HL Deb 16 November 1992 vol 540 cc449-52

2.51 p.m.

Lord Dean of Beswick asked Her Majesty's Government:

Whether an evaluation has been carried out centrally into the use of computers in the NHS; and if not, whether they will refer the matter to the Auditor General, in view of the levels of expenditure involved.

The Parliamentary Under-Secretary of State, Department of Health (Baroness Cumberlege)

My Lords, the National Audit Office conducted an in-depth audit of NHS computing and published a report Managing Computer Projects in the NHS in November 1990. The department has accepted and acted upon the recommendations made in the report.

Lord Dean of Beswick

My Lords, I am grateful to the Minister for that reply. However, is she aware that after the audit took place Wessex Regional Health Authority, for example, lost £43 million, of which only £21 million has been reclaimed so far as I am aware? West Midlands Regional Health Authority is now showing substantial losses. As I understand it, Guy's Hospital has discontinued the use of computers because of the failure to find a suitable one for the hospital's needs, and the London Ambulance Service has recently dispensed with computers as they put life at risk—indeed, some people may have died as a result of the operation of computers. Does the Minister think that that situation is good enough? When in another place Members raised the issue with Ministers, they were told to write to the chairman of the appropriate regional health authority. I do not believe the position is good enough. Will the Minister do her best to persuade the Secretary of State that some sense of direction is needed in this difficult situation'? Without that, I believe that there are further similar cases lurking below the surface that will surface shortly?

Baroness Cumberlege

My Lords, my answer to the first question is yes, and my answer to the second question is yes.

Lord Stallard

My Lords, will the Minister comment further on the use of computers, as that is what the Question on the Order Paper asks? As regards the ambulance débâcle, it would appear that the people who purchased the computers involved had no training and were conned by all kinds of slick salesmen. It would also appear that the people who used the computers had even less training. The whole matter ended in disaster. Will the Minister give some more information about those aspects of the matter?

Baroness Cumberlege

My Lords, I am well aware of the issues concerning the London Ambulance Service. Your Lordships will be aware that the chief executive, Mr. John Wilby, resigned from the service on 28th October. The NHS management executive has been developing national standards within which local managers can evaluate commercial systems. The aim is to publish revised guidance early next year.

Baroness Fisher of Rednal

My Lords, is the Minister aware that the report of the Audit Commission on the West Midlands Regional Health Authority—the difficulties it raises and the need for speedy action—is taking pride of place in the local press? Is she aware that there could be a possibility of fraud in this area?

Baroness Cumberlege

My Lords, the Audit Commission is now working with the regional health authority at its request. The Secretary of State has asked Sir Roy Griffiths to go to the West Midlands to help the authority discharge its duties efficiently and effectively.

The Viscount of Oxfuird

My Lords, will my noble friend the Minister advise and assure the House that any future evaluation of computer systems will take into account the latest technology? Much progress has been made recently and indeed there is much to come. It is vital that we in this country are up to date.

Baroness Cumberlege

My Lords, my noble friend will be aware that the management executive is pursuing the latest technology in computer systems. I am absolutely confident that that will improve health care in this country.

The Countess of Mar

My Lords, I understand that the district auditor's report on the situation in the West Midlands Regional Health Authority has not been published in full. Will the Minister say whether it will eventually be published in full and also whether the report of the inquiry of Sir Roy Griffiths will be published in full when it is completed?

Baroness Cumberlege

My Lords, the Audit Commission has not yet completed its work but I understand from the chairman of the West Midlands that he will wish to make all relevant information available to the public. Sir Roy Griffiths has not been asked to produce a report; he has been asked to work with the regional health authority to help it discharge its obligations efficiently and effectively.

Lord Ennals

My Lords, the Minister is clearly aware that one of the consequences of the £20 million loss in Wessex was the closure of 20 beds in St. Martin's Hospital which cares for the elderly and the mentally handicapped. Will she confirm that those beds are still closed, or has it been possible to find funds from other sources to enable that much needed service to continue to be provided?

Baroness Cumberlege

My Lords, that is a matter for local determination. I am not aware at the moment what the position is with regard to those particular beds.

Lord Cocks of Hartcliffe

My Lords, is the Minister aware that I serviced the entire captain's office on HMS "Siskin" with an old Imperial, a Gestetner and a few filing cabinets? Are we absolutely sure that all these advances are really in the best interests of patient care?

Baroness Cumberlege

My Lords, the NHS is a huge organisation. If we were to combine the turnover of British Airways, ICI, Shell, Glaxo and IBM, the NHS would still be larger than that combination. Computers are used in a whole range of diverse aspects in the NHS; for example, nursing, pharmacy, clinical diagnosis and treatment, accidents and emergency, in and out-patients, administration, stores, catering, maintenance, and clinical and scientific research. It is a huge complex organisation. No longer can we, sadly, administer it with a quill and ink.

Lord Skelmersdale

My Lords, is it not a fact that if one gets to the very forefront of technology in an organisation such as the National Health Service there are bound to be embarrassments and failures and this is what happened in the recent débâcle over the London Ambulance Service?

Baroness Cumberlege

My Lords, I think I have gone into the whole issue of complexity. It is enormous. I am absolutely convinced that the large organisations in this country are not perfect when it comes to developing computer systems.

Lord Desai

My Lords, given the size of the NHS, its complexity and what is at stake, is it not time we learnt the costs in terms of beds not being kept open, pacemakers not bought or units not kept open that result from the mismanagement of computer systems? Every time money is lost through computer mismanagement, something else has to give way. Will the Minister promise to provide us with a list of all the embarrassments and mistakes that have occurred and the cost of those mistakes to regional health authorities? If those costs are added up, they might show it is time we had central control of computerisation in the NHS.

Baroness Cumberlege

My Lords, I am absolutely convinced that the road to disaster lies in the centralisation of everything. It is essential with computers that they are developed locally, that there is a feeling of ownership and that they operate according to the local conditions.