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Mr. Bayley: Yes; that is exactly what I am saying, and those targets are targets which the contract itself requires a contractor to meet, so it is not a matter of requiring a contractor to do anything other than what the contract already states. We set the contract in order to drive up medical standards. We have not seen that reflected in the monthly reports. We want to see it reflected. Sema, too, wants to see it reflected. That is our approach.
Perhaps I should comment on a point raised by many hon. Members, including my hon. Friend the Member for Clwyd, West (Mr. Thomas) and the hon. Member for
Roxburgh and Berwickshire, who were unhappy with the concern expressed by the Government that no attempt had been made to check the reports of fault with medicals that had been brought to the Committee's attention by citizens advice bureaux and quite a wide range of voluntary bodies. I am not in any sense, and nor are the Government, complaining that the Committee should not collect that sort of evidence.As I explained in an intervention in the speech by my hon. Friend the Member for Hendon (Mr. Dismore), the reason that I became worried was that I wanted to investigate some of the complaints to find out what had happened. Perhaps I can explain my concern to the House by focusing on one group of complaints--the group of complaints about racism or cultural insensitivity. In the report, the Committee cited five identifiable but anonymous cases. The Committee, because it had received information about those cases anonymously, could not give us information--even confidentially--to allow us to identify those cases.
We have been able to identify two of the cases from the circumstances described by the Committee, and in both cases the Committee's description of the circumstances accurately reflects what happened. In both cases, the doctor concerned, who had behaved quite inappropriately, was suspended and retrained. Both doctors are now back at work. Obviously, their work is being monitored in the way that one would expect after such an occurrence, and no further complaints have been received.
I simply put it to the House that the complaint has been made, and that inappropriate behaviour has occurred in a very few cases, quite reprehensibly and quite wrongly, but that in response the Government have done exactly what the Committee and the House would expect us to do--to suspend the doctor, to address the issue through training and then to monitor the change in the performance of the doctor that occurs after training. My hon. Friend the Member for Hendon cited several other cases, and I hope that he can persuade his informants to release the facts about them, so that we can examine them closely.
The hon. Member for Roxburgh and Berwickshire made an interesting and important point about benchmarking. Had the contracts gone to three different companies, we would have been able to benchmark one company against another. I am considering the issue further, but we can, to some extent, benchmark between the different areas. In relation to administrative efficiency, I said that we were able to compare the performance of each of the three areas. That is useful, but we may be able to consider other ways of benchmarking. I need to inquire into that further.
The hon. Gentleman, like my hon. Friend the Member for Hendon and the hon. Member for New Forest, West (Mr. Swayne), asked whether enough money was in the contract to deliver it. We expect Sema to deliver a 4 per cent. saving each year, which is broadly what would have been required of BAMS if it had remained an in-house contract. I confirm that Sema expects to make a profit on the contract, although it expects to make less of one than it would on an information technology contract in the sector in which it has been working for a long time.
When one contracts out a service for the first time, it is difficult for us as a Government, and for those bidding for the work, to get costs right. We had an open-book
policy and bidders were able to examine the way in which we conducted the work, to examine our expenditure and to look for ways to make management savings. However, when a private firm bids for a contract, it hopes to make a profit and it also accepts risk. That risk justifies the profit, and it would be intolerable if the Government were expected to remove all risk and to contribute large profits to companies when they bid high and obtain the work. Some Members on the Opposition Benchers are nodding agreement, and if a company bids low, it must accept the risk attached to that. Nevertheless, we believe that the cost of the contract is broadly comparable to what the service would have cost in-house and that it is perfectly achievable. Sema also takes that view.My hon. Friend the Member for Hendon raised an interesting point when he asked why we did not negotiate to get some money back because of a fall in the scrutiny ratio, and then redistribute it in the form of remuneration to doctors. In a roundabout way, that is what we are doing. I told the Committee that, each year, we have an annual negotiation over the cost of the contract with the contractor. We make various bids for the return of moneys when, for example, there is a fall in the scrutiny- to-examination ratio, and the contractors make bids for additional costs that are not covered in the contract.
This year a six or seven-figure sum has been returned to the Department in relation to costs that have not been incurred by the company, and those include the costs not incurred in scrutiny cases. We have also decided to pay a similar sum--albeit not such a large one--to the company in respect of additional work principally for the introduction of a personal capability assessment. Although the incapacity element of the personal capability assessment test is exactly the same as for the incapacity and the all-work test, an additional part of the test examines personal capacity. Therefore, in a roundabout way, the Government are saving money on scrutiny and it is being recycled to the contractor to pay for more extended medicals in the form of personal capability assessments. That will be reflected in the expenditure that the company makes on doctors and doctor's time.
I return to the point about multilingual notices. Perhaps I should start by saying by saying that, on reflection, I do not defend the statement in the Government's response which says that as we do not have multilingual notices in the form suggested by the Select Committee in other parts of the Benefits Agency, that is a jolly good reason for not having them in BAMS. I agree with hon. Members on both sides that that is not a good argument. One should look at the merits of the case, and I give the House an undertaking that I shall do so.
Incidentally, it is not true that we do not have multilingual notices. The Service First unit in the Cabinet Office produced a report on the attitudes of people from minority ethnic groups to Government services. People were asked whether they were aware of the fact that services provided by various Departments, such as leaflets, audio and video tapes and interpreters, were available in their own languages, and whether they found that useful. I am not wholly satisfied, but I am pleased to say that the Benefits Agency came second on that list,
after GPS, but above 31 other Government services, including NHS hospitals, local councils, libraries, primary schools, citizens advice bureaux, council house services, and so on. Twenty-six per cent. of people from minority ethnic groups were aware of the provision of services in their own languages and 17 per cent. said that that was useful.
Mr. Pickles: The hon. Gentleman should be complimented on his straightforwardness. Will he tell the House which of his ministerial colleagues approved the text of the Government's response?
Mr. Bayley: The responsibility was mine. I shall be frank with the House, as I recall putting a red line through a certain sentence, but I failed to see that through to the end. I do not defend the statement, which I believe to be wrong. We shall continue to investigate whether we could improve our language and translation services.
A wide range of matters were raised by hon. Members, some relating to training and the payment of GPs for undertaking training to do DSS work. Under their NHS contract, GPs are required to spend the equivalent of five days a year on training and, as independent contractors, they are not paid for that. The training regime operated in BAMS is broadly the same. The training is provided free, and doctors do not have to pay for the courses, but have to attend in their own time. Most of our training will give doctors credit against their GP training requirement--which they would have to do anyway--which will help to deal with the problem of their reluctance to undertake training because they are not paid for the training sessions. If the training is of a medical nature, such as mental health assessment or looking at medical conditions, that counts against the GP training requirement. However, it will not count if it is to do with the way in which the benefits system works.
My hon. Friend the Member for Clwyd, West urged the Government to try and capture feedback from appeals. As the hon. Member for Roxburgh and Berwickshire knows, five years ago, I raised that issue as a constituency Member of Parliament with the Benefits Agency. We do not think that simply collecting the results of appeals would give a good indication of whether the doctor's report was good, as many other factors are involved, such as whether the reports of the GP, specialist and decision maker are good reports. Judge Harris, who runs the tribunal service, has given me a commitment that he will look at whether we could investigate if, for instance, a chairman of an appeal believes that a particularly poor medical report has been provided. The chairman could draw that to the attention of our chief medical adviser and we could investigate.
Time moves on, so I shall summarise. The Government are clearly demonstrating commitment to improving the medical quality of our reports, and customer care, by setting four challenging new standards. The goal, of course, is to improve the quality of the service to the public, and the Government and Sema will work together closely to see that that is achieved.
It being Seven o'clock, Mr. Deputy Speaker proceeded, pursuant to Order [25 October 1999], to put the Questions necessary to dispose of proceedings.
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