Examination of witnesses (Questions 120
- 139)
MONDAY 15 JUNE 1998
MR ROBIN
MOUNTFIELD, CB,
MR MARK
GLADWYN, SIR
ALAN LANGLANDS
and MR FRANK
BURNS
120. It was meant to be a national integrated
system when 100 million was spent. That is another piece of good
news for us.
(Sir Alan Langlands) Chairman, if it would help,
I do have my expert with me. He might want to talk about that.
(Mr Burns) You mentioned two systems, you mentioned
the RISP system which was a regional system which was actually
abandoned at the time.
121. It was abandoned, they were using a
residual basis, using some of the systems within.
(Mr Burns) The regionally integrated system was
abandoned. There are some regionally integrated patient administration
systems that are provided by a variety of suppliers.
122. Forget that and go on to the national
one.
(Mr Burns) All of these patient administration
systems are being actively investigated in conjunction with suppliers
and we expect all of them to be resolved in terms of year 2000
compliance problems by the dates that we have set.
123. That is good news but at what cost?
(Mr Burns) In many cases the costs will be covered
as part of the contract with the suppliers. I have not got individual
costs in terms of the costs falling on specific hospitals. They
are part of the general costs.
124. Is it possible going back to your office
you might be able—I do not mean this in any unpleasant sense—to
do us a note in relation to that?
(Mr Burns) Yes[3].
If you are alluding specifically to the hospital information systems
that were the subject of the previous PAC report we could let
you have a note of what specific costs for year 2000 compliance
arise.
125. All we want is the information.
(Sir Alan Langlands) Yes.
126. Sir Alan, I know you cannot say this
because as a civil servant you dare not but it must be a matter
of some concern that all these costs are having to be absorbed
within existing budgets when some people are not living within
their existing budget.
(Sir Alan Langlands) Well, I think when the Committee
sees the accounts for the Health Service, which are not published
yet, for the last financial year, you will see a very significant
improvement in issues of budgetary control and the scale of the
deficit has reduced very substantially indeed.
127. You are not suggesting that there are
going to be trusts who will not be in deficit?
(Sir Alan Langlands) No, I am not suggesting that
at all.
128. So what happens to them and what happens
to the people who are dependent on them?
(Sir Alan Langlands) Well, where people are in
deficit, in terms of the Committee's and the NAO's definition
of "deficit", there will be a recurring deficit. They
will be in a deficit position, if you like, in relation to their
year-on-year budgets.
129. Are you trying to say that they will
be in bigger deficit?
(Sir Alan Langlands) No, I am not saying that
at all. I was going on to say that where these trusts are in deficit,
there is either in place an action plan to reduce that deficit
or there is a special dispensation approved by ministers to carry
that deficit forward and there are often very good reasons why
a deficit will arise.
130. All we want to know, and this is what
we are concerned about, is that every trust, regardless of whether
it is in deficit or not, is going to be able to conform to the
requirements for the millennium change without the possible extra
loss of service to its patients.
(Sir Alan Langlands) The money will be allocated
on a non-recurring basis to deal with the millennium issue. The
lion's share of the expenditure, £210 million of the £320
million, will be spent this year. I think that sum is insulated
from the routine of Health Service spending and I do not think
that the expenditure of that sum will lead to any downgrading
of patient care.
131. What about the activities of the Medical
Devices Agency? They seemed to wake up to this problem very, very
late, did they not? In fact they were issuing quite sanguine reports
when you later came along and issued warnings that if there was
not compliance, there could be trouble, putting patients' health
at risk and lives at risk.
(Sir Alan Langlands) They did produce early reports
in 1996. I think you are right to suggest that it has taken some
time for the whole question of embedded chips of electro-medical
equipment to perhaps be given the same emphasis that has been
given to IT systems, which, as we have said earlier, have been
running since 1995/96, but I am sure, absolutely sure now that
the Medical Devices Agency and the NHS Executive are working hand
in glove on this issue and that the Medical Devices Agency are
providing proper support to the NHS.
132. So coming back to the point the Chairman
raised right at the outset of the 10 per cent of trusts who are
not confident of fixing their systems and the 15 per cent who
are not confident of fixing their medical equipment, how have
you singled these out for administrative supervision over this
period? Have you done anything special in relation to those to
try to bring them up into phase with everyone else?
(Sir Alan Langlands) I think as a generality that
the position has improved from the NAO study period which was
September/October 1997 and the position that we monitored and
recorded for every trust——
133. What would you make it now? What would
the 10 per cent and the 15 per cent be now then?
(Sir Alan Langlands) In terms of?
134. Well, it was 10 per cent of trusts
who are not confident of fixing their systems, so what per cent
would you say now?
(Sir Alan Langlands) I think all trusts have now
accepted that they have to meet the——
135. No, no, that is not the question. The
question is about the fact that they are not confident, but you
said that they understand that they have to, but that does not
mean they are confident of meeting it, does it?
(Sir Alan Langlands) I am assured———
136. You can tell the England team that
it has to go out and win, but there is someone else on the field
as well. It is not entirely within their control, is it? Just
for you to say that they have been told is not good enough and
it does not mean it gets done.
(Sir Alan Langlands) All the returns we have,
the March 1998 returns, and we will see the June returns just
in a few weeks' time, suggest that the two deadlines that I outlined
at the beginning to the Chairman will be met across the NHS.
137. That is so but you are saying that
ten per cent who were not confident of fixing their systems are
now confident?
(Sir Alan Langlands) That I believe to be true.
I think everyone will meet the targets that have been set.
138. So that is confidence there. And the
15 per cent who were not confident of fixing their medical equipment,
you think they are now confident?
(Sir Alan Langlands) I do not think they are necessarily
always confident of fixing their medical equipment and that is
one of the reasons that £150 million has been set aside by
the NHS as a contingency sum.
139. Why is the equipment giving so much
trouble when the specialist organisation, the Medical Devices
Agency, had indicated there was not a great problem?
(Sir Alan Langlands) First and foremost we do
not know if it is giving trouble. There are problems in some places
that seem to have been adequately resolved in the relationship
between the NHS and the Medical Devices Agency that I described.
There are some pieces of equipment that are so critical and cannot
be tested in the time frame that they might have to be replaced
or have parts renewed. That is why the £150 million has been
set aside as a contingency sum.
3 Note: See Evidence, Appendix 2, page 19 (PAC
344). Back
| 
