Select Committee on Public Accounts Minutes of Evidence



  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

CommissionedCompleted DiedMoved RemovedOther* CarriedTotal

1996-97 from list forward
London166106 1585 131166
North542505 20101 24542
227 1723017 530227
North562486 4075 717562
201** 1462513 791201
North590548 3232 23590

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.

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

CompletedTotal Caseload
in region
% of
NHSNHPt III LATotal Exclude


106 6.24,09521 5321,081491 9013,00673.4 97
North50529.7 3,31517 166 1,335265497 2,26368.3 480

172 10.24,09521 5321,081491 9013,00673.4 158
North48628.9 3,31517 166 1,335265497 2,26368.3 462

146 7.64,41021 5731,164529 9703,23773.4 124
North54828.5 2,87713.7144 1,158230432 1,96468.3 600

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.

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

previous page contents

House of Commons home page Parliament home page House of Lords home page search page enquiries

© Parliamentary copyright 1999
Prepared 1 September 1999