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Nearly one fifth of consultant posts in emergency departments were either vacant or filled by locums in 2012. Neither the Department nor NHS England have a clear strategy to tackle the shortage of A&E consultants and there is too much reliance on temporary staff to fill gaps. The Committee raised the possibility of paying consultants more to work at struggling hospitals. Greater use in A&E of consultants from other departments could also be made, or mandate that all trainee consultants spend time in A&E, or make A&E positions more attractive through improved terms and conditions. The slow introduction of round-the-clock consultant cover in hospitals - which will not be in place before the end of 2016-17 - is also having a negative impact. More people die as a result of being admitted at the weekend when fewer consultants are in A&E. Changing this relies on the British Medical Association and NHS Employers negotiating a more flexible consultants' contract, and neither the Department nor NHS England has direct control over the timescale or details of these negotiations. Hospitals, GPs and community health services all have a role to play in reducing emergency admissions - but financial incentives to make this happen are not in place. While hospitals get no money if patients are readmitted within 30 days, there are no financial incentives for community and social care services to reduce emergency admissions. Both the Department of Health and NHS England struggled to explain to us who is ultimately accountable for the efficient delivery of local A&E services
This report summarises the key areas of the Committee's work over the past five years. It draws out the areas where progress has been made and where their successors might wish to press in future. The Committee has assiduously followed the taxpayer's pound wherever it was spent. Since 2010 they held 276 evidence sessions and published 244 unanimous reports to hold government to account for its performance. 88% of their recommendations were accepted by departments. In many cases they successfully secured substantial changes, for example with the once secret tax avoidance industry. They secured consensus from government and from industry that private providers of public services do have a duty of care to the taxpayer, and in pushing the protection of whistleblowers further up the agenda of all government departments. By drawing attention to mistakes in the Department for Transport's procurement of the West Coast Mainline, more recent procurements for Crossrail, Thameslink and Intercity Express have all benefited from more expert advice and a more appropriate level of challenge from senior staff. After discovery in 2012-13 that 63% of calls to government call centres were to higher rate telephone numbers, the Government accepted our recommendation that telephone lines serving vulnerable and low income groups never be charged above the geographic rate and that 03 numbers should be available for all government telephone lines. They also secured a commitment to close large mental health hospitals.
The Department for Transport has approved expenditure of over £11 billion between 1998 and 2021 for the development of new and existing trunk roads and motorways by the Highways Agency, and just under £1.7 billion on major road schemes proposed and developed by local authorities in five year Local Transport Plans. Following on from a NAO report on this topic (HCP 321, session 2006-07; ISBN 9780102944600) published in March 2007, the Committee's report examines the steps taken by the Department for Transport and the Highways Agency to improve value for money and oversight of the roads programme and contracting methods and project management capability. By September 2006, the Agency's 36 completed schemes in the Targeted Programme of Improvement cost 40 per cent more than estimated initially, and for schemes still to be completed, latest forecasts indicate that final costs could be 27 per cent more than original estimates. The main causes for costs exceeding estimates are increases in construction costs, higher than forecast land prices and compensation to landowners, inflation and changes in the scope of the project. The report finds that the DfT has not been rigorous enough in its oversight of the Agency's delivery of major road schemes, allowing it too much latitude on delivery and cost plans, and has failed to monitor in-year expenditure against progress and delivery milestones. The Agency is overly reliant on consultants for project management expertise and needs to develop its in-house capability.
This report examines the first year of implementation of the MPs' expenses scheme, and proposals for improving service levels in the future. The Independent Parliamentary Standards Authority (IPSA) was established in the wake of the 2009 crisis in public confidence on MPs' expenses. IPSA established itself quickly and introduced a functioning expenses system on time in May 2010. Since then, IPSA has also been paying the salaries of MPs and their staff. Expenses have been paid within the rules, and MPs have been reimbursed accurately. In 2010-11, IPSA paid out over £118 million in total, comprising £98.6 million in salaries for MPs and their staff, and £19.5 million in MPs' expenses. IPSA assesses that 99.7% of all claims made by MPs are within the rules it has set. But its expenses scheme is expensive to administer and is not yet demonstrating value for money. Overall, 38% of claims submitted in 2010-11 were for less than the average cost IPSA incurs to process them. The Committee is also concerned about the lack of clear, easily accessible guidance for MPs and their staff, and the cumbersome nature of some processes, such as payment card reconciliation. There are two remaining issues which IPSA needs to address. Public confidence could be improved further if IPSA made clearer public statements about approved claims being wholly within the rules. And salaries should be separated from true expenses.
The Department of Transport and its seven executive agencies average 10.4 days of sickness for each full-time employee (compared to a Civil Service average of 9.8 days). However the performance is varied. The central Department and four agencies have sickness levels at or below comparable organisations but the Driving Standards Agency and the Driver and Vehicle Licensing Agency have absence rates of 13.1 and 14 day respectively. On the basis of a Comptroller and Auditor General's report the Committee have examined current sickness levels in the Department and actions being taken to meet their 2010 targets. They conclude that the Agencies need a better understanding of why some staff take so much sick leave. Although there appears to be a correlation with low paid repetitive administrative jobs there are also concerns about leadership within the Department. Measures have therefore been taken to strengthen management in areas involving repetitive work.
The Department for Education provides funding for local authorities to pay for three and four year olds to receive their entitlement to 15 hours of free education each week. The Department devolves delivery to local authorities and providers but it is responsible for the overall value for money from the system. In 2011-12 the Department's estimated funding for the entitlement of £1.9 billion provided over 800,000 three and four year olds with access to free education; an estimated annual allocation of approximately £2,300 per child. While the Department and local authorities have focused on ensuring places for children are available, there has been less attention on how value for money can be secured and improved. While there is evidence of educational improvement at age five, the evidence that this is sustained is questionable. The Department needs to do more to understand how educational benefits can be lasting. There is not enough good information for parents to make informed choices and there is concern at reports that some families are still not receiving the entitlement free of charge. It is important that all parents know what the entitlement is and that it should be provided completely free. Early years education has the greatest benefit for children from disadvantaged backgrounds however these children have the lowest levels of take-up and deprived areas have the lowest levels of high quality services. The Department needs to identify and share good practice from those local authorities which are having the most success.
In 2004-05, approximately £837 million was spent in England on a range of national programmes to help address problems in schools that were failing or at risk of failing to provide an acceptable standard of education for their pupils. Following on from a NAO report (HC 679, session 2005-06; ISBN 0102936633) published in January 2006, the Committee's report examines the activities of the DfES and Ofsted to identify and deal with poorly performing schools, to strengthen school leadership and to develop simpler relationships with schools. Findings include that, although the number of poorly performing schools has been reducing, there are still around 1,500 in England that are under-performing. Improvements in data on secondary school performance has helped to identify schools in decline at an earlier stage so that they can benefit from increased support, and similar improvement needs to be done at primary school level. The system of shorter Ofsted inspections, based on school self-evaluation of performance, may be appropriate for the majority of schools, but some schools are not evaluating themselves effectively and incentives needs to be created to help achieve this. School leadership is essential to achieving and maintaining improvements, and Ofsted reports need to diagnose any leadership problems in failing schools explicitly. Local authorities and other schools are important sources of support for struggling schools and there should be greater opportunities for schools to collaborate and share good practice.

Hmrc

Great Britain. Parliament. House of Commons. Committee of Public Accounts

Published: 2008

Total Pages: 40


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Tax lost through the hidden economy could be over £2 billion and involve some 2 million people. HM Revenue & Customs (HMRC) spent 41 million in 2006-07 on encouraging people and businesses into the formal economy, detecting and imposing sanctions on those operating in the hidden economy, achieving a return/cost ration of 4.5:1. HMRC detects some 30,000 hidden economy cases a year, a detection rate of only around 1.5 per cent, but the amount of tax recovered has increased by 13 per cent in real terms since 2003-04. Areas of risk include: self-employed builders and decorators who often receive cash payments; individuals who trade on the internet; and buy-to-let landlords. To increase detections HMRC is making more use of data matching techniques, and the Tax Evasion hotline received over 120,000 calls in 2006-07, but progress in investigating cases has been slow with only 2000 completed against a target of 5,500. HMRC can impose penalties of up to 100 per cent of tax owed, but usually imposes a lower penalty or waives them. Prosecutions are not given much publicity, limiting their wider deterrent effect. Advertising campaigns to encourage people to declare tax owed have led to 8,300 registrations bringing in extra tax of £38 million over three years. Offshore Disclosure arrangements have been even more successful following landmark rulings requiring financial institutions to release details of around 400,000 offshore accounts. Some 45,000 people came forward bringing in around £400 million at a cost of £6 million, a return of £67 for every £1 spent.
This report is a follow-up to the Committee's report on Accountability for Public Money (HC 740, session 2010-11 (ISBN 9780215559029)) an issue at the core of the relationship between Parliament and government. Accounting Officers remain accountable to Parliament for funds voted to their departments but the policy intention is that local bodies will have significant discretion over the services they deliver. In the Government's response, 'Accountability: Adapting to Decentralisation', Sir Bob Kerslake drew a distinction between those services that government delivers directly and those that it may fund but are delivered in more decentralised arrangements. He proposed that Accounting Officers set out, in Accountability System Statements, the arrangements they have in place to provide assurance about the probity and value for money of funds spent through devolved systems. All departments are expected to produce Statements by summer 2012. Departments have made a genuine effort to develop arrangements which reconcile accountability and localism but the Statements so far are unwieldy and considerably more needs to be done to improve their clarity, consistency and completeness. There is concern that accountability frameworks must drive value for money and, critically, are sufficiently robust to address the operational or financial failure of service providers. Departments are placing increasing reliance on market mechanisms such as user choice to drive up performance and value for money, but there are limits to what these mechanisms can achieve. The Treasury needs to take ownership of the system and ensure that the Comptroller and Auditor General has the necessary powers and rights of access to examine the value for money of funds spent through devolved systems