not being offered a second.
The damning report, commissioned by the NHS Trust Development Authority, highlighted a lack of continuity in leadership and ownership to address issues, ineffective relations between the outpatients department and clinical services and confusion and lack between several different managers.
Two managers were suspended in the cancer unit during an internal investigation, one resigned from the trust and the other has been re-instated into a different position.
The trust refuses to say if any disciplinary action has been taken against staff members involved in the failing.
However it confirmed Paul Jenkins, the trust's former director of partnerships, was partially responsibility for two-week-wait cancer referrals for a period - he resigned from the trust and left in April with no exit package.
When asked if any staff had been disciplined, trust chief executive Samantha Jones said: "We followed the appropriate human resources policies and procedures in relation to staff involved in this incident, and for confidentiality reasons we are unable to comment further."
She added: "We welcome the findings from the external review report and will carefully reflect and implement actions. We have recently approved and published a comprehensive cancer improvement plan to build on improvements already underway following our internal review. We will continue this work to deliver against these recommendations to ensure patients see real benefits from improved management of cancer referral pathways.
"I apologise unreservedly to the patients and families affected and wish to assure them that we have already put failsafe mechanisms in place to stop these issues arising again. We have published the report to share the findings with our patients and local community and will continue to work in partnership with local and national health partners to ensure all aspects of the cancer referral pathway can be improved to enhance the patient care experience."