HC 414 - Overseeing financial sustainability in the further education sector


Book Description

The declining financial health of many further education colleges has potentially serious consequences for learners and local economies, but the bodies responsible for funding and oversight have been slow to address the problem. Too often, they have taken decisions without understanding the cumulative impact that these decisions have on colleges and their learners. Oversight arrangements are complex, sometimes overlapping, and too focused on intervening when financial problems have already become serious rather than helping to prevent them in the first place. The Department for Business, Innovation & Skills and the Department for Education appear to see area-based reviews of post-16 education as a fix-all solution to the current problems, but the reviews do not cover all types of provider and it is not clear how they will deliver a robust and financially sustainable sector.




HC 505 - Economic Regulation of the Water Sector


Book Description

The General Practice Extraction Service (GPES) is an IT system designed to allow NHS organisations to extract data from all GP practice computer systems in England. This data would be used to monitor quality, plan and pay for health services and help medical research. The National Audit Office conducted an investigation into the service following concerns raised during a financial audit of the Health and Social Care Information Centre (HSCIC). The investigation found that the project had been delayed and only one customer, NHS England, had so far received data from GPES. Mistakes in the original procurement and contract management contributed to losses of public funds, through asset write-offs and settlements with suppliers. However, the need for the service remains and further public expenditure is needed to improve GPES or replace it. This inquiry will examine the procurement and development of the GPES system, the total expected cost of the GPES programme, which increased from £14 million to £40 million during planning and procurement, and how the capability of GPES can be used to provide a suitable data extraction service in the future.




HC 583 - Cancer Drugs Fund


Book Description

Survival rates for cancer patients in England have generally been worse than those in other high-income countries in Europe, mainly because patients in England tend to be diagnosed later and have poorer access to treatment. The government set up the Cancer Drugs Fund in 2010 to improve access to cancer drugs that would not otherwise be routinely available on the NHS. In the last five years about 80,000 people received drugs through the Fund. However, the Department of Health and NHS England do not have the data needed to assess the impact of the Fund on patient outcomes, such as extending patients' lives, or to demonstrate whether this is a good use of taxpayers' money. NHS England overspent the Fund's �480 million budget for the two years 2013-14 and 2014-15 by �167 million. The cost of the Fund grew from �175 million in 2012-13 to �416 million in 2014-15, an increase of 138% in two years, but NHS England did not start to take action to control the cost until November 2014. There is agreement that the Fund is not sustainable in its current form and NHS England and the National Institute for Health and Care Excellence (NICE) are currently consulting on proposals to reform the Fund from April 2016. We expect NHS England, in making changes, to take account of our recommendations and apply the clear lessons from the last five years to ensure that the new Fund is managed better in the future.




HC 788 - Corporate Tax Settlements


Book Description

A six year investigation by HM Revenue & Customs (HMRC) has resulted in Google paying a further £130 million to settle its corporation tax liabilities over the last 10 years. This vindicates the previous Committee's concerns in 2012 and 2013 that Google did not appear to be paying the full tax it owed in the UK. However, in the absence of full transparency over the details of this settlement and how it was reached we cannot judge whether it is fair to taxpayers. The sum paid by Google seems disproportionately small when compared with the size of Google's business in the UK, reinforcing our concerns that the rules governing where corporation tax is paid by multinational companies do not produce a fair outcome. Google's stated desire for greater tax simplicity and transparency is at odds with the complex operational structure it has created which appears to be directed at minimising its tax liabilities. Google admits that this structure will not change as a result of this settlement.




HC 564 - the Sale of Eurostar


Book Description

In March 2015 HM Treasury agreed to sell its 40% stake in Eurostar for £585.1 million, almost double the valuations produced before the sale by both the government's project team and UBS its financial adviser. While some of this difference may be explained by the successful sale process and favourable market conditions, it is also further evidence of the government and its advisers undervaluing assets. We are also concerned about the seeming over-reliance by government on a small pool of costly advisers for asset sales. For example, UBS, the financial adviser for this transaction, was also involved in the sale of the Royal Mail and High Speed 1 (HS1). Eurostar also agreed, in a separate transaction, to redeem the government's preference share, providing a further £172 million for the taxpayer. The sale of the UK government's entire financial interest in Eurostar therefore generated proceeds of £757.1 million, significantly less than taxpayers' total financial investment in Eurostar which is estimated to have been some £3 billion. In October 2015, some two years later than expected, the Department for Transport published an evaluation of the economic impact and regeneration benefits for HS1. We are concerned that this delay has prevented the evaluation, which shows that the costs of HS1 far outweigh its quantified benefits, from being used to aid the scrutiny of other projects such as High Speed 2. Despite the results of its own evaluation, which it described as "world class", the Department maintains that there are further "wider wider benefits" from HS1 that it cannot yet value which make the investment worthwhile.




HC 643 - e-Borders and Successor Programmes


Book Description

On current projections the Home Office's e-Borders programme and its successors will cost over a billion pounds, be delivered 8 years late and not provide the benefits expected for transport carriers and passengers. A major reason for this delay was the termination by the Department in 2010 of its e-Borders contract with Raytheon. This had required Raytheon to deliver its own solution to meet the Department's objectives to a fixed price and timescale which turned out to be unrealistic as government had detailed and evolving requirements, and wanted high assurance that the proposed solution would work. The Department was emphatic that our borders are secure. However, the Department needs to accept that its assertion that it checks 100% of passports is both imprecise and unrealistic due to the complexity of our border. It is now five years since the e-Borders contract was cancelled yet the capabilities delivered so far still fall short of what was originally envisaged. Since 2010 the Major Projects Authority has issued seven warnings about these programmes. The Department's complacency about progress to date increases our concerns about whether the programme will be completed by 2019 as the Department now promises, and whether tangible benefits for border security, transport carriers and passengers will result.




HC 563 - Management of Adult Diabetes Services in the NHS: Progress Review


Book Description

Since the previous Committee of Public Accounts reported in 2012, the Department of Health and NHS England have made progress in improving outcomes for diabetes patients. International evidence now available also suggests that the UK performs well compared to other countries in terms of outcomes for diabetes patients. However, there are significant variations in the routine care and support that diabetes patients receive, and in outcomes for diabetes patients. We are concerned that the witnesses from the Department and NHS England painted an unduly healthy picture of the state of diabetes services in England. Although an individual diabetes patient's prospects are getting better, the number of people with diabetes is rising by 4.8% a year, and performance in delivering the nine care processes and achieving the three treatment standards, which help to minimise the risk of diabetes patients developing complications in the future, has stalled. In addition, very few new diabetes patients are taking up education that could help them manage their condition, and the number of diabetes patients experiencing complications (which account for over two-thirds of the cost of diabetes to the NHS) continues to rise. This all means that the costs of diabetes to the NHS will continue to rise. In order to control these costs, the Department and NHS must take significant action to improve prevention and treatment for diabetes patients in the next couple of years.




HC 502 - Services to People with Neurological Conditions: Progress Review


Book Description

Over 4 million people in England have a neurological condition. Services for people with these conditions are not consistently good enough, and there remains wide variation across the country in access, outcomes and patient experience. As well as affecting patients, poor care has implications for the NHS; for example, it costs �70 million to deal with emergency admissions of epilepsy patients and many of these admissions are likely to result from shortcomings in care. Neurological services remain poorly integrated with a lack of joint commissioning of health and social care. Over 40% of people with a neurological condition do not think that local services work well together, and only 12% of people have a written care plan to help coordinate their care. There has been some progress in implementing the recommendations that the previous Committee made in 2012, including the appointment of a national clinical director for adult neurology and some improvements in data. However, these changes have not yet led to demonstrable improvements in services and outcomes for patients. It is clear that neurological conditions are not a priority for the Department of Health and NHS England, and we are concerned that the progress that has been made may not be sustained. We therefore intend to review the position again later in this Parliament.




HC 601 - Universal Credit: Progress Update


Book Description

We acknowledge that Universal Credit has stabilised and made progress since the previous Committee of Public Accounts first reported on the programme in 2013. However, there remains a long way to go. Implementation of Universal Credit so far has focussed mainly on the simplest cases and the Department for Work & Pensions has again delayed the programme. The completion date for the roll-out of its new digital service is six months later compared to when we looked at the programme only a year ago, and the Department now expects that Universal Credit will be fully operational in March 2021. The Office for Budget Responsibility forecasts that there will be a further six-month delay beyond the Department's latest planned end-date. We remain disappointed by the persistent lack of clarity and evasive responses by the Department to our inquiries, particularly about the extent and impact of delays. The Department's response to the previous Committee's recommendations in the February 2015 report Universal Credit: progress update do not convince us that it is committed to improving transparency about the programme's progress.




HC 581 - Automatic Enrolment to Workplace Pensions


Book Description

Since the introduction of automatic enrolment in October 2012, almost all larger employers have enrolled their workers in a workplace pension, thereby increasing the number of people saving for retirement. Employer compliance has been high and the proportion of people choosing to opt out from automatic enrolment has been lower than expected. The Department for Work & Pensions, the Pensions Regulator and the National Employment Savings Trust and other pension providers are now facing the more difficult task of supporting 1.8 million small employers through automatic enrolment. They will need to monitor the experiences of small businesses-including 900,000 employers with only 1 or 2 employees-and minimise administrative burdens, while also ensuring that increased enrolment translates into adequate incomes in retirement. We will be returning to this subject, which is of vital importance to both employees themselves and to future governments as they plan for pensions, and we have asked the Department to update us on progress over the next 12 months