Examination of Witnesses (Questions 40
- 59)
MONDAY 23 MARCH 1998
MR ALAN LANGLANDS, MR FRANK BURNS, DR JAMES READ AND MR DAVID BIRD.
40. When did you first realise that something
was going wrong with the management of this project, whether that
be in accountability or in any other way?
(Mr Langlands) Really personally
I realised when the matter was first raised by the NAO in I think
about September 1996, the first management letters started coming
through from the NAO. I knew that their study was under way and
I knew that their study had been instigated as a result of some
criticisms. The depth of that became clear as their study unfolded
and it was at that point that I decided to act. I did not know,
for example, about the consultant's report in 1994, had I known
about that I would have acted at that time.
41. There is this, it has been referred
to, the Health Service Journal from February 1995 which outlines
some of these problems and refers to "unusual arrangements".
Were you aware of that at the time?
(Mr Langlands) I cannot remember
being aware of what the Health Service Journal writes on an issue
like that. I am sure my staff, who were dealing with it, must
have been aware.
42. Another matter of concern, if I may,
is the matter of conflict of interest, the person who is responsible
for the procurement also being the person responsible for providing
the services. The directors of CAMS are Dr Read and Mr Bird, is
that right?
(Mr Bird) No, there are currently
four directors of the company: Dr Read, the managing director,
Mr Lea, Dr Amos and myself.
43. May I ask a question of Dr Read. Dr
Read, how much do you earn?
(Dr Read) 70 something thousand
from the Centre and about £40,000 from CAMS.
44. Mr Robert Read, how much does he earn?
(Dr Read) I am not sure, about £40,000.
45. About £40,000, I understand he
is a primary school teacher by profession, is that right?
(Dr Read) He used to be a primary
school headmaster.
46. What particular experience does he bring
to this project, this enterprise?
(Dr Read) To CAMS?
47. Yes?
(Dr Read) He came in at a very difficult
time for me when I was put into this position of conflict, I had
to have a non executive role at CAMS and it was essential for
me at that time that people were running CAMS that I could trust
and leave to run CAMS. He had experience and running a school
is a management post of some consequence.
48. I understand that. You wanted people
there with whom you had a personal connection of some weight because
thereby you felt you could trust them.
(Dr Read) It was important to me
then that the person in charge of day to day affairs of CAMS was
somebody whom I could trust from day one and that was not a problem
to me. I had to when one day I was running CAMS and the next day
I was running the Centre and having nothing to do with CAMS day
to day. It was very important to me that whilst I was running
the centre I could leave them to get on with that. There was no
way I could interview and find somebody who I would have reason
to suppose was not going to give me a problem.
49. In an environment as you described and
as the NAO Report describes, it would be quite easy for individual
employees to benefit from patronage or favours. The report says
on page 50 in many cases breaches of procedure or policy occurred.
Were any employees promoted, receiving large pay increases? Did
that happen at all?
(Dr Read) Where, at the centre?
50. Yes, at the centre.
(Dr Read) Centre staff were promoted
from time to time from when we first opened the Centre.
51. Was a person called Yvonne Sutton promoted
and did she receive a massive pay increase?
(Dr Read) She was promoted. She
came to me from another branch of the information management group
in charge of the clinical coding support unit. At the time I was
asked to take the whole unit into the Centre to form effectively
the classification team. At the time of her coming into the Centre
I was asked by her then manager, Andre Rogers[4],
for her to be effectively deputy director and I did not want that
to happen. I said no I would rather she came just as a line manager
and see how she performed and then if she performed well we would
promote her. A few months later I was asked by the supervisory
board for the Centre to make sure that I had in place deputy directors
so that-to quote them-if I fell under a bus things could carry
on at the Centre without any problem. At that time the director
of Read Codes, Dr Stuart-Buttle, and the classification manager[5],
Yvonne Sutton, were made deputy directors.
52. Do you have a personal connection with
Yvonne Sutton?
(Dr Read) I did not then, I do now.
Maria Eagle
53. Mr Langlands, if you saw someone walk
into a brick wall, pick themselves up and walk into that same
brick wall again, and pick themselves up and walk into the brick
wall again, would the thought maybe cross your mind that they
might be drunk or of unsound mind or would you perhaps conclude
that they were incapable of avoiding brick walls?
(Mr Langlands) I think I know the
next question and therefore I fashion my answer accordingly. I
think that this Committee has heard on a number of occasions about
failings in relation to information management and technology
in the NHS Executive and in the NHS.
54. Can I just concentrate, Mr Langlands,
on the NHS Executive because you are the accounting officer and
you are responsible for an organisation that has run into three
major problems with IT systems within their control, is that not
right? Do you think it is about time that this Committee concluded
your Executive was incompetent?
(Mr Langlands) I think that the
Committee have heard evidence in relation to Wessex, the HISS
systems and the Read Codes and I think there have been very serious
criticisms made in relation to Wessex which has changed the face
of the way in which the NHS works and the corporate governance
arrangements in the NHS. I think they have heard less dramatic
criticisms in relation to HISS and I think there is a number of
management and personnel failings in relation to this report which
should not have occurred.
55. Personally I believe that to be in front
of this Committee on three occasions with such serious reports-and
I consider this report to be one of the worst that I have seen
in my short time on the Committee but we see some bad ones-I consider
that you ought to be considering your position as the accounting
officer of an organisation that is perfectly capable time after
time of losing millions of pounds of public money. I am surprised
that you are not here telling me why you should not be resigning.
I want to concentrate a lot of my questions, Mr Langlands, on
the question of whether or not the Read Codes Version 3 actually
works. In spite of all the problems that there have been and others
have referred to in respect of arrangements, conflict of interest
that Dr Read had and that your Executive and the CCC allowed to
continue for so long, there is certainly going to be no value
for all this money that has been spent if the Read Codes do not
work. Can you tell me whether or not Read Version 3 is now a complete
service strength product that is capable of doing its job in an
NHS Acute Unit?
(Mr Langlands) I think in the right
circumstances with the right clinical systems, what I have referred
to earlier as the host systems, it is pretty well service strength.
That is not to say --
56. Pretty well service strength, when did
it achieve that strength, that level of useability? Was it very
recently or going back years? Perhaps you would tell me because
it seems to have been announced at regular intervals that Version
3 has reached service strength. When do you think it reached service
strength?
(Mr Langlands) I think in the study
that Mr Williams referred to earlier, the Withybush Study, the
conclusion was it was fit for purpose but I think this is something
that by its very nature constantly has to be refined and improved.
57. I accept that it can be refined, I am
asking you when it became useable in an NHS Acute Unit? When did
it become of service strength?
(Mr Langlands) I think probably,
and I am guessing really, I would guess about six months ago,
nine months ago.
58. About six months, you are guessing,
I would have thought you would have known.
(Mr Langlands) Six to nine months
ago.
59. Six to nine months ago.
(Mr Langlands) I have seen it working
but, of course, it is not working comprehensively in any Acute
Unit.
4 Note by Witness: Yvonne Suttons' manager was actually
Mr Ian Nichols, not Mr Andre Rogers. Back
5
Note by Witness: Yvonne Sutton was, in fact, the Classification
Director, not the Classification Manager. Back
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