HL Deb 12 May 1993 vol 545 cc1273-5

Lord Dean of Beswick asked Her Majesty's Government:

What are the terms of reference of the Audit Commission inquiry, announced on 21st April, into fraud in the National Health Service.

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

My Lords, the Audit Commission has not as yet drawn up its terms of reference for the inquiry which it plans to undertake into the National Health Service.

Lord Dean of Beswick

My Lords, I am grateful to the Minister for that reply. Will she accept that the health service, which is the prime target of my Question, should be asked to dictate the terms of reference for the inquiry? Is she aware that my Question is particularly aimed at the corruption and maladministration that have gone on over the purchase of computers and their operation in regional health authorities? Would it not be right and proper, in order to deal with this situation, for the investigation to concentrate as a matter of urgency on that facet? Will it then report to both Houses of Parliament as a matter of urgency so that we can have a debate, which would be in the interests both of the Government and those in both Houses who may be involved?

Baroness Cumberlege

My Lords, Ministers very much welcome this initiative on behalf of the Audit Commission. It is an independent body, and therefore its workload and timescales are of its own deciding. Every year the commission carries out about five independent inquiries into the National Health Service. In this instance it is to be a very thorough inquiry. But it wishes to carry out the review that it will undertake for local government first. From that it believes it will learn a great deal which will affect the terms of reference that are to be drawn up for its inquiry into the National Health Service.

Baroness Robson of Kiddington

My Lords, is the Minister able to tell the House whether there are any similarities between the failure of the Wessex computer system and the failure of the London ambulance service computer system; or are we simply incapable as a nation of introducing an efficient computer system into the NHS?

Baroness Cumberlege

My Lords, it is not only the NHS that finds difficulty with computer systems. But the National Health Service has learnt from these inquiries. The chief executive has set out a revised set of standards of business conduct. They were issued in January 1993. Sir Duncan Nichol also wrote to all regional chief executives in September 1992 drawing attention to the importance of ensuring that the proper procedures for tendering, contracting and finance were applied. My right honourable friend the Secretary of State wrote to all regional and trust chairmen in April 1993 about the lessons to be learnt from the audits of the West Midlands regional health authority.

Lord Cocks of Hartcliffe

My Lords, is the Minister able to reassure the House that there are no similar computer problems lurking in the 12 other regional health authorities apart from Wessex and the West Midlands?

Baroness Cumberlege

My Lords, I cannot give that absolute assurance. The National Health Service is an enormous organisation, with a £30 billion budget. We are doing all that we can at the moment to take measures to ensure that these situations do not re-occur. But I cannot give an absolute guarantee.

Lord Bruce of Donington

My Lords, is the Minister aware that the House and the public would be greatly assisted if the Government would publish the results of their investigations into this extremely grave matter, which has been the subject of press features over quite a number of months? Would it therefore not be best for the Government themselves to publish what they have found out without any prejudice to whatever views may be formed after detailed investigation by the auditors? Does the noble Baroness agree that the utmost frankness with the House and with the country is required in this matter?

Baroness Cumberlege

My Lords, I agree with the noble Lord. The reports of the National Audit Office have been published, as have those of the Audit Commissioners. As noble Lords will be aware, the Public Accounts Committee has also taken a great interest in this whole area. Its deliberations are public and we look forward to the minutes that will he published next week on the Wessex system. I agree entirely with the noble Lord that we should he as open as possible.

Lord Carter

My Lords, is the Minister aware that there is a damaging atmosphere of secrecy and a cavalier disregard of the ethics in the public service surrounding the whole business? Since her first reply, it appears that the report of the Audit Commission will now be long delayed. Have the Government or the National Health Service Executive issued instructions expressly forbidding the so-called "sweetheart deals" for the supply of goods and services between health authorities and their former employees? If they have not, why not?

Baroness Cumberlege

Yes, my Lords, that is all part of the guidance that has been issued. I want the National Health Service to be as open as possible. Noble Lords will have read in the national press today about a conference yesterday which I chaired. That conference looked specifically into some of the shortcomings of the National Health Service in terms of security. We not only ran that conference but also contributed to the cost of the National Association of Health Authorities' security manual. We have commissioned in-depth studies into six hospital sites and commissioned and launched a training video. We are aware of the problems that exist in the National Health Service. If any are lurking, we are anxious that they should be made known, made public and dealt with.

Lord John-Mackie

My Lords, in view of the fraud and stealing of which we have been told, are the police not being brought into the picture?

Baroness Cumberlege

Yes,of course, my Lords. If there is any suspicion of law-breaking the police are immediately brought in.

Lord Dean of Beswick

My Lords, is the Minister aware that last week I sat for four hours as an observer in the Public Accounts Committee in another place? Will she accept that, although I knew that something was wrong, I felt that the evidence produced by the Audit Commission on corruption, maladministration and insider dealing in tenders in the Wessex situation was absolutely mind-boggling? Is it not strange that Sir Duncan Nichol has now expressed deep concern? Some weeks ago in your Lordships' House I produced an official document from the National Audit Office from over two years ago showing that it knew that there was a £63 million error somewhere in Wessex, but nobody was brought to book over it.

I do not want to appear to be getting at the present Minister, who is carrying the can for previous officers or Ministers in that department. But does she agree that, unless this matter is completely opened up, it will remain a running sore and the public will expect some action? Why do the Government try to subsume this issue in a general investigation into public expenditure? Why do they not treat it in isolation? That is what should be done.

Baroness Cumberlege

My Lords, the Wessex failures took place in 1986. The noble Lord will be aware of the action that the Government have taken since then. A number of people have left that region because of the results of inquiries that have taken place. There has been police activity in this instance. All the issues have been faced. We welcome the Audit Commission's decision to make an even more thorough investigation into National Health Service dealings. That is important and we believe that it will come up with some useful advice.

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