§ Mr. Woodasked the Secretary of State for Social Services whether he has concluded his consideration of the report of the working group on National Health Service audit; and if he will make a statement.
§ Mr. John PattenOur consultation is now complete and we shall shortly be issuing guidance to health authorities on the recommendations made in the report of the working group, which was chaired by Mr. Patrick Salmon. Copies of this guidance will be placed in the Library.
The Government are determined to raise the professional standards and scope of NHS audit, and better equip it to help management secure value for money.
The recommendations in this report seek to achieve this objective and many health authorities are already taking action to improve internal audit on the lines suggested. We are asking each authority to prepare regular audit plans designed to achieve a minimum acceptable level of audit in all key areas of financial responsibility, with audit teams staffed to meet those plans and any value for money work assigned to them. Health authorities are to ensure that matters of importance rising from audit findings are considered by members of the authority, for which purpose thay may wish to establish Audit Committees. Also health authorities are being encouraged to consider consortia arrangements with neighbouring authorities as a means of strengthening their audit structures.
Training of audit staff, including training for computer audit, is to be intensified and widened; we have decided that this would be best achieved through the recently created NHS Training Authority as part of the training programme for the finance discipline as a whole rather than by setting up a separate training department in DHSS for auditors as recommended in the report. Close collaboration between internal and external audit is also to be encouraged. The scarcity of computer audit expertise in the NHS led the working group to recommend that this should be provided by DHSS audit branch enhanced by staff seconded from the Health Service and from the commercial sector. On further consideration we do not regard this as a practical solution and health authorities are being asked to build up such expertise on a regional basis.
The working group also recommended that until health authorities had secured an adequate internal audit, the external audit provided by DHSS should be temporarily strengthened. Subsequently there should be a major review of the DHSS audit Branch to determine its long-term size and organisation. In the event the number of internal auditors employed by health authorities has increased substantially already and some replanning of the external audit programme within the existing complement of staff means that the letter does not need to be enhanced. It will 109W be reviewed in due course when the results of improved training and new approaches to collaboration between internal and external audit are known.
In looking at the contribution which audit can make to the search for increased efficiency the Working Group considered that value for money (VFM) activities generally should be put on a more arganised basis. In particular they recommended that multi-disciplinary VFM units should be set up in each authority and at DHSS. We fully support the view that further efforts are needed to find savings which can be redeployed to improve services to patients, but it is inappropriate to prescribe such an organisational framework when we have already asked authorities to implement the general management function recommended by the Griffiths management inquiry team — see Official Report, Vol. 61, c. 25. We have therefore left it to individual authorities to adopt such an approach if it is helpful within their own management arrangements.
The working group has produced a very valuable report which is already providing the impetus to a more efficient and effective NHS audit service and I am most grateful to the chairman, Mr. Patrick Salmon, and the members for their contribution to this endeavour.