APPENDIX 4
ADDITIONAL CORRESPONDENCE BETWEEN THE
CLERK OF THE COMMITTEE AND THE CHIEF EXECUTIVE, PUBLIC TRUST OFFICE,
RELATING TO FIGURE 14 OF THE C&AG'S REPORT (PAC 98-99/222)
Thank you for your letter of 14 May. I have
now had an opportunity to examine the information you provided
and it is helpful. However, there are a number of matters relating
to your responses on Figure 14 in the C&AG's report on which
the Committee still needs urgent clarification before its report
can be finalised.
The Committee's main concern is with your interpretation
of the data provided in Tables 1 and 2 of your response. You say
in the third paragraph of your letter that failure to carry out
visits does not account for or explain the variances between London
and the North in Figure 14. It is difficult, however, to see how
you can draw this conclusion when a far larger proportion of commissioned
visits was completed in the North compared with London in each
of the three years shown in Table 1.
Data provided in Table 2 similarly conflicts
with evidence you provided to the Committee at the hearing and
in your supplementary memorandum that variations in visit rates
may reflect, in part, regional variations in the proportions of
patients who meet the Court's criteria. Table 2 however shows
that the difference attributable to the criteria for excluding
visits is small. I would therefore be grateful for your further
comments on your previous statements.
I would also be grateful if you would check
the NHS exclusions column in Table 2 for all three years for the
North. The percentage you have applied here is 13 per cent rather
than the 5 per cent you gave in the Supplementary Memorandum.
The total column also contains minor arithmetical inaccuracies
relating to the figures for London. The final column in the table
appears to have been incorrectly computed, with the effect that
the numbers of visits per 1,000 patients have been substantially
overstated for both London and the North.
Finally, I think that the first paragraph of
the second page of your letter should refer to Figure 14 rather
than Figure 12.
I emphasised to you previously the Committee's
strong concern that its reports should be based on accurate and
complete information rather than the report having to resort to
caveats on the rationale leading to the Committee's conclusions
and recommendations. Urgent clarification is needed on the points
outlined above to enable the Committee's requirements to be met
and a report to be prepared which members can agree for publication
before the recess. I would therefore ask you to respond by Thursday
25 June at the latest. I have to advise you that any failure to
meet this request may well lead to comment by the Committee in
its report.
As with my first letter, I am copying this to
Sir Hayden Phillips.
Public Accounts Committee
17 June 1999
I refer to your letter to me of 17 June. It
is pleasing to see that my letter of 14 May[19]
was helpful in your deliberations on the Committee's behalf. You
ask in your most recent letter for some clarification on a number
of points relating to Figure 14 in the C&AG's report. I have
provided that clarification, I hope, below.
Paragraph 2
I note and understand the point made, but stand
by my previous comments. However, I accept that your view, as
set out in the final sentence, goes towards explaining
or accounting for the variances. Since receivingyour letter, I
have looked again at our manual records covering those visits
not apparently completed in London and the North. I can provide
some additional background information for you.
As I mentioned in paragraph 4 of my letter of
14 May, the "Completed" column Table 1 excluded those
commissioned visits where the patient had died, moved during the
course of the year or where the Visitor was unable to complete
them in that business year. Clearly, in view of the opinion expressed
in your letter, this situation would have an impact on the issue
and therefore I have provided a breakdown of the figures for the
"deaths", "moves" and "carried forwards"
in tables below. You will see that there was a slight problem
with the number "carried forward" for London in 1996-97,
but this was resolved after discussions with the Visitor concerned.
The situation has not re-occurred.
Table 1
|
| Commissioned | Completed
| Died | Moved |
Removed | Other* |
Carried | Total
|
|
| 1996-97 | | |
| | from list
| | forward |
|
| London | 166 | 106
| 15 | 8 | 5 |
1 | 31 | 166
|
| North | 542 | 505
| 20 | 10 | 1 |
2 | 4 | 542
|
1997-98
London | 227 |
172 | 30 | 17 |
5 | 3 | 0 | 227
|
| North | 562 | 486
| 40 | 7 | 5 |
7 | 17 | 562
|
1998-99
London | 201** |
146 | 25 | 13 |
7 | 9 | 1 | 201
|
| North | 590 | 548
| 32 | 3 | 2 |
2 | 3 | 590
|
|
Please note:
*The "Other" column may include where patients refused to see a Visitor, papers were incorrectly addressed or were provided to the Visitor before the proper due date in a two or three year cycle.
**This figure was shown as 232 in my letter of 14 May 1999. However, further work has shown that this figure actually included commissioned visits for another area (Wales) given to the London Visitor to complete in the absence of the other visitor through ill health. The net result is a reduction of 31 commissioned visits for London and an increase of 31 for Wales.
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Paragraph 3
I note what you say, but I do not think that Table 2 does
conflict with my evidence. There are regional variations in the
proportion of patients who meet the visiting criteria, and the
difference could be significant. Specific work was undertaken
on this whilst agreeing the report with the C&AG's staff,
and this work, and our view, was reflected at 3.8 in the report.
Paragraph 4
Please accept my sincere apologies for the percentage error
in Table 2 you correctly identified in your letter. The figure
should be 5 per cent and not 13 per cent (a mistake in the spreadsheet
used in calculations). Interestingly this change in the level
of exclusions slightly strengthens my view (see comment on Paragraph
3 above) that regional variations in the proportion of patients
meeting the visiting criteria may have a significant impact on
the visitable population.
The previous version of Table 2 did have a number "rounding-up"
anomalies, and miscalculation in providing percentage figures.
These were the result of problems in the spreadsheet and, in the
case of the 1998-99 "London Exclusion Total" a simple
typographical error. Please accept my sincere apologies for this.
I have therefore taken the opportunity, in terms of both your
enquiries and the problems mentioned above, to review the calculations
used in preparing this table. A new version of Table 2 (below)
now includes the corrected figures duly emboldened.
Table 2
|
| Visits
| Region |
Exclusions |
| Completed | Total
| Caseload
in region | % of
caseload
| NHS | NH | Pt III
| LA | Total |
Exclude
| Visitable
|
|
1996-97
London | 106
| 6.2 | 4,095 | 21
| 532 | 1,081 | 491
| 901 | 3,006 | 73.4
| 97 |
| North | 505 | 29.7
| 3,315 | 17 | 166
| 1,335 | 265 | 497
| 2,263 | 68.3 |
480 |
1997-98
London | 172
| 10.2 | 4,095 | 21
| 532 | 1,081 | 491
| 901 | 3,006 | 73.4
| 158 |
| North | 486 | 28.9
| 3,315 | 17 | 166
| 1,335 | 265 | 497
| 2,263 | 68.3 |
462 |
1998-99
London | 146
| 7.6 | 4,410 | 21
| 573 | 1,164 | 529
| 970 | 3,237 | 73.4
| 124 |
| North | 548 | 28.5
| 2,877 | 13.7 | 144
| 1,158 | 230 | 432
| 1,964 | 68.3 |
600 |
|
Please note:
1. The percentage figures used to calculate the potential number of cases to be excluded from the visiting lists are those mentioned at Q133 in the Supplementary Memorandum. They were valid for the live caseload as a whole at 5 March 1999 and have been applied identically to each year's visit results.
2. The base caseload figure used for all 1998-99 calculations is 21,000, otherwise it is the 19,500 figure quoted in the C&AG's report.
3. That cases may seem to meet the criteria for visits as indicated in 1 above, but may have already had their visit.
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Paragraph 5
You are correct.
I understand and sympathise with your desire to ensure that
you have accurate and complete information for the Committee.
I do hope that I have now met the Committee's needs. No doubt
if there are still matters requiring even further clarification
then perhaps you would wish to call me in the first instance.
Chief Executive
Public Trust Office
24 June 1999
19
See Evidence, Appendix 3, page 26. (DAC 98-99/193.) Back
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