Labour's scramble to launch £11bn IT spending spree

Labour was accused of rushing through huge contracts before the election to safeguard the party's "nanny state pet projects".

The NHS computer scheme has cost £12.7bn; Home Secretary Alan Johnson with the aborted compulsory National ID card; the MOD computer system is £180m over budget.

Labour was accused yesterday of rushing through £11bn of spending before the general election in a "scorched earth" policy to prevent its pet projects being scrapped by an incoming Conservative government.

Despite the looming squeeze on public spending, ministers are trying to push through several massive computer contracts before ballot day, which is widely expected on 6 May. The "break clauses" in some deals may make them very expensive to cancel, locking in the new government.

Tory frontbenchers believe that, if they win power, they would discover "poison pills", making it harder for them to announce the immediate spending cuts they have promised. As well as contracts that are difficult to scrap, the Conservatives fear that Whitehall budgets have been drawn up to protect flagship Labour projects such as housing and children's services, so that any attempt to find small-scale savings would inflict maximum political damage.

Labour insists it has every right to carry on governing and argues that the new information technology (IT) contracts will provide value for money. Cabinet Office rules say that decisions on matters of policy and "other issues such as large and/or contentious procurement contracts, on which a new government might be expected to want the opportunity to take a different view from the present government, should be postponed until after the election, provided that such postponement would not be detrimental to the national interest or wasteful of public money". 

However, the guidelines do not kick in until the election is called – which Gordon Brown is not expected to do for three weeks. Although the Tories would call an immediate halt to all IT contracts if they won power, The Independent understands that last-ditch actions planned by the labour Government this month include:

*approving local supplier contracts for the controversial £12.7bn NHS electronic patient records scheme, the largest computer project in the UK, which the Tories would dismantle;
*signing a £1bn logistics software contract for the Ministry of Defence;
*speeding up a £600m contract to run new personal pension accounts due to start in 2012;
*completing an £800m agreement for communications equipment and services at the Serious Organised Crime Agency;
*starting to print the 30 million forms for the 2011 census, even though the Tories have said they would scale back the £482m project.

Labour denies acting irresponsibly and says an incoming government would be able to cancel the personal pensions contract at a cost of only £25m this autumn. But one minister admitted privately: "We are pushing hard on what we can get through by the end of March and asking civil servants to prioritise that, rather than medium- and long-term projects which could not be completed by the election."

However, some senior civil servants are frustrated that Labour and Tory frontbenchers will engage in frank talks with them about the spending cuts that will inevitably be needed to close this year's £178bn gap in the public finances. They say politicians fear their intentions would leak before the election.

Francis Maude, the shadow Cabinet Office Minister who heads an implementation unit planning the early work of a Tory government, said: "Labour's actions resemble a dying administration making reckless and irresponsible spending commitments to wreck the finances for any incoming government."

He added: "Once again we see Gordon Brown putting the Labour Party ahead of the country. Labour is unable to ditch its obsession with partisan dividing lines. The choice at the election will be clear: a responsible united government under David Cameron or a reckless irresponsible government under Gordon Brown who are only going to make things worse."

About £4bn is believed to have been spent already on the long-delayed NHS scheme for patient records to be available to any GP or hospital in England. The Tories want a local rather than a centralised scheme but fear the contracts would cost billions to unravel.

Labour insists the NHS contracts are being revised to save taxpayers £600m. The Health Minister, Mike O'Brien, said: "What we want to do is make sure we get these savings. I am certainly not going to get into a situation where because we are approaching a general election some day soon, the whole of government stops and we cannot make any contracts with suppliers of key NHS equipment. That would be complete nonsense."

But Stephen O'Brien, the shadow Health Minister, said: "At best it is a last-ditch attempt to tackle a deficit of Labour's own making. At worst it is an underhand effort to tie the hands of the next government."

From:

http://www.independent.co.uk/news/uk/politics/labours-scramble-to-launch-16311bn-spree-1917781.html

Government to clamp down on health tourists

A new clampdown on health tourism by foreigners who visit Britain for NHS treatment was announced by ministers.

Compulsory health insurance for visitors, refusal of treatment to failed asylum seekers who do not co-operate with the authorities, and a ban on entry for foreigners who have outstanding debts for previous NHS treatment are among measures proposed.

The Department of Health said the measures could save between £6m and £20m over five years. Emergency treatment and treatment for infectious diseases would remain free for all. 

The measures were condemned by human rights organisations but received a qualified welcome from the British Medical Association, which has previously refused to countenance the denial of treatment to patients in need.

A spokesman said: "The BMA appreciates that the NHS does not have infinite resources and that there is a need to restrict services to patients who are eligible to receive them."

"However, we will seek assurances from the Department of Health that, where there is genuine clinical need, doctors will have the discretion to provide treatment, irrespective of an individual's immigration status."

From:

http://www.independent.co.uk/government-to-clamp-down-on-health-tourists

NHS’s major trauma services - not good enough

England has an unacceptably poor service for dealing with major trauma, in spite of 20 years of reports identifying the problem, and a real terms doubling of NHS spending in the past decade, the National Audit Office found.

Some 450 to 600 lives a year could be saved, and much long-term disability prevented, if the NHS had an effective network of centres to deal with multiple injuries from road crashes, burns, blasts, serious falls and major crush injuries, the NAO said.

Death rates from major trauma are 20 per cent higher in the UK than in the US, which has well organised trauma centres, and almost certainly higher than in Germany and some other European countries, according to spending watchdog’s research.

Victims of major trauma need specialist surgical teams that may include orthopaedic, cardiac and neuro-surgeons, but such consultants are not normally on duty at night and weekends when most major trauma occurs. 

Few hospitals have sufficient CT scanning available round the clock to help with diagnosis, and what data there is shows that barely a third of patients who need moving to a more specialist centre in fact get transferred.

Not enough of the patients who need a critical care bed get one, and access to rehabilitation services which can improve quality of life and reduce hospital stays varies widely, the NAO said.

Major trauma services are simply “not good enough”, Amyas Morse, head of the NAO, said. They “have not significantly improved in the last 20 years, despite numerous reports identifying poor practice”.

The result is unnecessary deaths and disability and poor value for money, and while the health department has just appointed a national director for trauma it and the NHS “must get a grip,” Mr Morse said. Co-ordinated trauma networks need developing, with much better information on costs and outcomes. 

The performance of 40 per cent of hospitals cannot even be measured because they do not submit data to the voluntary network which does audit trauma care.

The NAO’s warning came as the department told primary care trusts they must do a better job of monitoring the quality of care delivered by out-of-hours GP services following the death of David Gray, a patient given a fatal overdose by Dr Daniel Ubani, a German flown over as a weekend locum by Take Care Now, Cambridgeshire’s private contractor for out-of-hours care.
 

From:

http://www.ft.com/cms/s/0/581d0e9a-11a4-11df-bceb-00144feab49a.html

Labour's computer blunders cost £26bn- and rising

Labour ministers blamed for 'stupendous incompetence' after taxpayers are left with huge bills for bungled IT projects.

A series of botched IT projects has left taxpayers with a bill of more than £26bn for computer systems that have suffered severe delays, run millions of pounds over budget or have been cancelled altogether.

An investigation by The Independent has found that the total cost of Labour's 10 most notorious IT failures is equivalent to more than half of the budget for Britain's schools last year. Parliament's spending watchdog has described the projects as "fundamentally flawed" and blamed ministers for "stupendous incompetence" in managing them.

Further evidence has emerged over the failings of Labour's most costly programme, the mammoth £12.7bn IT scheme to revolutionise the NHS. 

Following Health Direct's post last week- Labours' only success- wasting taxpayers money, the Independent has repeated that just 160 health organisations out of about 9,000 are using electronic patient records delivered under the scheme. 

The vast majority of those were GP practices. New figures have also revealed that millions of pounds have been paid out in legal fees. The taxpayer has footed a £39.2m bill for "legal and commercial support" for the National Programme for IT (NPfIT).

Alan Milburn, the former health secretary, said in 2001 that everyone would have access to their health records online by 2005, but it is understood that the Department for Health is still "years away" from fulfilling the pledge.

Government departments right across Whitehall have been guilty of overseeing embarrassing IT failures. A project that was meant to save the Department for Transport (DfT) about £57m eventually cost £81m, and workers at the Driver and Vehicle Licensing Agency (DVLA) were forced to brush up on their language skills when computer systems gave them messages in German.

Another ill-fated IT scheme, designed to allocate subsidies to farms, cost the Department for Environment, Food and Rural Affairs about £350m and left British farmers more than £1bn out of pocket. Last year the Public Accounts Committee (PAC) warned that the system was already "at risk of becoming obsolete". 

In 2004, the Department for Justice gave the go-ahead for the National Offender Management Information System (C-Nomis) to be rolled out to prisons and the probation service in an attempt to make sharing information about offenders easier. But in 2007, when the estimated cost doubled to more than £600m and senior officials questioned the validity of the project, it was abandoned – after £155m had been wasted.

The MoD's Defence Information Infrastructure project is currently running more than £180m over budget and 18 months late, and is now set to cost £7.1bn. Last year, Edward Leigh, chairman of the PAC, said: "No proper pilot for this highly complex programme was carried out, and entirely inadequate research led to a major miscalculation of the condition of the Department's buildings in which the new system would be installed."

Other botched IT projects include the identity cards scheme; the Libra system for modernising magistrates' courts; an attempt to move the Government's GCHQ computer systems into a new building which ended up costing more than £300m; the Benefit Processing Replacement Programme; and the Foreign and Commonwealth Office's Prism system.

IT experts blamed ministers for being too easily wooed by suppliers. Insiders said a lack of expertise within the Government about the technology industry meant they were willing to believe claims made by major IT firms before contracts were awarded.

Several projects are now under renewed threat of being cut back or abandoned altogether as Alistair Darling, the Chancellor, has targeted them as an area of government spending that can be reined in as he attempts to tackle Britain's record £175bn deficit.

Tony Collins, an expert on the Government's IT failures, said Labour had displayed an "irrational exuberance" for IT projects that has often led them to throw good money after bad at failing schemes. "There are too few people in the hierarchy of Labour who understand IT enough to understand that it is not a talisman – there is nothing magical about it."

David Cameron, the Tory leader, has signalled a move away from big IT projects, suggesting he will use technology to increase the transparency of government. "It is easy to make these noises out of office," said Mr Collins. "Once you've got civil servants giving you a host of reasons why you should not be more open, I fear the Tories will sink into the same depths of secrecy that Labour has found itself in."

Botched projects: The cost of failure
£12.7bn National Programme for IT (NHS)

It was meant to revolutionise the way the health service worked. But far from heralding a new age of efficiency, the National Programme for IT is now widely perceived as the greatest government IT white elephant of history. 

As well as the huge costs involved, suppliers have walked away, projects are running years behind schedule, while medical professionals have complained that they were never consulted on what they wanted the new system to achieve.

£7.1bn Defence Information Infrastructure (DII)
It seemed like a good idea at the time. In 2005, the Ministry of Defence decided to offer a contract to a consortium of suppliers to replace the hundreds of different computer systems being used by the military with a single system that would be used by the army, navy and air force, as well as the MoD itself. It was to be used by 300,000 people across 2,000 sites. 

However, it is running more than £180m over budget and 18 months late. A parliamentary inquiry also warned that forces' reliance on older systems put them at risk of a security breach.

£5bn National Identity Scheme
Originally budgeted at £3bn, the labour Government’s plan for new identity cards, containing biometric data and linked to a central database, soon came under heavy criticism from civil liberty campaigners. As the costs spiralled, so the Home Office began to water down the aims of the scheme to assuage the critics.

In July 2009, Alan Johnson announced that the cards would no longer be compulsory, while moves to force all airport workers to use the cards were also abandoned. However thousands are still being wasted trying to get students to sign up as an alcohol proof card.

£400m Libra system (for magistrates' courts)
An attempt to bring records used by magistrates courts into the digital age backfired when trying to introduce one universal IT system to all courts descended into a costly mess. Fujitsu originally bid £146m to deliver the Libra system in 1998. However, the project proved more complicated than anticipated, and costs have now been put at more than £400m.

£350m Single Payment Scheme system (SPS)
The Single Payment Scheme system was designed in 2003 to be a sophisticated way of giving farmers their subsidies, by mapping their land and working out their level of payment. But failures with the IT systems being used mean that farmers were left short-changed. 

In 2006, around £1.28bn of the £1.5bn subsidies destined for British farmers still had not been given out. 

The Rural Payments Agency overseeing the project was ordered to make 23 major changes to the system. Despite the £350m spent on the technology, the Public Accounts Committee warned last year that it was already “at risk of becoming obsolete”.

£300m GCHQ "box move" of technology
When the Government’s intelligence organisation, GCHQ, decided to move its complex computer systems into a new building in 1997, the projected £41m cost was so small that officials believed it could be absorbed within existing budgets. 

That was until the Curse of the Government IT Project struck. Costs of the so-called “box move” soon began to rise out of control. In 2003, the National Audit Office (NAO) put the costs at more than £300m. Edward Leigh, Tory chairman of the Commons Public Accounts Committee, called the original budget “staggeringly inaccurate”.

Now part of the "old office" housing super computers in Cheltenham has been retained in parallel to the new "doughnut".

£155m National Offender Management Information System (C-Nomis)
In an attempt to make sharing information about offenders easier, the Department for Justice gave the go-ahead for the National Offender Management Information System (C-Nomis) to be rolled out to prisons and the probation service. As the estimated cost doubled to more than £600m and senior officials questioned the whole point of the project, it was abandoned in 2007, with £155m already spent.

£106m Benefit Processing Replacement Programme
In June 2006, the Department for Work and Pensions confidently assured Parliament that new funding for its Benefit Processing Replacement Programme (BPRP) had been approved. So it came as a surprise to many when it emerged just three months later that the project had been quietly scrapped. Little information has emerged on why BPRP was abandoned, but the Government has admitted that £106m had already been spent on it before it pulled the plug.

£88.5m Prism IT project
Undeterred by past failures, the Foreign and Commonwealth Office (FCO) thought it would be a good idea in 2002 to order a new computer system for their 200 offices around the globe. The result was the Prism IT project, seemingly a bargain at just £54m. 

However, delays and costs have risen, while the contractor was even forced to temporarily halt the scheme in 2005 while an investigation took place into its various problems. The system has not proved a hit with staff. 

One wrote in 2004: “In all the FCO’s long history of ineptly implemented IT initiatives, Prism is the most badly designed, ill-considered one of the lot.”

£81m Shared Services Centre
To officials at the Department for Transport, the Shared Services Centre seemed to good to be true: not only would it integrate the human resources and financial services of the department and its various agencies, it would even save the taxpayer £57m. 

Unfortunately, those hopes were dashed as the scheme became another example of an IT project going horribly wrong. Workers at the Driver and Vehicle Licensing Agency (DVLA) were forced to brush up on their language skills as computer systems gave them messages in German. It will now cost £81m, a failure in management that the Public Accounts Committee described as a display of “stupendous incompetence”.

TOTAL: £26.3bn

From:

http://www.independent.co.uk/news/uk/politics/labours-computer-blunders-cost-16326bn-1871967.html

Swine flu- move to recover cost of vaccine

The government is attempting to claw back tens of millions of pounds from flu vaccine manufacturers as it seeks to scale down an immunisation plan to protect the country from a severe pandemic.

Officials have cancelled further orders from Baxter, and are finalising a deal to limit purchases from GlaxoSmithKline, in an effort to recoup part of a £500m deal with the two companies for sufficient vaccine to cover the entire population.

Ministers have decided to abandon the aim of a universal flu vaccination programme, although they are pursuing the drive to vaccinate children under five as well as pregnant women, people with underlying health problems and health and social care workers.

The mild nature of the swine flu virus, the need for only a single rather than a double dose of vaccine and public suspicion and indifference to vaccination have led to lower take-up than anticipated in the UK and other countries.

The government's decision - in the context of severe pressure on public spending - comes at a time of similar moves by other countries including France, Germany, the Netherlands and Spain.

Sir David Salisbury, director of immunisation at the Department of Health, said a break clause had now been activated in the contract agreed with Baxter of the US, while discussions were under way with GSK, from which most of the vaccine had been purchased.

Similar formal break clauses were not included in many countries' contracts with vaccine suppliers, because they were drawn up at a time when governments and manufacturers expected demand would substantially outstrip supply.

However, GSK, like other large suppliers, including Sanofi-Aventis of France, is coming under political pressure to accept a scaling back of previously agreed volumes of orders.

GSK stands to lose tens of millions of pounds alone from the UK renegotiations and smaller amounts from other large purchasers such as France.

The drugmaker had previously estimated total sales of its pandemic flu vaccine across more than 70 countries at £2bn over 2009 and 2010.

It may be able to recover some losses from sales to other countries including in Latin America. Sanofi-Aventis, the world's largest supplier of flu vaccine, stands to lose significant sales, with smaller losses from Novartis, while other suppliers such as Baxter, CSL and MedImmune - part of AstraZeneca - had lower initial sales and much lower exposure.

The UK and other countries are in talks about making donations of surplus vaccine stocks available to poorer countries and selling excess stocks to richer ones - although there are concerns about the issue of liability in such cases.

Sir David said the UK would keep some surplus stocks, both to prepare for any possible third wave of the pandemic and for a future different infection.

The vaccine contains an antigen to protect the body against the current H1N1 virus which would not be useful against future mutations.

But it has an adjuvant stored separately until just before vaccination, which enhances the body's immune response and could be stored over longer periods to help fight a future pandemic.

The latest figures from England show that fewer than 3.8m people have been vaccinated against pandemic flu since last autumn, although 12.5m doses of vaccine have been sent out for health services ready to be used.

From:
http://www.ft.com/cms/s/0/182021e8-fe52-11de-9340-00144feab49a.html?nclick_check=1

NHS paid doctor £375 an hour

NHS spending on agency workers has risen sharply in the past financial year in spite of attempts to control such expenditure, according to figures issued by the Conservatives.

Andrew Lansley, shadow health secretary, cited examples of NHS Trusts paying "hugely inflated" salaries to temporary workers for covering shifts.

A nurse in Yeovil was paid £146 an hour, another in Derby £136 an hour, and an IT manager in Whittington received £400 an hour.

The freedom of information disclosures also show that an agency doctor in King's Lynn was paid £375 an hour - equivalent to an annual salary of £660,000. Mr Lansley said that such payments divert funds from the front line and prove that Labour's attempts to control health agency expenditure are failing.

The NHS spent £1.25bn on temps in 2008-09, according to figures provided by the department of health to the Tories. This was a sharp increase on the £831m spent the previous year and the £785m in 2006-07.

But it is below the £1.4bn bill that agencies presented to the NHS in both 2002-03 and 2003-04, when agencies accounted for 5.5 per cent of the payroll.

Patricia Hewitt, former health secretary, described agency pay as "massively expensive" and called for hospitals to use permanent staff instead.

About 130,000 workers in the health service are not permanent staff.

While most trusts did not disclose fees paid to agencies, some of them received as much as 43 per cent of each payment, according to the Tories. The typical agency fee, among the 33 trusts that replied in detail, was 26 per cent.

Trusts and local authorities have been urged to pool resources to improve their purchasing power.

A report last year by Leeds university and the Economic and Social Research Council found that, although fees had dropped in recent years, temps were still generally more expensive than permanent staff.

The presence of temps, while "unavoidable", could also damage the morale of permanent staff because they were often given easier tasks.

But the National Audit Office said last year that agency workers could be used as a way for the NHS to control costs. Temps could be cheaper because they did not receive the same training and perks as permanent staff.

From:

http://www.ft.com/cms/s/0/ed1bd7c2-f4e1-11de-9cba-00144feab49a.html

Government departments waste £4m on website redesigns

Labour government departments have spent £4 million of public money revamping their existing websites over the past two and a half years.

Much of the money has gone to external consultants and contractors.

In total, £3.96 million has been spent on redesigns and upgrades since June 2007. The figure does not include the estimated £220 million annual cost of running the government sites.

David Davies, Conservative MP for Monmouth who asked for the information in a string of parliamentary questions, said: "Dfid ministers should be giving financial support to the poorest people in the world not the wealthiest web designers.

"The money spent on a web upgrade could have paid the wages of 100 nurses in one of the poorest African nations for a year, but for Labour ministers, internet propaganda is far more important.

The Central Office of Information (COI) is conducting a study, to be published in June, into whether government websites offer value for money. The investigation was prompted by a National Audit Office report that said over one quarter of government organisations did not even know the running cost of their own websites, making it impossible to assess whether they provide value for money.

The NAO also found that one in six government bodies had no data about how their websites were being used.

Matthew Elliot, the campaign director for The TaxPayers' Alliance, said: "This astonishing £4 million figure shows departments must concentrate on content rather than the appearance of government websites. Many of these sites look a lot better than they actually are."

What departments said they spent on redesigns since June 2007:

Department for International Development £970,419
Department for Business, Enterprise and Regulatory Reform £528,912
Department of Health £513,000
Intellectual Property Office £355,000
Electoral Commission £283,744
Department for Environment, Food and Rural Affairs £181,000
Ministry of Defence £150,000
Electoral Commission voter information site £140,600
Serious Fraud Office £113,309
Office of Rail Regulation £107,169
Department for Innovation, Universities and Skills £105,167
British Army £75,000
Crown Prosecution Service £60,085
Attorney General's Office £59,184
Revenue and Customs Prosecution Office £58,741
Office of Government Commerce £54,000
Bona Vacantia £42,598
UKTI Defence and Security Organisation £42,000
National School of Government £27,683
National Measurement Office £20,649
Government Actuary Department £19,461
Scotland Office £12,880
Disposal Services Authority £12,000
Wales Office £10,500
NI Organised Crime Office £6,825
Forensic Science NI £6,187
NI Youth Justice Agency £4,802
Treasury Pre-Budget £4,578
TOTAL £3,965,493

From:

http://www.telegraph.co.uk/Government-departments-spend-4m-on-website-redesigns

Rich list reveals 80 NHS chiefs paid more than Gordon Brown

At least 350 NHS executives in hospitals and primary care trusts were paid more than £150,000 last year, according to new research.

A “Public Sector Rich List”, compiled by the TaxPayers’ Alliance and covering 350 public bodies, shows that 806 executives collected more than £150,000, with eight on packages worth more than £1 million.

The list, which covers Whitehall departments, quangos and nationalised industries, shows that average pay among those identified was £225,000, with 120 chiefs on more than £250,000. More than 250 quango heads were on more than £150,000 in 2008-09. Nearly 80 NHS executives earned more than the Prime Minister.

At a time when all three main parties are proposing a squeeze on public sector pay, salaries at the top have been shooting up, the figures show. While some private companies froze or cut pay, that of the 800 public sector chiefs identified rose by 5.4 per cent, the TaxPayers’ Alliance says.

George Osborne, the Shadow Chancellor, has already pledged to publish the salaries of all public sector staff earning more than £150,000 if the Tories win power. He has also said that anyone earning more than the Prime Minister’s salary of £194,000 would need his approval.

Many of the highest earners in the list include present and former employees of recently nationalised banks. Mark Fisher, former executive director of Royal Bank of Scotland, tops the list with a package of £1.39 million. Sir Fred Goodwin, the bank’s former chief executive, was on £1.3 million.

Vince Cable, the Liberal Democrat Treasury spokesman, said: “With 806 public sector employees taking home more than £180 million a year between them, it is clear that even in these difficult times, profligacy at the top of the public sector lives on.”

The NHS figures show substantial rises for some staff as trusts compete for the best managers. Nearly 60 NHS chiefs earn more than the Prime Minister, with one said to be earning nearly twice as much. A further 290 earn more than £150,000.

Professor Salman Rawaf, who recently retired as director of public health at Wandsworth Primary Care Trust in West London, earned £370,000 last year, comprising a salary of £150,000 and £175,000 of other remuneration.

Sian Thomas, director of NHS Employers, said that many of the individuals’ pay combined salary and clinical excellence awards, all set nationally. “Pay of senior managers in NHS organisations is set by their remuneration committees and boards,” she said. “Therefore these arrangements will vary. Across the public sector the practice of linking remuneration to performance varies.”

Philip Hammond, Shadow Chief Secretary to the Treasury, said: “Nobody objects to paying public sector executives properly if they are delivering excellent results for the taxpayer. But over the last decade, public sector pay has risen while performance has languished. Under a Conservative government, only those who deliver value for the taxpayer can expect high salaries.”

From:

http://www.timesonline.co.uk/tol/news/uk/article6943540.ece

Health department spent £585m on consultants

The Department of Health has spent £585m – the cost of building a district general hospital – on management, legal and financial consultants over the past four years.

The half-a-billion pound bill “is a huge amount of money”, Kevin Barron, chairman of the Commons health select committee, said. The committee has been pressing the department to disclose the sum and Mr Barron said now that it was public “we will be returning to the issue”.

Spending on management consultancy by the NHS itself is not included in the total – an amount that the Management Consultancies Association estimates to have run to about £300m last year, although that figure is likely to include the department’s own spending.

The Conservatives are promising to slash Whitehall’s expenditure on consultants if they win the general election, with the cash earmarked to help introduce a council tax freeze. They are also promising to cut the cost of Whitehall itself by 30 per cent over a Parliament.

However, the level of spending on consultancy services “shows that, at least in part, the department does not have the capacity and staffing to do the work it needs to do,” warned Alan Maynard, professor of health economics at York university, and an adviser to the select committee.

Under pressure from the committee, the department has agreed to start publishing the NHS’s own spending on consultancy, having originally argued that to do so would amount to “micromanaging” the NHS.

The figures for the department’s consultancy expenditure for the past four years show that since 2005/06 it has spent £133m, £205m, £132m and £125m last year – a total of £585m.

A breakdown has been provided for last year only. Then, £93m was spent on general consultancy, about £23m on financial and commercial advice and some £8m on legal consultants. Just over £19m of the total was spent on Connecting for Health, the NHS’s £12bn IT programme.

The spending is spread over more than 120 consultants and advisers. The top three earners were Ernst & Young at £12m, McKinsey at £9m and QI Consulting at £7.1m. The top five, who include PA Consulting and KPMG, accounted for 30 per cent of the total.

Expenditure over the past four years is marginally distorted by the £205m spent in 2006/07 when the department bought in private sector “turnround teams” to sort out the NHS’s then £1bn deficit.

“That was an important thing to do,” Mr Barron said, “and Patricia Hewitt’s determination to sort that out was one of the bravest decisions a secretary of state has taken for a long time”.

But even allowing for that, spending is running at about £130m a year “and we do have real concerns about the ongoing cost of all this,” Mr Barron added.

The MCA argues that its estimate of total spending by the NHS amounts to less than 0.3 per cent of the NHS’s total budget. It is currently agreeing a concordat with the department aimed at ensuring that the NHS gets value for money from consultancy contracts.

From:

http://www.ft.com/cms/s/0/36e48e44-c715-11de-bb6f-00144feab49a.html

Labour blows more money on websites as patients urged to rate GPs online

Patients will be able to praise or criticise their doctor on a health website- but the nanny state will not allow us to actually name the person.

Patients are being encouraged to rate their GP surgeries on a new NHS website designed to drive up standards in primary care.

At www.nhs.uk, patients will be able to post comments ranging from how they were treated to whether it was easy to book an appointment.

But mentioning staff by name will not be allowed, say health officials.

The website will compare the 8,269 GP practices in England only.

The health minister Mike O'Brien said the website was part of plans to modernise the health service.

He said: "As we open up real choice in primary care, it is vital we equip patients with enough information to make the right choice for them. This new tool allows every single GP practice in the country to see the patient's view on what they are doing well and what needs to be improved.

"It will help drive up quality across the board, and is another step in ensuring we have a modern NHS which reflects the needs of the patient," he added.

There are 23 million visits to GP practices and related services every month.

In September, ministers announced they wanted to abolish GP boundaries, allowing patients to register with a practice of their choice.

Yet another similar site to compare the performance of hospitals is already up and running.

From:

http://news.bbc.co.uk/1/hi/health/8306041.stm

Convict wins right to NHS cosmetic treatment

A double murderer serving a life sentence has won a High Court victory in his long running legal campaign for the right to undergo cosmetic surgery to remove a large facial birthmark.

The publicly funded legal challenge by Dennis Harland Roberts, 59, could prompt other prisoners to seek treatments they might otherwise have been denied because of an undisclosed policy operated by Jack Straw, the Justice Secretary.

The policy restricts prisoners’ access to cosmetic and certain other treatments regarded as non-urgent — even though the labour Government has said that they are entitled to the same NHS care as the rest of the population.

Roberts won a declaration at the High Court in London that Mr Straw had acted unlawfully and “contrary to good administration”in failing to disclose his full policy.

Coincidentally, Roberts, a Category A prisoner, was represented in court by Adam Straw, a barrister who is a nephew of the Justice Secretary.

The court case led to the full policy being publicly revealed last week. After its disclosure, the Ministry of Justice agreed to reconsider Roberts’s application to be escorted to hospital for laser treatment, if he could show that the birthmark was having a negative impact on his health. But Roberts and his lawyers continued their legal action to obtain a formal High Court declaration, making the position clear for other prisoners.

Roberts said that the large, congenital port-wine stain on the left side of his face, neck and shoulder had led to his being bullied at school and was linked to a violent temper. He had previously had hospital treatment to remove it on three occasions, the last one in July 2007. But his appointments last year were cancelled.

Roberts, from Newhaven, Sussex, was convicted at Lewes Crown Court in March 1991 of stabbing to death Stephen and Iris Hadler, both in their 70s, after breaking into their home in the summer of 1989. He is now at Frankland Prison, Durham.

A consultant dermatologist recommended him for treatment for the birthmark in 2006.

The consultant stated: “This has always been an embarrassment to him, but he is now developing small vascular nodules within it and I think that laser treatment on the NHS is entirely justified.”

Roberts said in a written statement to the court that the treatment he had already received appeared to have had some success, lightening and removing some 30 per cent of the birthmark. He said he was “extremely pleased” and was expecting an estimated further four sessions of treatment but delays over further treatment caused by the failure to provide him with hospital escorts had sent him into depression.

Adam Straw told the court that, as a result of being bullied at school, “he has a low tolerance for people commenting on his face. He “feels self-conscious and fearful of his own reaction when he becomes aware of others looking at the mark. When the treatment was halted in July 2007, Roberts slid into depression and his violent temper re-emerged.”

The Government’s full policy, which had now come to light, allowed “elective treatment” only if there was “a negative impact on the prisoner’s mental or physical health”. The policy required the need for treatment to be balanced against “public acceptability” issues, and the fact that Category A escorts were “resource intensive, both for staffing and expenditure”.

This differed from the published policy relied on by the Government in a case last year, which gave inmates “access to the same range and quality of services as the general public receives from the NHS”.

Had Roberts known about the unpublished policy, his lawyer said, he would have sought a medical report to show the impact that the birthmark was having on his health, and legal proceedings would have been avoided.

Mr Straw said that it had been necessary to seek a High Court declaration “to prevent prejudice to many other prisoners with similar claims”. Prisoners were entitled to know the correct policy so that they had a proper and fair chance to make their case.

Agreeing with Mr Straw, Michael Suppertone, QC, a deputy High Court judge, declared in a judgment revealed: “In my judgment it is contrary to good administration, and unlawful, for the defendant’s full policy on medical appointments not to be published.”

From:

http://business.timesonline.co.uk/tol/business/law/article6819350.ece

The new CRB check nanny state paranoia won’t stop another Soham

"I helped to catch Ian Huntley and I know these new stupid rules would not have prevented his crimes." Health Direct reproduces the article below by Chris Stevenson who is a retired detective chief superintendent. 

In 2002 I was a senior detective with Cambridgeshire police. That August two ten year old girls disappeared, and I took over the investigation. Two days later I set up the surveillance operation that led to the arrest of Ian Huntley and Maxine Carr a few hours later.

Huntley has not been a free man since. He was convicted of the murders of Holly Wells and Jessica Chapman in December 2003.

Last weekend my actions came back to haunt me. My wife and I went to Benson, Oxfordshire, to celebrate the birthday of my nine-year-old grandson. We went off to see him play as goalkeeper for his village under-10s football team. Mum and dad, sisters, uncles and both grandparents were there to cheer him on.

One of my hobbies is photography, so I took my camera to take a few “action shots” of my grandson. Ten minutes later I was approached by the manager, who said: “Can I ask you not to take photographs, it’s against the regulations. You have to get permission in writing from every parent of every child.”

I felt humbled. I am now a suspected paedophile — along, I fear, with millions of other parents and grandparents. 

I looked at the pictures I had taken. They were of my grandson making saves as his team came under pressure. I am sure he would have liked to look back on them in the future. Who knows, he may be England’s goalkeeper at a future World Cup, although it’s a remote chance. I deleted the photographs.

The furore that has gripped the nation since the Soham murders has made us all paranoid. Is this in children’s interests? The latest “regulations” will require us to be checked by the Criminal Records Bureau if we give lifts to children going to Scouts or similar activities.

Commentators constantly refer to Huntley and the events in Soham as the reason for this. I am sure Sir Michael Bichard, who chaired the inquiry into the murders, did not intend such a wave of recrimination over one case. Yes, changes were necessary: Huntley lived a charmed life in Humberside, where he was investigated for a number of crimes. He was charged with rape, but after he spent a week in custody the case was dropped for lack of evidence.

As a result of poor intelligence, Huntley was appointed a school caretaker in Soham. Did that give him access to children? Yes, hundreds. Did he abuse them? No. In fact he reported to the headteacher that several teenage girls had made inappropriate comments. 

What Huntley did to Holly and Jessica was as bad as it gets, but did he come into contact with them through being a caretaker? Not exactly — he was caretaker of Soham Village College, a school for the over-11s. The two girls attended St Andrew’s Junior School. Different building, different caretaker. Huntley had contact with them because Carr was employed at St Andrew’s as a classroom assistant. 

She worked in a class with Holly and Jessica, who both liked her. Holly’s mother sent Carr a box of chocolates on the last day of term to say thank you for helping her daughter.

The girls were sorry when Carr was not given a permanent job. This was what led them to Huntley.

Out for a ramble around Soham on the Sunday evening, they stopped outside Huntley and Carr’s house to ask after Carr. Huntley told the media that they were sorry she hadn’t got the job.

Tragically, she was away, visiting her family in Grimsby. It was the first time they had been apart overnight since their relationship started. Huntley was in a bad mood as Carr had told him she was going to her second party in successive nights. He was alone. Somehow he conned the girls into the house and they were never seen alive again.

Did he achieve this because he was a caretaker? He could have been in any occupation, lorry driver, architect, anything, and lived with a woman that the two girls knew and trusted. And were right to, as I am convinced that Carr would never have done anything to hurt them.

How do we prevent such chance encounters happening? We can’t. No amount of legislation, record keeping or checking could prevent this type of crime completely. Thankfully it is extremely rare. Children are far more likely to be killed by a family member or on the roads.

Only recently a young girl was murdered by her mother’s partner. There is a suggestion that she had been sexually abused. He then hanged himself. The girl’s mother described him as loving, caring and the last person she would expect to do anything like that. We await the inquest, when it will be asked if the killings could have been prevented. I doubt that the answer will be yes.

We are subjecting our whole community to paranoia. On Friday a BBC journalist announced on breakfast television that “a million children are being abused”.

Where do these figures come from? How do we know? Are we feeding the paranoia that stops a grandfather taking a picture of his nine-year-old grandson playing football? Surely this cannot continue. Someone needs to put things back on an even keel.

Chris Stevenson is a retired detective chief superintendent

From:
http://www.timesonline.co.uk/tol/comment/columnists/guest_contributors/article6834362.ece

Child vetting database will cost £200 million and create 1,450 jobs in Labour marginal

The total cost of the child vetting scheme is expected to soar close to £200 million – and will lead to the creation of around 1,450 jobs in a key Labour marginal constituency.

Public bodies such as the NHS and the Prison Service will be forced to spend millions of pounds registering their employees on the scheme at a time when their budgets have already been squeezed.

Almost all of the NHS’s 1.3 million employees will have to join at a cost of around £83m. The Local Government Association has already warned about the increased cost to councils and their staff.

Labour Ministers will have to sanction a huge spending increase as the Criminal Records Bureau employs 582 staff who dealt with 3.9 million cases last year, or 6,700 cases per employee.

By contrast, the Independent Safeguarding Authority (ISA) has 250 staff whose case load will soar to 45,200 cases per employee as they reach the target of monitoring one in four adults. If, as expected, the ISA processed the work at the same rate as the Criminal Records Bureau it will require 1,686 employees, up 1,430. The staff bill will rise to £43 million.

It will provide a timely jobs boost for Darlington, where the ISA is based, which is a key election battle ground. Alan Milburn, the former Labour Cabinet minister and local MP is standing down at the election in a seat which until 1992 was Conservative held.

James Dawkins, Research Associate at the TaxPayers’ Alliance, said: “The Criminal Records Bureau already struggles, at huge cost, to do its job and this task is more complex and larger. While taxpayers and the people forced to undergo the ISA’s checks will lose out, the only people to benefit will be the army of bureaucrats needed to attempt the impossible. The Government have already created far too many quango jobs, and the last thing taxpayers need is yet more officials on the public payroll.”

Tom Brake, the Lib Dem home affairs spokesman, said: “The new database is not only a disproportionate response to the problem it is trying to solve, it is also a very expensive proposal. It is not clear that asking public bodies to pay millions to prove their staff are not sex offenders will significantly enhance the safety of children. Asking people to pay £64 to prove their innocence may put a lot of them off working with children.”

Parents who do not register for driving their children's friends to a sports event or Cub or Scout meeting face fines of up £5,000.

From:
http://www.telegraph.co.uk/Vetting-database-will-cost-200-million-and-create-1450-jobs-in-Labour-marginal

NHS IT project still on critical list

“If you live in Birmingham,” declared Tony Bliar when he was UK prime minister, “and you have an accident while you are, for example, in Bradford, it should be possible for your records to be instantly available to the doctors treating you.” Not any more.

Or not, at least, if the Conservatives win the next general election. For the Tories have pledged to scrap the countrywide version of the National Health Service’s electronic patient record.

Back in 2002, the idea of a full patient record, available anywhere in an emergency, was the principal political selling point for what was billed as “the biggest civilian computer project in the world”: the drive to give all 50m or so patients in England (the rest of the UK has its own arrangements) an all-singing, all-dancing electronic record. 

Roll-out was meant to start in 2005 and be completed by 2010.

Under a Conservative government, development of the local record – exchangeable between primary care physicians and their local hospitals – would continue. Nationally, clinicians would still be able to seek access to it when needed from the doctors who would hold it locally. But the idea of a national database of patients’ records, instantly available in an emergency from anywhere in the country, would disappear.

This may or may not matter, depending on your point of view. For many clinicians, the idea of an instantly available national record was always something of a diversion. It is access to a comprehensive record locally that is crucial for day-to-day care.

Nonetheless, the Conservatives’ decision to scrap the central database is a symbolic moment for a £12bn ($20bn, €14bn) programme that has struggled to deliver from day one. 

It is currently running at least four years late – and there looks to be no chance in the foreseeable future of its delivering quite what was promised.

So what went wrong? Too much ambition, too much speed, too much centralisation, too little local ownership and not enough choice have been just some of the problems. 

‘It is more difficult than people think. But I do think that by now, seven years on, we would have been further forward’ Glyn Hayes, former chairman of the British Computer Society’s health section

In hindsight, it is easy to see why the programme was set up the way it was – with big central contracts and a one-size-fits-all central offering. For a start, while there had been some local successes, the health service had also had its share of IT disasters when things were run locally.

“The arguments for centralisation were first that all these systems had to be able to talk to each other,” says someone who was closely involved in the government’s original decision to launch the programme. “Second, there were powerful arguments for economies of scale if the system was bought centrally. And, third, the NHS had a long history at local level of taking ringfenced money, whether for IT or other projects, and finding ways of spending it on something else.

“Looking back, it was the wrong thing to do. It was right to centralise standards for communication and for what should be in the record. It was right to use centralised purchasing power. But the next step, that the whole programme had to be centralised, did not have to flow from that. It proved to be a mistake.”

With a staggeringly ambitious goal to get the first electronic records running just three years down the line – when what was to be in them had yet to be fully defined – Richard Granger, the then director, decided that the fragmented and small providers of IT still in the NHS hospital market did not have the scale or industrial muscle to deliver.

So he brought in some of the big boys of IT – Fujitsu, CSC, BT and Accenture – to install the systems. They, however, were not health IT specialists. And, according to Mr Granger, the two providers of the electronic record software ended up with mirror-image problems.

The US company Cerner had good clinical systems. But software designed for hospital billing systems in the US needed a big rewrite to run all the administration and reporting functions of the NHS. By contrast, iSoft, which at the time was a British company, knew how to run the administrative side of the health service but lacked a clinical record. It has taken years for the often troubled company to come up with one. The first deployments of early versions of it are only just under way.
 

For all the difficulties in getting early versions of an electronic patient record into the NHS, the IT programme has had some success. England is one of the first countries to have fully digital imaging – replacing film X-rays and scans with manipulable digital images that largely put an end to lost films and unnecessary repeat examinations.

In spite of the delays, suppliers insist they will get there in the end. Gary Cohen, CEO of iSoft, one of the record suppliers, says: “It is a bit like swimming the English Channel. If you are 80 per cent of the way there and tired, what you don’t do is say ‘Well, we’ll swim back and start again’.”

On top of that, while there was a £6bn budget for the 10-year central contracts, no money was earmarked for training, in spite of the lesson, from the relatively few successful installations of electronic records in US hospitals, that at least as much has to be spent on changing the way staff work as is spent on the systems themselves.

Furthermore, there was no local ownership of the programme. Local developments of electronic records that were under way were halted. The national programme became something that was delivered from on high to hospitals and clinicians, not something that they chose or voted for. They also had to fund their own training and other costs. On top of that, all the installations of early versions of the software into big hospitals have caused serious disruption.

So where does the programme go now? BT and CSC, the two remaining systems installers, have been given deadlines of November 2009 and March 2010 respectively to achieve a smooth implementation in a big acute hospital. Failing that, the department of health says it will “look at alternative approaches”.

Quite what plan B is, however, remains a mystery. Any decision to cancel the contracts is likely to result in mighty litigation. The for hundreds of millions of pounds set aside to achieve an electronic record could go up in smoke in claim and counter-claim as each side blames the other.

It has been a sorry tale to date- and one that still continues.

From:

http://www.ft.com/cms/s/0/6b74e4c8-8cdd-11de-a540-00144feabdc0.html

Surgical centres protest at ISTC contract delays

Private providers of independent surgical centres are to protest to the department of health at the ponderous timetable for re-tendering for five year contracts to treat tens of thousands of NHS patients annually.

The contracts begin to expire between January and May next year. But the department is proposing that where a primary care trust decides it wants to keep a service on, the tendering process will take as long as six months.

The first to be renewed is the Eccleshill treatment centre in Bradford, whose contract formally expires in January. However, the department of health said a new contract would not be awarded until February.

The Bradford and Aire-dale primary care trust declined to say whether Circle, its operator, would be given a contract extension to keep the service running as it was put out to tender - although it did say it was "planning to ensure service continuity".

With no timetable set for re-tendering another 12 contracts that expire next year, their operators fear they too will face renewals that run up to or beyond the contract end.

Jill Watts, chief executive of Ramsay Health Care, which has four treatment centres whose contracts expire in the first part of next year, said: "The timetable is quite ludicrous. The message we were originally given was that there would be a much quicker process."

Ken Anderson, former commercial director at the department of health and the original negotiator of the contracts, said going through a full tendering process for centres that had performed well was "a waste of taxpayers' money".

Now a banker with UBS, Mr Anderson said the department had known for five years that the contracts would need to be renewed.

The providers have already agreed that the services will be provided at NHS prices, he said, and all that was needed was a re-negotiation.

The process the department has proposed was "farcical", he said. "It leaves staff and the companies hanging on the wire, not knowing if they are going to be providing healthcare."

http://www.ft.com/cms/s/0/54e55b18-7e35-11de-8f8d-00144feabdc0.html

NHS surgery centres in doubt over £400m bill

The future of fast track surgery centres that are run privately was in doubt after it emerged that the NHS faced a £400m bill when their contracts expire during the next two years.

Mike O'Brien, health minister, told the Financial Times it would be up to primary care trusts whether to recommission the treatments they provided.

Independent sector treatment centres (ISTCs) have cut waiting lists and introduced competition since the first ones opened in 2005.

However, Mr O'Brien disclosed that as the contracts expire the NHS is likely to have to pay about £200m for operations that it agreed to buy from them but has not used, and another £200m to buy back premises built by the private sector operators.

In spite of the £400m bill, he insisted that ISTCs had been "value for money", cutting NHS waiting lists and introducing more choice for patients.

So far, they have provided more than 1.7m operations and other procedures, helping cut the maximum NHS wait to 18 weeks while recording very high satisfaction rates in patient surveys.

Leading private sector operators also expressed alarm at the labour government's timetable for re-tendering, which they said in some cases looked likely to lead to contract renewal only after, or just as, they were due to end. With many of the centres staffed from overseas "there is a real risk that staff will leave", one leading private sector operator said, putting services at risk.

To attract operators, the five year deals offered guaranteed volumes of patients, a buy-back clause on the buildings, and prices that, on Department of Health figures, are about 11 per cent above the NHS price.

Although some are now treating more patients than contracted for, on average they have treated only about 85 per cent of the patients they offered to take. As a result, the NHS is likely to have to pay about £200m for operations it has not used, as well as another £200m for the residual value of the ISTC buildings, Mr O'Brien said.

But he insisted that the centrally negotiated deals had cleared more than 40 per cent of a "backlog" of 250,000 NHS patients who had to be treated to get waiting times down.

In future it will be up to primary care trusts whether to recommission services from the ISTC buildings, Mr O'Brien said, and he expected those to be at standard NHS prices with no guarantees of volume - "although PCTs will be free to negotiate otherwise".

Trusts have an incentive to renew the service as otherwise they will be left with an empty surgical centre.

http://www.ft.com/cms/s/0/9621c792-7ca0-11de-a7bf-00144feabdc0.html

Sex, drugs roll up with labour's nanny state- teenage pregnancies a real sex scandal

The disappointing rise in teeanage pregnancies is the result of a shocking failure of labour's nanny state policy.

There have been many policy failures by this labour Government; but few can have been as spectacular as its avowed aim of reducing teenage pregnancies by half.

Since 1998, there has been a reduction of just 11 per cent – and recent trends have been upwards once more.

The strategy has involved the expansion of sex- education programmes and the provision of contraception in school. Girls under 16 can already get the morning-after pill from school nurses without their parents' knowledge.

Yet an academic study has found that encouraging children to talk about sex could have increased the number of pregnancies, by tempting them to become sexually active at an early age.

The evidence is now overwhelming that these schemes are not effective in cutting teenage pregnancy rates.

An improvement in wider educational standards seems to be the most significant factor in reducing teenage pregnancies; yet the Government has failed there, too, especially among the children of poorer families, where the problem is greatest.

More than 12 years after this strategy was launched, and despite the expenditure of many millions of pounds, the UK still has the worst teenage pregnancy problem in western Europe.

Any parent could have told ministers that bringing children into contact with what the study calls "risky peers" might have the opposite effect to that intended. This approach undermines any attempt by parents to discourage their children from having early sexual relationships, and the consequences have been all too predictable.

Yet any suggestion that a moral dimension, or the virtues of abstinence, might be included in sex education classes is derided by those who think they know better – but who have been shown by the failure of their policy to know very little indeed.

Teenage-pregnancies-a-real-sex-scandal

Patient records should be given to Microsoft or Google, say Tories

NHS patient records would be outsourced to Microsoft or Google under Tory plans, instead of being held on an expensive, flawed central government database.

The Conservatives, who have close links with Google, argue that developing a database would be unnecessarily expensive, and it would be more beneficial to hold the information on secure systems which already exist, such as Microsoft Healthvault or Google Health.

Patients would be given the choice of storing their records with private companies, although it is not yet clear what would happen to the notes of patients who do not consent.

The Tories estimate that if data were outsourced to sites such as these, the country would save half of the £1.65 billion it spends on IT annually.

Under the plans, which emerged at the weekend, medical staff with appropriate access would log on when necessary, although it does raise issues over security.

David Cameron, leader of the Conservatives, has previously singled out the "Electronic Patient Records system" as an example of the government's wasteful spending.

Winning a contract for medical records would guarantee revenue for Google or Microsoft for years, while it would also help increase the use of their technology in healthcare.

The National Programme for IT, one of the biggest computer contracts in the world, is designed to link more than 30,000 GPs to nearly 300 hospitals.

Parliament's public accounts committee however warned in January that if the scheme was not showing signs of moving forward by July, hospitals should have the option to ditch the plans.

The new system is designed to provide an online booking system, centralised medical records for 50 million patients, e-prescriptions and fast computer links.

But the MPs' report found that progress was "very disappointing" with further delays expected. A revised completion target of 2014/15, already four years behind schedule, was "in doubt", while the report also found the scheme was now costing taxpayers an estimated £12.7 billion.

http://www.telegraph.co.uk/Patient-records-should-be-given-to-Microsoft-or-Google-say-Tories

Health Direct raises one cheer for the proposals. At last- some common sense and recognition that the current project is hopelessly flawed and expensive.

However Microsoft and Google both have bad records for using personal data. The "Opt In" option for patients must be offered and respected.

Warnings ignored over NHS IT system in 2002

Whitehall officials warned repeatedly in private that the NHS information technology programme (NPfIT) would run into serious problems as early as 2002, according to freedom of information requests.

The Office of Government Commerce, a wing of the Treasury, was concerned about the labour government’s ability to take on such an enormous project from the beginning.

Over several years the OGC repeatedly raised issues of unrealistic timetables, unknown procurement risk and an inability to predict costs or value for money.

It questioned whether the labour government had enough qualified staff or an ability to manage large IT programmes. For example, it wrote that there was “no overall concept of affordability or ability to demonstrate value for money”.

The warnings now appear eerily prescient, given that the estimated cost of the project has since ballooned from £5bn to £13bn ($8bn to $21bn). The project is running four years late, prompting the Department of Health to warn that contracts could even be terminated if progress is not made by November.

Companies including CSC, Cerner and BT are involved in the mammoth task of letting half of patients book referral appointments online, setting up broadband connections within the NHS and delivering digital x-ray communication systems.

The OGC’s concerns came to light after the Tories obtained 31 of its reports through an FoI claim.

Nine of the reports gave “red” status to elements of the programme, implying that urgent remedial action was needed for the project to succeed.

“These reviews expose Labour’s incompetence over the NHS IT system,” said Stephen O’Brien, shadow health minister.

“It’s incredible that, right from the beginning, the government should have ignored these repeated warnings about problems.”

The information has only emerged now because the Department of Health previously blocked publication. Six reports, undertaken since 2006 are still being withheld.

From:
http://www.ft.com/cms/s/0/80bcc8c8-604b-11de-a09b-00144feabdc0.html

Ditch management consultants from the NHS

Management consultants should be ditched as the NHS is entering a 'dark and dangerous' period, leading doctor warns conference.

Public money must not be diverted away from patient care 'into the pockets of shareholders' at a time when the NHS may see real cuts in budgets, Dr Jonathan Fielden, chairman of the consultants committee of the British Medical Association said in a speech.

He said the £350m reportedly spend on independent management consultants in the NHS in England last year should be spend on patient care instead.
* NHS consultancy bill is £350m
* NHS could have hired 10,000 nurses with money spent on management consultants

This is even more important as in the coming years investment in the NHS is likely to fall, he said.

Dr Fielden said: "For the first time in working memory, we may see real cuts in health spending. This will provoke some stark choices: what is kept, what is cut, what can the NHS afford? Let's ensure that it's doctors making those difficult decisions in partnership with our patients and health care colleagues, not faceless bureaucrats, accountants, and those out to fleece the taxpayer."

He said that an estimated £927m was also spent on contracts with independent sector treatment centres for work that was not carried out as patients shunned the private centres.

This was a 'dangerous waste', Dr Fielden said, and he urged the Treasury not to snatch back the £1.7bn surplus currently in the NHS and for it to be spent on patients instead.

Dr Fielden said overall the NHS has been improving but there have been 'dreadful blots' on the landscape where care has been poor.

He told the BMA's Consultants Conference: "In each of these there is a common theme: targets being put in front of quality, staff not being listened to, aberrant corporate cultures suppressing concerns and disregarding safety. Doctors must challenge this culture of denial and lead a better way forward."

From
http://www.telegraph.co.uk/health/healthnews/5437279/Ditch-management-consultants-from-the-NHS-leading-doctor.html

Travel, food, chauffeurs - quangos are at it too

Quangocrats are claiming up to £35,000 a year each in expenses for hotels, lavish meals, sat navs and, in one case, £18.50 for dishwasher tablets.

One quango boss made 12 trips abroad during two years in which she claimed £70,000 in expenses. Another claimed nearly £800 for a 42in flatscreen television which he said he would watch only in “times of emergency”. Another spent £16,500 on chauffeur-driven cars.

Details of the claims, released under freedom of information laws, reveal how quangocrats earning six-figure salaries routinely claim tens of thousands of pounds extra in expenses, paid for by taxpayers.

Matthew Elliott, director of the TaxPayers’ Alliance, said: “Quango expenses are potentially even worse than MPs’. Quangocrats are unelected and hidden from public view. They should have all their expenses published on the internet.”

Some of the most controversial claims were made by Paul Evans, former chief executive of the Royal Armouries in Leeds. Evans, who was paid £100,000 a year, claimed nearly £24,000 in 2007-8 including £180 in Farlows, a shooting accessories shop, and £62 in Graingers, a supplier of fishing equipment. He also spent £69 of taxpayers’ money in Davidoff, a London tobacconist renowned for its cigars.

He claimed a further £3,000 on expenses at top bars and restaurants in Leeds and London, £1,170 on an Apple laptop and accessories and £259 on an Apple iPhone.

His claims caught the eye of accountants at the Royal Armouries and he was suspended on full pay in April 2008 over alleged “financial irregularities”. He resigned in September after agreeing to return his computer equipment and to reimburse the Royal Armouries for £289.70 of “personal” expenses claims. An internal investigation later cleared him of any impropriety. Evans last week declined to comment.

Although Evans’s case is unusual, other quango chiefs are making large claims regarded as legitimate.

Dr William Moyes, chief executive of Monitor, a quango that regulates National Health Service trusts, claimed more than £35,000 in expenses in 2007-8 and 2008-9.

His biggest charge was for chauffeur-driven cars, which cost £16,500. Moyes, whose basic salary is £215,000 a year, also spent £7,500 on meals at some of London’s finest restaurants with public servants and consultants.

His favourite venue was the Cinnamon Club, an Indian restaurant in Westminster where he dined on 24 occasions, spending a total of £2,600. A spokeswoman said the meals were important for maintaining relationships with “key stakeholders”.

From:
http://www.timesonline.co.uk/tol/news/politics/article6396004.ece

Children's database launched amid leak concerns

A database with details on every child in England has began operating recently, amid criticisms that the labour government cannot be trusted to amass large amounts of information without it falling into the wrong hands.

Nervousness over ContactPoint, which has been delayed twice while ministers met security concerns, has risen following a string of data losses from government departments. These included the 2007 case of two discs containing the child benefit details of 25m people.

Information stored on ContactPoint will be accessible to hundreds of thousands of government and voluntary sector workers, and will span health, education, social work and youth offending.

"We have serious child protection concerns about this database, which will give too many people access to sensitive information about every child in the country," said Isabella Sankey, policy director at Liberty, the civil rights group.

"Kids in most need of urgent attention could be lost like needles in a haystack, while all of this information will be vulnerable to accident and abuse."

David Laws, the Liberal Democrat schools spokesman, said: "The government has shown it can't be trusted with sensitive data. Parents have every right to demand that their children's personal details aren't put at risk."

But Martin Narey, chief executive of Barnardo's, the children's charity, which will share in ContactPoint, said the directory would provide a quick way for professionals to find out who else was working with a child, making it easier to deliver better co-ordinated services.

"ContactPoint has the potential to make the world a safer place for vulnerable children," said Mr Narey.

The database will supply limited information about children, and any "warning flags" - for example, telling users whether social workers have become involved. It began in the north-west yesterday, prior to a planned national roll-out.

It was first proposed after the 2003 Laming report into the death of Victoria Climbié, the eight-year-old girl who died after failures by social services.

The August 2007 death of "Baby Peter" amid further mistakes by welfare services has heightened concerns about how the state can prevent such extreme abuse, although child care experts say it is not clear that ContactPoint would have prevented either death.

Christine Blower, general secretary of the National Union of Teachers, said: "The solutions to preventing future tragedies lie in the provision of proper resources, back-up and training for frontline services such as social work, and in enabling local authorities to construct effective co-ordinated services in the know-ledge that they will face tough action if they fail.

"This database can very easily be viewed as a bureaucratic response to a failure in communications at local level, where face-to-face work plays a crucial role in early intervention."

From:
http://www.ft.com/cms/s/0/dfd694a8-440b-11de-a9be-00144feabdc0.html?nclick_check=1

Health Direct notes that labour has an appalling record of protecting our data. To endanger every single child in the country with this useless database is not only dangerous but a crass waste of tax payers' money.

NHS bribes to kick bad habits by nanny state

The NHS is offering iPods, hotel breaks and helicopter trips as incentives to drinkers, smokers and drug users to adopt healthier lifestyles or undergo tests and treatment by the nanny state.

Teenagers who agree to be tested for the sexually transmitted disease chlamydia are being entered in prize draws to win Nintendo Wii games consoles.

Under a pilot scheme run by NHS Fife, smokers who give up cigarettes for three months are entered into a prize draw for a helicopter trip across the River Forth or an overnight stay for two in a luxury hotel. Other gifts on offer include iPods, toiletries and cinema vouchers.

Bexley NHS Care Trust and NHS Lothian have offered smokers who quit cash prizes of up to £500; another authority offers Asda food vouchers worth about £150. In Lanarkshire, recovering alcoholics and drug abusers are offered free passes to leisure centres.

NHS Northamptonshire offers people the chance to win Nintendo Wii games consoles worth about £160 in a monthly prize draw if they agree to be tested for chlamydia. It has also spent about £4,000 on book vouchers for 14 15 year olds who take part in the scheme.

Camden Primary Care Trust in London has spent almost £5,000 on Wiis and iPods for a chlamydia scheme; in Nottinghamshire, participants could win a £1,000 Fujitsu laptop.

The schemes, details of which have been obtained by The Sunday Times under the Freedom of Information Act, have been criticised by politicians and taxpayers’ groups.

They question the efficacy and ethics of using hundreds of thousands of pounds of public money to reward people for giving up vices that they chose to take up in the first place.

“We are extremely sceptical about whether public money should be handed over in this manner,” said Andrew Lansley, shadow health secretary for the Conservatives.

“Incentives should be geared around helping people to live healthier lives, for example by encouraging them to do more exercise, not simply handing over taxpayers’ hard earned money.”

Mark Wallace, campaign director for the TaxPayers’ Alliance, added: “A lot of people would be concerned that this is not what they pay their taxes for. Particularly when a lot of these things people should be doing anyway of their own accord. It’s in people’s own interests to get their health checked out and there are serious questions about the effectiveness of these incentives.”

However, health officials insist that the incentive schemes are cost-effective because they raise awareness and save the NHS money in the long run by preventing disease.

The cost to the NHS of treating smoking related diseases is £3 billion a year. An estimated 1% of women aged 16 to 19 have chlamydia, which can cause infertility. More than 2,000 15-year-olds contracted it in 2008 due to underage, unprotected sex.

From:
http://www.timesonline.co.uk/tol/news/uk/health/article6350486.ece

Health Direct asks when will the insanity stop?

Labour's nanny state rewards those that do wrong then reform. Why don't we try rewarding those that do right in the first place- how about IPods and helicopter trips for kids that are drug free and don't have sexually transmitted diseases?

It's yet another example of how they have created a society that rewards failure.

Public services waste £1.5m on 'non jobs'

Health boards and other quangos have been accused of wasting more than £1m of public money every year on “non jobs”, including a wellbeing unit manager, events planner and buddy project worker.

Despite concern over a shortage of police officers on the beat and frontline medical staff, an investigation by The Sunday Times has revealed that £1.5m a year is being lavished on unnecessary jobs.

The roles, which have little to do with the delivery of core services, include a £40,000 a year wellbeing unit manager and £22,000 a year events planner employed by Lothian and Borders police. The force also pays £17,000 a year for a chauffeur for David Strang, its chief constable.

NHS Fife has a buddy project worker “to support volunteers who help people stop smoking” (between £20,000 and £26,000 a year), a graphic designer (£25,000-£33,000) and a librarian, to help ensure “professional staff keep up to date” (£20,000-£26,000). In the past, the health board has also employed an artist-in-residence.

Most health boards employ chaplains or “spiritual care providers” on salaries of about £30,000 a year. NHS Dumfries and Galloway also has an organist. The National Secular Society has called for an end to NHS funding for chaplains, and says the cost should be borne by churches.

Matthew Elliott, the chief executive of the Taxpayers’ Alliance, said the jobs were evidence of unacceptable public sector profligacy at a time when private firms were shedding jobs or imposing pay cuts.

“We’re in the grip of a recession, and it’s high time those in the public sector started cutting back on these ridiculous non-jobs that would be an extravagance even in good economic times,” he said.

“The public sector must wake up and realise taxpayers want value-for- money, frontline public services, not unnecessary frills that are of no tangible benefit to most ordinary people. Any right-minded person can see this money would be far better spent on more nurses, doctors and bobbies on the beat.”

Margaret Watt of the Scotland Patients Association added: “This is quite obscene when we are short of GPs, consultants, nurses and midwives.

“The health boards seem to have their responsibilities all back to front — these jobs should not be a priority. It is more important that we have the staff to take care of our patients than anything else.

“They should be dealing with the core business at the moment where we have insufficient staff in hospitals across the country.”

NHS Fife said it did not consider any of the jobs “nonessential”.

“The modern NHS requires a range of staff to work together to enable it to develop a service for the 21st century,” said a spokeswoman.

From:
http://www.timesonline.co.uk/tol/news/uk/scotland/article6301788.ece