Sunday, 14 October 2007
"Helping the nation spend wisely" Sir John Bourn
A visitor from Mars, looking at the way government spending and taxation have increased over the last 10 years, would surmise that we have wasteful and profligate politicians. On the contrary, our leaders approach government spending as if taxpayers' money was their own and, if they do squander it, they have the National Audit Office to answer to.
The National Audit Office is funded by the taxpayer but independent of government. Sir John Bourn, head of NAO, has, for example, congratulated NHS Direct on its success:
"NHS Direct, the national telephone healthcare advice service operated by nurses, has achieved a high level of customer satisfaction since its introduction. The service, which has been fully available throughout England and Wales since November 2000, has a good safety record. Evidence at the local level suggests that it can help reduce demand on healthcare services provided outside normal working hours, for example by GPs, and is directing callers to more appropriate forms of care during the day." This was the same NHS Direct where the operators pretended to be answering machines to avoid dealing with callers and has been widely blamed for directing patients unnecessarily to A&E departments while conversely delaying the treatment of severely ill children.
On the National Programme for IT in the NHS, Sir John commented:
"Substantial progress has been made with the National Programme for IT. The Programme promises to revolutionise the way in which the NHS uses information to improve services and patient care. But significant challenges remain for the Department and NHS Connecting for Health." This is the same NHShIT that is widely seen as unworkable, overambitious, wasteful and unwanted by the medical profession and is projected to cost more than £20 billion with no measurable benefit. In fact the most widely touted benefit of having the patients records available online in an emergency is now being offered for free by Microsoft, and PACS (digital imaging and archiving), for which the NHShIT is widely praised, owes as much to the NHShIT programme as the move from film to digital photography.
A later NAO report on the progress, (or more accurately the lack of progress) of NHShIT was, according to documents discovered by the BBC, altered by the Department of Health to remove the more critical findings.
Still, even if the NAO isn't as independent as we would like it to be, at least its head, Sir John Bourn, is an honourable man, leaving no stone unturned and enduring any personal hardship in his protection of the public purse.
It comes as a shock therefore to find he has his nose in the trough too. A BBC report of Sir John's spending for the 6 months to September 2007 revealed he had spent £16500 on five overseas trips and £1650 on business meals. This was after having previously been criticised for spending £336,000 on 45 business trips in a 3 year period. Maybe this is not an unusual level of spending for a high ranking public servant but the accounts reveal that the trips were taken as First or Business class and the taxpayer was picking up the tab for entertaining parliamentarians and senior government officials at 5* London hotels and upmarket restaurants. Even more surprising, for the person in charge of safeguarding the taxpayers money, his wife accompanied him on some of the trips and was paid for by the taxpayer. For comparison, the code of practice governing doctors and the pharmaceutical industry stipulates that the choice of venue for meetings should be no better than a doctor would normally choose for themselves and the entertainment of doctors' spouse is strictly prohibited.
One wonders why the taxpayer has been paying for Mrs Bourn to go on overseas trips. It can't be that Sir John is hopeless without her because he managed single handedly on his trips to Kazahkstan, Moldova and Belfast but was accompanied to the much more desirable tourist locations of San Francisco, Lisbon and Venice.
I think the taxpayer will be reassured that our money is being wisely spent to benefit our population and that the NAO is leading the way by example.
Update 25th October